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2011 World Congress

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  1. 2011 World Congress Female & Male Genital Cosmetic Surgery

  2. Liposuction& Autologous Fat Transfer

  3. Marco A. Pelosi, III, MD FACOG, FACS, FICS, FAACS

  4. CME Disclosure • The Faculty reports no significant financial relationships or other relationships with the manufacturers of any commercial products and/or providers of commercial services discussed in this educational presentation and with any commercial supporters of this activity. Furthermore, no off-label or investigational uses of products will be discussed without explicit notification thereof.

  5. Terminology • Lipolysis • Lipoplasty • Liposuction • Liposculpture • Suction lipectomy • Suction-assisted lipectomy (SAL)

  6. Terminology • Small-volume (<100 mL fat) • Medium-volume (<1500 mL fat) • Large-volume (<4000 fat mL/ 5000 mL total) • Megaliposuction • CA Speier Bill: >5000 mL “unprofessional” • FL: 4000 mL limit

  7. Terminology Dry = nothing infiltrated Wet= saline/hyaluronidase

  8. Superwet Solution 1,000 ml 10 ml 1 ml 25 ml

  9. Tumescent Local Anesthesia 1,000 ml 10 ml 1 ml 100 ml

  10. Generally Accepted Lidocaine Limits • Intravenous: 7 mg/Kg • Tumescent w/o liposuction: 25 mg/Kg • Tumescent w/ liposuction: 45 – 55 mg/Kg • Thin = 45 • Avg = 50 • Heavy = 55 • Florida Law: cannot exceed 50 mg/Kg

  11. Terminology • Manual Liposuction • Power-Assisted Liposuction • Ultrasound-Assisted Liposuction (UAL) • Internal • External • Laser-Assisted Liposuction • Internal: “Hot” laser • External: “Cold” laser • Disruption-Assisted Liposuction

  12. The Tools

  13. Aspiration Equipment • Suction pump -100 kPa max • Syringe for small volume

  14. Liposuction Cannulas

  15. Fat Transfer Cannulas

  16. Lips Type 3

  17. NLF V-Dissector Type 1

  18. Non Lines Type 2

  19. Hands Type 2

  20. Buttocks Type 2

  21. Labia Type 2

  22. Augmentation Labia Majoraplasty

  23. Typical Process • Patient is consented, marked & photographed • NIBP, ECG, SpO2 monitors are placed • Hep-lok is inserted • Knee-high SCDs applied

  24. Punch or scalpel

  25. Always Parallel

  26. Reverse Jackknife PostionAbdominal Lipo

  27. Long strokes

  28. Multi-Directional Contouring

  29. Nondominant Hand Control

  30. Nondominant Hand Control

  31. Blend margins

  32. Avoid superfical layer 5mm No-Suck Zone

  33. EBL = 5mL/liter of total aspirate

  34. Regional Applications

  35. High Definition Liposuction • Etching • Pectoral • Abdominal • Manual, Laser, Vaser • Ideal < 15% Body Fat

  36. Pectoral Etching

  37. Access

  38. Abdominal Etching

  39. Leaner = Better Result

  40. Flanks & Back Strategies

  41. Arms Liposuction

  42. Access: Post

  43. Medial