Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Art of Abdominal Contouring: Advanced Liposuction
Sanjay Parashar
CHAPTER 1:
History
INTRODUCTION
ENERGY-BASED LIPOSUCTION
SUPERFICIAL LIPOSUCTION
HIGH-DEFINITION LIPOSUCTION
HISTORY OF ABDOMINAL AESTHETICS
CHAPTER 2:
Abdominal Wall Anatomy
INTRODUCTION
RELEVANT ANATOMY
Abdominal Planes
Abdominal Regions
ABDOMINAL SKIN
Langer Lines
Umbilicus
SUPERFICIAL FASCIA
Camper and Scarpa Fasciae
Extent of Scarpa's Fascia
Anatomy of Superficial Fascial System
ABDOMINAL MUSCLES
External Abdominal Oblique Muscle
Internal Abdominal Oblique Muscle
Transversus Abdominis Muscle
Rectus Abdominis Muscles
Pyramidalis Muscle
Arcuate Line
Linea Alba and Linea Semilunaris
TRANSVERSALIS FASCIA
Abdominal Wall Vasculature
HUGER'S ZONES
Inferior Epigastric Artery
Superior Epigastric System
Posterior Intercostal Arteries and Lumbar Arteries
CHAPTER 3:
Aesthetic Subunits of Abdomen
INTRODUCTION
ANATOMICAL VARIATION OF ABDOMINAL REGION
Anterior Abdominal Wall (Figs. 3.1A and B)
Skin
Musculoskeletal Anatomy
Fat Distribution
Lateral Abdominal Wall (Fig. 3.5)
Skin
Musculoskeletal Anatomy
Fat Distribution
Posterolateral Region (Fig. 3.8)
Skin
Musculoskeletal Anatomy
Fat Deposition
Posterior Midline Region (Figs. 3.12A and B)
AESTHETIC UNITS OF ABDOMEN (FIGS. 3.14A TO C)
CHAPTER 4:
Abdominal Fat Pathophysiology
INTRODUCTION
LOCATION OF ABDOMINAL FAT
Visceral Fat (Fig. 4.1)
Role of Hormones in Fat Distribution and Correlation with Dieting and Exercise
What Happens in Women?
What is Wrong with Abdominal Fat?
Subcutaneous Fat (Nonvisceral Fat) (Fig. 4.2)
Abdominal Roles/Panniculus
CHAPTER 5:
Clinical Conditions
INTRODUCTION
HOW TO EVALUATE THE PATIENT FOR ABDOMINAL CONTOURING?
Patient Request
Medical History
COUNSELING
PHYSICAL EXAMINATION
MEASUREMENTS
Body Mass Index
Formula: Weight (kg)/Height (m2)
Formula: Weight (lb)/Height (in2) × 703
Circumferences
Pinch Measurement
Measurement of Skin Excess
Physical Evaluation in Standing Position
Aesthetic Subunits
Abdominal Tests
Intra-abdominal Volume
DECISION-MAKING LIPOSUCTION OR ABDOMINOPLASTY
Clear Indications for Liposuction of Abdomen (Figs. 5.4A and B)
Clear Indications for Abdominoplasty with or without Liposuction (Fig. 5.5)
Sequential: Liposuction Followed by Second Stage Abdominoplasty if Necessary
HOW TO MANAGE THE ABDOMEN IN DIFFERENT PATIENT CATEGORIES?
Type 1: Normal Weight, Firm Skin, Minimal Intra-abdominal Fat (Figs. 5.7A to F)
Type 2: Disproportionate Abdominal Bulge, Moderate Skin Excess, Moderate Intra-abdominal Fat (Figs. 5.8A to D)
Type 3: Fat Bulge, Striae, Mildly Lax Skin, Mild Intra-abdominal Fat, Muscle Bulge (Figs. 5.9A to D)
Type 4: Small to Moderate Panniculus, Muscle Bulge, Moderate Intra-abdominal Fat (Figs. 5.10A and B)
Type 5: Large Intra- and Extra-abdominal Fat or Large Panniculus with or without Large Diversification (Figs. 5.12A and B)
Type 5: P-pathological Abdomen with Abdominal Wall Hernia (Fig. 5.13)
Type 6: Post Weight Loss Abdominal Skin Laxity (Fig. 5.14)
CHAPTER 6:
Concept and Technique of Liposuction
INTRODUCTION
LIPOREDUCTION OR DEBULKING LIPOSUCTION (FIGS. 6.1A TO D)
Limited Liposuction (Figs. 6.2A to D)
Circumferential Liposuction (Figs. 6.3A to D)
Liposculpturing
HIGH-DEFINITION LIPOSCULPTURING (FIGS. 6.4A TO D)
LIPOSUCTION AND LIPODISSECTION
FOUR-DIMENSIONAL LIPOSCULPTURING
ABDOMINAL ETCHING (FIGS. 6.5A TO D)
TECHNIQUE OF LIPOSUCTION
MEDICAL FACILITY FOR LIPOSUCTION (FIGS. 6.6 AND 6.7)
ANESTHESIA FOR LIPOSUCTION
Local Anesthesia with Oral/IV Sedation
General Anesthesia
Infiltration Anesthesia
Total Volume
TECHNIQUE OF INFILTRATION
SELECTION OF CANNULAS
TECHNIQUE OF LIPOSUCTION
GUIDELINE FOR GOOD OUTCOME
APPEAL (Assessment, Patient Expectations, Proportions, Eliminate Dead Space, Adjacent Structures, Laxity and Skin Elasticity)
Five Pillars of Success in Abdominal Contouring
LIPOSUCTION MOVEMENTS/MANEUVERS (STROKES)
Short Strokes Versus Long Strokes
Number of Strokes
Fanning Movement
Back and Forth Movement/Reciprocating Movement
Pinching the Skin Versus Stretching the Skin (Figs. 6.10A and B)
Stretching the Skin
Skin Tenting (Fig. 6.11)
SUPERFICIAL AND DEEP LIPOSUCTION
Positioning of the Patient
END POINT OF LIPOSUCTION
POSTOPERATIVE DRESSING AND COMPRESSION (FIG. 6.14)
CHAPTER 7:
Technology-Assisted Liposuction
INTRODUCTION
BASICS TO UNDERSTAND
Fat Avulsion Versus Emulsification (Figs. 7.1A and B)
Primary Versus Secondary Skin Laxity (Figs. 7.2 and 7.3)
CONVENTIONAL LIPOSUCTION
Suction-Assisted Lipoplasty (SAL)
Advantages of SAL
Disadvantages of SAL
Technical Pearls
Syringe Liposuction
Advantages of Syringe Technique
ENERGY BASED
Laser-Assisted Liposuction
The Nd:YAG Laser
Diode Laser (Continuous Wave and High-Power Output 25 W)
Sequential Laser
1,470 nm Laser
Advantages of LAL
Disadvantages of LAL
Technical Pearls
Ultrasonic-Assisted Lipoplasty
Mechanism
Vibration Amplification of Sound Energy at Resonance (VASER) Lipoplasty
Infiltration
Ultrasonic Treatment and Emulsification
Postemulsification Liposuction
Postoperative Compression and Dressing
Advantages of UAL
Disadvantages of UAL
Complications of UAL
Technical Pearls
Radiofrequency-Assisted Liposculpturing
Technology
Principle of RFAL
Technique of RFAL
SAL and RFAL
Postoperative Dressings
Complications of RFAL
Disadvantages of RFAL
Technical Pearls
Power-Assisted Liposuction
High-Power Vibratory Machine: Vibro Liposuction (Euromi, Belgium)
Advantages
Disadvantages
Technical Pearls
Low-Power Vibration (Microaire PAL, Virginia, USA)
Advantages
Disadvantages
Water-Jet-Assisted Liposuction
Technique
CHAPTER 8:
Preoperative Analysis and Protocol
INTRODUCTION
DOCUMENTATION
Patient Medical History (Form 8.1)
Preoperative Instructions (Form 8.2)
Preoperative Worksheet and Planning (Form 8.3)
ASA Risk Assessment (Table 8.1)
Thromboembolic Risk Assessment Protocol (Form 8.4)
Postoperative Instructions (Form 8.5)
CHAPTER 9:
Three-Dimensional Liposculpturing
INTRODUCTION
Upper Midline Aesthetic Unit
Two Upper Rectus Aesthetic Units
Lower Recti Aesthetic Unit
Two Lateral Abdominal Aesthetic Units
Two Lumbar Aesthetic Units
Posterior Midline Aesthetic Unit
Pubic Area
PREOPERATIVE MARKING
Markings in Men (Figs. 9.1A and B)
Markings in Women (Figs. 9.1C and D)
Infiltration
EMULSIFICATION AND PRETUNNELING
LIPOSUCTION
LUMBAR AESTHETIC UNIT
Posterior Midline and Sacral Area
Extended Liposuction and Transitioning
Feathering
Post-tunneling and Crisscrossing
Postoperative Management
CONCLUSION
CHAPTER 10:
Waist Sculpturing
INTRODUCTION
ANATOMY OF WAIST
Lateral Abdominal Aesthetic Units
Lumbar Aesthetic Units
TECHNIQUE OF WAIST SCULPTING
Marking (Figs. 10.14A to C)
Anesthesia
Emulsification and Liposuction
POSTOPERATIVE DRESSINGS
CHAPTER 11:
Nonsurgical Technologies
INTRODUCTION
FAT REDUCTION METHODS
EXTERNAL ULTRASOUND
INJECTION LIPOLYSIS
LOW LEVEL LASER THERAPY
CRYOLIPOLYSIS
RADIOFREQUENCY
CARBOXYTHERAPY
COMBINATION OF TECHNOLOGIES
INDICATIONS AND CLINICAL APPLICATION
Some of the Technologies that can be Combined
External Ultrasound and Endermology Therapy
Bipolar Radiofrequency, Infrared/Low-level Laser, and Pulsatile Suction Devices
CHAPTER 12:
Postoperative Management
INTRODUCTION
DISCHARGE CRITERIA
PROTOCOL FOR POSTOPERATIVE VISIT
DRAINAGE
COMPRESSION GARMENT
How Long to Wear the Garment?
MANUAL MASSAGE
EQUIPMENT-BASED THERAPIES
Combination of Vacuum, Low-Level Laser and Radiofrequency
External Ultrasound
Warnings
CHAPTER 13:
Complications of Liposuction
INTRODUCTION
BLEEDING
SEROMA
INFECTION
PREOPERATIVE PROTOCOL
Preoperative Betadine Scrub and Shower
INFECTION CONTROL POLICY
POSTOPERATIVE FOLLOW-UP
NECROSIS
THROMBOEMBOLISM
FAT EMBOLISM
PULMONARY EMBOLISM
SCARS
CONTOUR DEFORMITIES
LIDOCAINE TOXICITY
Signs of Toxicity (Versus Serum Levels of Lidocaine)
Internal Scar Tissue
Postinflammatory Hyperpigmentation
Perforation
Patient Dissatisfaction
CHAPTER 14:
Abdominoplasty
HISTORY
TYPES OF ABDOMINOPLASTY
Why Do We Need to have this Classification?
What are these Modifications?
CONVENTIONAL LIPOABDOMINOPLASTY
Introduction
Advantages
Disadvantages
MINIABDOMINOPLASTY (SHORT SCAR)
Introduction
Short Scar Abdominoplasty
Indications
Advantages
Disadvantages
Technique
Endoscopic-assisted Miniabdominoplasty
Indications
Advantages
Disadvantages
Technique
Dermolipectomy with Umbilical Relocation (Floating Umbilicus)
Indications
Advantages
Disadvantages
Technique
EXTENDED ABDOMINOPLASTY
Indications
Advantages
Disadvantages
CIRCUMFERENTIAL ABDOMINOPLASTY
Indications
Limitations
REVERSE ABDOMINOPLASTY
Disadvantages
Technique
FLEUR-DE-LIS ABDOMINOPLASTY
Limitations
HORSESHOE ABDOMINOPLASTY
SELECTION OF PATIENT AND PLANNING OF ABDOMINOPLASTY
What are the Options We have?
Consultation and Counselling
General Evaluation and Work-up
Worksheet Planning
Documenting Skin Excess (see Figs. 14.1A to I)
CASE 1 (FIGS. 14.6A AND B)
Consultation and Counselling
General Evaluation and Work-up
Worksheet Planning (Table 14.2)
Mutual Decision
Results
CASE 2 (FIGS. 14.8A AND B)
Consultation and Counselling
General Evaluation and Work-up
Worksheet Planning
Mutual Decision
CASE 3 (FIGS. 14.10A AND B)
Consultation and Counselling
General Evaluation and Work-up
Worksheet (Table 14.6)
Mutual Decision
CASE 4 (FIGS. 14.12A AND B)
Consultation and Counselling
General Evaluation and Work-up
Worksheet (Table 14.7)
Mutual Decision
CONVENTIONAL ABDOMINOPLASTY (LIPOABDOMINOPLASTY)
Introduction
Preoperative Consideration
Preoperative Protocol
Worksheet Planning
Preoperative Marking
Intraoperative Steps
Intraoperative Marking (Figs. 14.16A and B)
INFILTRATION AND LIPOSUCTION
POSTOPERATIVE CARE
UMBILICAL RECONSTRUCTION IN ABDOMINOPLASTY
Umbilical Changes in Abdomen
Umbilicus Location
Marking of New Umbilicus Position
Characteristics of an Aesthetic Umbilicus
INCISION TECHNIQUES
Fixation Technique
COMPLICATIONS OF ABDOMINOPLASTY
Classification of Complications
Hypothermia
Deep Vein Thrombosis
Hematoma
Seroma
Fat Necrosis
Scar Problems
Umbilical Complications
INDEX
TOC
Index
×
Chapter Notes
Save
Clear