In 1977, Illouze of Paris, France, began to use liposuction with a high vacuum suction and a small blunt cannular for the patients who have unnecessary fat accumulation, which has led to the popularity of this technique of suction-assisted lipectomy in many countries.
After the suction technique became dependable at the Los Angeles meeting in the United States in February 1983. The authors and a few surgeons began to apply this technique in our country from March 1983. Now it has gained popularity as a procedure in field of plastic surgery. With the cooperation of a medical machinery company we devised a more powerful pump modeled after Illouze’s type which has the function of raising the vacuum pressure quickly when switched on and dropping quickly when switched off. Two collecting bottles are attached to the pump in order to offer more convenience when comparing the volumes aspirated from the left and right side of the body. so that the body will remain symmetrical. Also our devised cannular is not pure stainless steel but an alloy fo bronze. Its shape can be adjusted by hand, the shape of the cannular tipis similar to that of the Illouze’s type. The tubular surface consists of 2 different types (oval or round shapes) featuring large gripsized handle opposite the suction opening. The standard length of the tubes is 30cm with 6 different diameters(5, 6, 7, 8, 9 or 10mm) with a straight or curved distal.
In our experience over the pst 4 years. 73 patients with a total of 132 figure faults have undergone suction assisted lipectomy at our center. 58 figure faults were abdominal lipectomy, 26 figure faults from the flanks, 17 figure faults from the buttocks, 18 figure faults from the thighs, 6 figure faults from the calfs, one figure fault from the upper arms, 2 were defattening procedures for the flap and 4 adjuvant uses in abdominoplasty or reduction mammoplasty.
The majority of the cases were performed under general anesthesia on a one day admission basis. Local and spinal anesthesia also were used. There was a lesser amount of fat removed in local anesthesia than with other anesthesia. There were 3 case with a volume under 200cc with local anesthesia among 58 cases of abdominal lipectomy. There was a similar result in other body areas.
The volume of fat removed from one patient ranged from 3 cc in defattening flap to 796cc from the 5 different body areas; abdomen, buttocks, thighs, flanks and upper arms.
The volume of fat removed according to the anatomical area ranged from 165cc to 546cc in abdomen, 56cc to 180cc in the flanks, 87cc to 210cc in the buttocks, 36cc to 150cc in the thighs, 58cc to 110cc in the calfs. 3cc to 5cc in the defattening flap and 7cc to 32cc in the adjuvants therapy as shown in table 1. There is a considerable variation from patient to patient in most body areas. The maximun volume of the fat removed in our lipectomy were a relatively small compared to the reported lipectomies in western countries, we think this is due to the different pathophysiologic natures between the races.
We experienced no serious disaters during the operation and post operative periods. There was only one noticable bleeding during the operation and short period of post operation. A hypertrophic change of the operative scar was noticed in 2 cases. most of cases complained about transient cutaneous ecchymosis and numbness but they spontaneously recovered in a one to 2 month postoperative period.
In an effort to find out to what degree the patients were satisfied, we called each of the patients, asking them to comment on the result of their operation. Of the 27 patients who would be contacted, 21 indicated that they accepted the results, whereas 4 were not satisfied and 2 complained about an operative scar and lack of improvement. A high number of patients who accepted the results of the procedure (19 out of 21) said that they were satisfied and would recommend the procedure to other patients who suffered from similar figure faults but 2 said that they wouldn’t.
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