Melvin A. Shiffman · Alberto Di Giuseppe Liposuction
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Melvin A. Shiffman · Alberto Di Giuseppe Liposuction
Transcript of Melvin A. Shiffman · Alberto Di Giuseppe Liposuction
Melvin A. Shiffman · Alberto Di GiuseppeLiposuction
Melvin A. Shiffman · Alberto Di Giuseppe
LiposuctionPrinciples and Practice
With 352 Figures in 622 Separate Illustrations and 84 Tables
ISBN-10 3-540-28042-1 Springer Berlin Heidelberg New YorkISBN-13 978-3-540-28042-2 Springer Berlin Heidelberg New York
Library of Congress Control Number: 2006920795
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law.
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The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protec-tive laws and regulations and therefore free for general use.
Editor: Gabriele SchröderDesk Editor: Ellen BlasigProduction: LE-TEX Jelonek, Schmidt & Vöckler GbR, Leipzig, GermanyCover desing: eStudio Calamar, SpainTypesetting: Satz-Druck-Service, Leimen, Germany
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Melvin A. Shiffman, MD, JD1101 Bryan Avenue, Suite GTustin, CA 92780, USA
Alberto Di GiuseppeInstitute of Plastic and Reconstructive SurgerySchool of MedicineUniversity of AnconaAncona, Italy
This book is dedicated to the memory of Francesco Di Giuseppe MD (father of Alberto Di Guiseppe), who was a pioneer of cardiology in Italy from 1950 to 1970.
Alberto Di Giuseppe
Introduction
This work was undertaken because there is no true “text” on liposuction that cov-ers the gamut of techniques, indications, uses, complications, and medical legal problems. Even the term liposuction has been converted to such things as lipo-plasty, liposculpture, lipostructure, lipexeresis, suction lipectomy, and suction-as-sisted lipectomy. This variety of terms is to attract patients to the individuals who have coined these terms or to describe a more artistic form of doing liposuction. The procedures and their variations are all (perhaps taking the glamour out of the surgery) simply liposuction.
Since 1974, when the procedure was first conceived by Arpad and Giorgio Fisch-er, [1,2] to its production of a variety of cannulas, suction machines, and attempts to make the surgery easier on the surgeon with power cannulas, laser assisted lipo-suction, external and internal ultrasound, and massage, there have been attempts to modify, improve, and extend the indications for liposuction by surgeons in a variety of specialties. The addition of tumescent local anesthesia,3 an old concept, [4-9] has improved the safety of the procedure and increased the amount of fluid that can be removed. Today liposuction is one of the most frequent cosmetic pro-cedures performed.
Physicians performing liposuction must be adequately trained and experienced in the potential and actual complications before attempting to perform liposuc-tion. Patient safety is the most important aspect of all surgeries, but especially cosmetic surgery, which is an elective and not a medically necessary surgery. It is, however, a psychological necessary surgery where the patient wishes to be his/hers imagined perfect body image. What patients do not understand is that cosmetic surgery may not meet his/hers expectations. This requires the surgeon to be espe-cially careful in explaining the surgery and possible risk and complications to the patient. New technology helps to improve results but experience, care, and skill of the cosmetic surgeon, thinking in three-dimensional terms, is necessary to obtain optimal results that satisfy the patient.
Liposuction alone may not be the answer to a patient’s beautification. There may be other procedures necessary to meet the patient’s expectations and these must be a thorough explanation by the surgeon to the patient.
Liposuction began as a contouring procedure but has evolved into the treatment of the obese patient, gynecomastia, ptosis, macromastia, and even patients who have complications from heart disease or diabetes. Other disorders such as axil-lary sweat hypersecretion, lipomas, and angiomas are also potential disorders that may be treated with liposuction.
The contributors to this book have spent time and effort to present to the cos-metic and plastic surgeon as much information as possible in the techniques and uses of liposuction for cosmetic and non-cosmetic surgery purposes. There is an attempt to present broad subjects that will peak the surgeon’s interest in perhaps exploring other uses for liposuction. There are still more disorders that may be treated with liposuction that have not yet been explored.
The contributors are international so that techniques and applications of lipo-suction that may not be in common use in the certain countries can be presented.
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Liposuction is a surgery that is international in origin, in concept, and in usage. There is a need to bring together the international community of physicians to examine, evaluate, and research this procedure. It is the editors’ hope that all sur-geons performing liposuction will benefit from this book.
Melvin A. ShiffmanAlberto Di Giuseppe
References
1. Fischer, G.: Surgical treatment of cellulitis. Third International Congress of International Academy of Cosmetic Surgery, Rome, May 31, 1975
2. Fischer, G.: First surgical treatment for modeling body’s cellulite with three 5mm incisions. Bull Int Acad Cosm Surg 1976;2:35-37
3. Klein, J.A.: The tumescent technique for liposuction surgery. Am J Cosm Surg 1987;4:263-267
4. Matas, R.: Introduction. In Allen, C.W.(ed), Local and Regional Anesthesia, Philadelphia, W.B. Saunders 1915
5. Bickham W.S.: Operative Surgery (Vol. 1), Philadelphia, W.B. Saunders, 1924:189-1906. Lewis, D.: Practice of Surgery (Vol. 1), Hagerstown, MD, W.F. Prior, 1933:Chapter 47. Pokrovsky, B.A.: Infiltration anesthesia by creeping infiltration method of A.V. Vishnevsky.
In Obstetrics and Gynecology Practice, Kiev, Scientific Dunka 19548. Welch, J.D.: History of tumescent anesthesia. Part I: From American surgical textbooks of
the 1920s and 1930s. Aesthet Plast Surg 1998;18(5):353-3579. Welch, J.D.: History of tumescent anesthesia. Part II: Vishnevsky’s anesthesia from Russian
textbooks, 1930 to 1970. Aesthet Plast Surg 2002;22(1):46-51
Introduction
Preface
Liposuction surgery is one of the commonest cosmetic procedures performed in the USA. Despite its popularity there have been some poor results and even fa-talities from the operation. Not enough information has been distributed to physi-cians and the public on the non-cosmetic applications of liposuction. Breast re-duction with the use of liposuction as well as the treatment of obesity and male gynecomastia are performed regularly. There has been an evolution in liposuction as physicians have found successful treatment of a variety of other medical and surgical problems.
This book brings together all of the present known non-cosmetic uses of lipo-suction and shows the specific methods utilized as well as the results. The future will introduce liposuction as a treatment of other medical and surgical problems as medical knowledge and experience progresses.
Melvin A. Shiffman
Contents
Part I: General Information
Chapter 1The History of LiposuctionTimothy Corcoran Flynn MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Chapter 2Pathologic Disorders of Subcutaneous FatMaurizio Podda MD, Marcella Kollmann MD, Roland Kaufmann MD . . . . . 7
Chapter 3Lipedema and Lymphatic EdemaManuel E. Cornely MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Chapter 4Biochemical Effects of LiposuctionLina Valero Pedroza MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Chapter 5The Anatomy and Physiology Metabolism/Nutrition of Subcutaneous FatMitchell V. Kaminski MD, Rose M. Lopez de Vaughan PhD . . . . . . . . . . . . . . . 17
Chapter 6Liposuction Technique and Lymphatics in LiposuctionAndreas Frick MD, Rüdiger G.H. Baumeister MD, Johannes N. Hoffmann MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Chapter 7Proposed Safety Guidelines for the Maximum Volume Fat Removal by Tumescent LiposuctionWarwick L. Greville MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Part II: Anesthesia
Chapter 8Anesthesia for LiposuctionGary Dean Bennett MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Chapter 9Pharmakokinetics of Tumescent Anesthesia: Timothy D. Parish MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
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Chapter 10Liposuction with Local Tumescent Anesthesia and Microcannula TechniqueBernard Raskin MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Chapter 11Tumescent TechniqueMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Chapter 12Safety of Lidocaine During Tumescent Anesthesia for LiposuctionKimberly J. Butterwick MD, Mitchell P. Goldman MD . . . . . . . . . . . . . . . . . . . 75
Chapter 13Tumescent Local Anesthesia with ArticaineAfschin Fatemi MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Part III: Cannulas
Chapter 14Cannula DesignsPaul S. Collins MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Chapter 15Inadequate Sterilization of Liposuction Cannulas: Problems and PreventionAllan E. Wulc MD, Brenda C. Edmonson MD . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Part IV: Preoperative
Chapter 16Preoperative ConsultationMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Chapter 17Drugs to Limit Use of or Avoid when Performing LiposuctionMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Part V: Techniques
Chapter 18 Facial Recontouring with LiposuctionEdward H. Farrior MD, Raymond D. Cook MD, Stephan S. Park MD . . . . . . 111
Chapter 19Liposuction of the Upper Extremities: Melvin A. Shiffman MD, JD, Sid Mirrafati MD . . . . . . . . . . . . . . . . . . . . . . . . . . 120
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Chapter 20Refinements in Liposculpture of the Buttocks and ThighsLuiz Toledo MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Chapter 21Liposculpture of the Lower Extremities Using a TourniquetKamal Cherif Zahar MD, Soraya Bensenane-Hasbelaoui MD . . . . . . . . . . . . . 133
Chapter 22Liposuction of the TrunkGiorgio Fischer MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Chapter 23Liposuction and DermolipectomyIvo Pitanguy MD, Henrique N. Radwanski MD,Barbara H.B. Machado MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Chapter 24The Modern LipoabdominoplastyJorge I. de la Torre MD, Luis O. Vásconez MD . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Chapter 25Abdominal Liposuction in Colostomy PatientsBernard I. Raskin MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Chapter 26Liposuction and Lipotransfer for Facial Rejuvenation in the Asian PatientTetsuo Shu MD, Samuel M. Lam MD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Chapter 27Microcannula LiposuctionBernard I. Raskin MD, Shilesh Iyer MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Chapter 28Superficial Liposculpture: Rationale and TechniqueRobert F. Jackson MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Chapter 29Three-Dimensional Superficial Liposculpture for Aged and Relaxed SkinMarco Gasparotti MD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Chapter 30Reduction Syringe LiposculpturingPierre F. Fournier MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
Chapter 31Orthostatic LiposculptureGiorgio Fischer MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Part VIUltrasound
Chapter 32Ultrasound-Assisted Liposuction: Past, Present, and FutureWilliam W. Cimino MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
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Chapter 33Ultrasound-Assisted Liposuction: Physical and Technical PrinciplesAlberto Di Giuseppe MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Chapter 34VASER-Assisted Lipoplasty: Technology and TechniqueWilliam W. Cimino MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Chapter 35Ultrasound-Assisted Lipoplasty for Face Contouring with VASERAlberto Di Giuseppe MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Chapter 36Mastopexy (Breast Lift) with Ultrasound-Assisted LiposuctionAlberto Di Giuseppe MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Chapter 37Histologic Changes with Breast Ultrasound-Assisted LiposuctionJoseph T. Chun MD, James W. Taylor MD, Stuart E. Van Meter MD . . . . . . . 258
Chapter 38Excessive Free Radicals Are Not Produced During Ultrasound-Assisted LiposuctionRolf R. Olbrisch MD, Marc A. Ronert MD, Jürgen Herr MD . . . . . . . . . . . . . . 262
Chapter 39External Ultrasound and Superficial Subdermal LiposuctionCarlo Gasperoni MD, Marzia Salgarello MD, Paolo Gasperoni MD . . . . . . . . 265
Chapter 40External Ultrasound Before and After LiposculptureWilliam R. Cook Jr. MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Part VII: Power-Assisted
Chapter 41Powered Liposuction EquipmentTimothy Corcoran Flynn MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Chapter 42Power-Assisted LipoplastyÂngelo Rebelo MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Chapter 43Safety Protocols for Power-Assisted External Ultrasonic LiposculptureRobert A. Shumway MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Part VIII:Newer Techniques
Chapter 44Reduced Negative Pressure in LiposuctionMichael V. Elam MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
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Chapter 45Tissue Stabilization in Liposuction SurgeryGerhard Sattler MD, Dorothee Bergfeld MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Chapter 46External Percussion Massage-Assisted LiposuctionMelvin A. Shiffman MD, JD, Sid Mirrafati MD . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Chapter 47Low-Level Laser-Assisted LiposuctionRodrigo Neira MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
Chapter 48LaserlipolysisDiego E. Schavelzon MD, Guillermo Blugerman MD, Anastasia Chomyszyn MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Chapter 49Water-Jet-Assisted LiposuctionA. Ziah Taufig MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326
Part IX: Complications
Chapter 50Prevention and Treatment of Liposuction ComplicationsMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Chapter 51Disharmonious Obesity Following LiposuctionJames E. Fulton Jr. MD, PhD, Farzin Kerendian DO . . . . . . . . . . . . . . . . . . . . . . 342
Chapter 52Blood Loss in Liposuction SurgeryE. Antonio Mangubat MD, Colin Harbke MS . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Chapter 53Fat Shifting for the Treatment of Skin IndentationsMelvin A. Shiffman MD, Guillermo Blugerman MD . . . . . . . . . . . . . . . . . . . . . 353
Chapter 54Liposuction MortalityMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
Part X:Principles and Standards
Chapter 55Psychology and Quality of Life of Patients Undergoing Liposuction SurgeryGerhard Sattler MD, Dorothee Bergfeld MD, Boris Sommer MD, Matthias Augustin MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363
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Chapter 56Liposuction Practitioner Profile and Current Practice Standards and Patient SafetyRobert F. Jackson MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366
Chapter 57Principles of LiposuctionMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Part XI:Medical Legal
Chapter 58Medical Liability Claims For Liposuction-Improving the OddsRudolph H. de Jong MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
Chapter 59Medical Legal Problems in LiposuctionMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393
Part XII: Commentary
Chapter 60Editors CommentaryMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405
Chapter 61Non-Cosmetic Applications of LiposuctionMelvin A. Shiffman MD, JD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
Chapter 62Ultrasound-Assisted Liposuction For Breast ReductionAlberto Di Giuseppe MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
Chapter 63Large-Volume Liposuction For ObesityEnrique Hernández-Pérez MD, Jose A. Seijo-Cortes MD, Hassan Abbas Khawaja MD . . . . . . . . . . . . . . . . . . . . 425
Chapter 64Metabolic and Clinical Studies of Liposuction in ObesityBeniamino Palmieri MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Chapter 65Large-Volume Liposuction for the Treatment of the Metabolic Problems of ObesityBeniamino Palmieri MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Chapter 66Megaliposuction: over 10 LitersPierre F. Fournier MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
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Chapter 67Cardiovascular Risk Profile Improvement with Large-Volume LiposuctionGabriel Uwaifo MD, Jack A. Yanovski MD, PhD . . . . . . . . . . . . . . . . . . . . . . . . . 451
Chapter 68Liposuction for GynecomastiaEnrique Hernandez-Perez MD, Hasson Abbas Khawaja MD, Jose A. Seijo-Cortes MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460
Chapter 69Axillary Approach in Suction-Assisted Lipectomy of GynecomastiaAntonio C. Abramo MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
Chapter 70Ultrasound-Assisted Liposuction for GynecomastiaAlberto Di Giuseppe MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474
Chapter 71Lipomas Treated with LiposuctionJohn S. Mancoll MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Chapter 72Treatment of Multiple Symmetrical Lipomatosis with LiposuctionJorge A. Martínez-Escribano MD, PhD, Rafael González-Martínez MD . . . . 485
Chapter 73Treatment of Madelung’s Disease with Ultrasound-Assisted LiposuctionAngela Faga MD, FICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
Chapter 74Treatment of Multiple Angiolipomas by Liposuction SurgeryTakehiko Kaneko MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 492
Chapter 75Treatment of Excessive Axillary Sweat Syndromes (Hyperhidrosis, Smidrosis, Bromhidrosis) with LiposuctionRen-Yeu Tsai MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 496
Chapter 76Treatment of Fox–Fordyce Disease with Liposuction-Assisted CurettageStephanie Marschall MD, Michael Marschall MD, Mireille Chae MD . . . . . . 502
Chapter 77Laser-Assisted Liposuction of Axillary Sweat Glands and Hair RemovalMartin Klöpper MD, Gosta Fischer MD, Guillermo Blugerman MD . . . . . . . 505
Chapter 78Liposuction in Dercum’s DiseaseErik Berntorp MD, Kerstin Berntorp MD, Hakan Brorson MD . . . . . . . . . . . . 516
Chapter 79Treatment of Hematomas with LiposuctionAntonio Ascari-Raccagni MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519
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Chapter 80Syringe Liposuction for Residual Fat in Involuted Facial HemangiomaBeatriz Berenguer MD, PhD, Javier Enríquez de Salamanca MD, Beatriz González MD, Pilar Rodríguez MD, Antonio Zambrano MD, Antonio Pérez Higueras MD, PhD. . . . . . . . . . . . . . . 523
Chapter 81Aspiration of Breast Cysts with LiposuctionShridhar Ganpathi Iyer MB, MS, FRCS, Thiam Chye Lim MBBS, FRCS (Ed), FICS, Jane Lim MBBS, FRCS (Ed), FRCS (Glas) . . . . . . . . . . . . . . . 527
Chapter 82Blunt Liposuction Cannula Dissection in Reconstructive SurgeryLawrence M. Field MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532
Chapter 83Cellulite SyndromesPier A. Bacci MD, Lorenzo Scatolini MD, Serena Leonardi, Paola Belardi RN, Sergio Mancini MD . . . . . . . . . . . . . . . . . . 536
Chapter 84Liposuction Treatment of CelluliteClara Lieberman MD, Jose A. Cohen MD, Rashi Rosenstock MD . . . . . . . . . . 539
Chapter 85Vibro-Assisted Liposuction and Endermologie for LipolymphedemaPier A. Bacci MD, Lorenzo Scatolini MD, Serena Leonardi, Paola Belardi RN, Sergio Mancini MD . . . . . . . . . . . . . . . . . . 542
Chapter 86Liposuction of LipedemaManuel E. Cornely MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547
Chapter 87Liposuction in Treatment of Plexiform NeurofibromasSrdan Babovic MD, Dusica Babovic-Vuksanovic MD . . . . . . . . . . . . . . . . . . . . . 550
Chapter 88HIV Lipodystrophy Treatment (Buffalo Hump) with VASER Ultrasound-Assisted LipoplastyAlberto Di Giuseppe MD, Marianne Wolters MD, Herman Lampe MD, Guido Zanetti MD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 554
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563
List of Contributors
Matthias Augustin MDSenior Resident, Deptartment of Dermatology, University of Freiburg, Freiburg, Germany
Pier Antonio Bacci MDProfessor of Aesthetic Surgery, University of Siena, Siena, Italy; Chairman Aesthetic Medicine and Surgery Center, Private Hospital S. Chiara, Florence, Italy
Rüdiger G.H. Baumeister MDPrivate Practice, Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik – Grosshadern, Klinikum der Universität, Munich, Germany
Gary Dean Bennett MDVice Chairman, Department of Anesthesiology, Director of Pain Management Services, Chapman Medical Center, Orange, CA, USA
Soraya Bensenane-Hasbelaoui MDPrivate Practice, Paris, France
Dorothee Bergfeld MDPrivate Practice, Center for Cosmetic Dermatologic Surgery, Rosenparkklinik, Darmstadt, Germany
Guillermo Blugerman MDPrivate Practice, Plastic Surgery, Buenos Aires, Argentina
Kimberly J. Butterwick MDClinical Faculty, Scripps Hospital, San Diego, CA, USA
Kamal Cherif-Zahar MDPrivate Practice, Paris, France
Anastasia Chomyszyn MDPrivate Practice, Plastic Surgery, Buenos Aires, Argentina
Joseph T. Chun MDAssistant Professor of Surgery, Department of Surgery, Division of Plastic Surgery, The University of Tennessee Medical Center, Knoxville, TN, USA
William W. Cimino MDPrivate Practice, Louisville, CO, USA
XX
Paul S. Collins MDPrivate Practice, San Luis Obisbo, CA, USA
Raymond Cook MDAssistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of North Carolina and Wake Medical Center, Raleigh, NC, USA
William R. Cook Jr. MDPrivate Practice, Miami Beach, FL, USA
Manuel E. Cornely MDPrivate Practice, Düsseldorf, Germany
Rudolf H. de Jong MDProfessor (Hon) of Surgery/Anesthesia, School of Medicine, University of South Carolina, Columbia, SC, USA
Alberto Di Giuseppe MDAssociate Professor in Plastic and Reconstructive Surgery, Institute of Plastic and Reconstructive Surgery, School of Medicine, University of Ancona, Ancona, Italy
Brenda C. Edmonson MDInstructor in Oculoplastics, Drexel Hahnemann University, Philadelphia, PA, USA
Michael V. Elam MDPrivate Practice, Newport Beach, CA, USA
Edward H. Farrior MDClinical Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, FL, USA
Afschin Fatemi MDS-thetic Clinic, Düsseldorf, Germany; Department of Dermatology, Katharinen-Hospital, Unna, Germany
Giorgio Fischer MDPrivate Practice, Rome, Italy
Timothy Corcoran Flynn MDClinical Professor, Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
Pierre F. Fournier MDPrivate Practice of Plastic Surgery, Paris, France
Andreas Frick MDPrivate Practice, Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik-Grosshadern, Klinikum der Universität, Munich, Germany
James E. Fulton Jr. MD, PhDPrivate Practice, Tustin, CA, USA
Marco Gasparotti MDProfessor of Aesthetic Surgery, University of Rome Tor Vergata, Rome, Italy
List of Contributors
XXI
Carlo Gasperoni MDProfessor of Aesthetic Surgery, Plastic Surgery Specialization School, Università Cattolica Del Sacro Cuore, Rome, Italy
Paolo Gasperoni MDPlastic Surgery Resident, Università Cattolica Del Sacro Cuore, Rome, Italy
Mitchel P. Goldman MDClinical Professor of Dermatology/Medicine, University of California, San Diego, CA, USA
Beatriz González MDAttending Physician, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Warwick L. Greville MBBS, FACCSPrivate Practice, South Yarra, VIC, Australia
Colin Harbke MS Graduate Student, Washington State University, WA, USA
Enrique Hernández-Perez MDPrivate Practice, Center for Dermatology and Cosmetic Surgery, San Salvador, El Salvador
Jürgen Herr MDPrivate Practice, Düsseldorf, Germany
Antonio Pérez Higueras MD, PhDAssociate Professor of Medicine, Universidad Autonoma of Madrid, Head Department of Neuroradiology, Clinica la Concepcion, Madrid, Spain
Johannes N. Hoffmann MDPrivate Practice, Plastische, Hand-, Mikrochirurgie, Chirurgische Klinik-Grosshadern, Klinikum der Universität, Munich, Germany
Shilesh Iyer MDClinical Instructor, Division of Dermatology, Department of Medicine, UCLA School of Medicine, 23861 Mc Bean Parkway, Suite E-21, Valencia, CA 91355, USA
Robert F. Jackson MDPrivate Practice, Ambulatory Care Center, Marion, IN, USA
Roland Kaufmann MDProfessor, Department of Dermatology, Medical School, University of Frankfurt, Frankfurt, Germany
Mitchell V. Kaminski MDClinical Professor of Surgery Physician Assistant Program, Finch University of Health Sciences, Chicago Medical School, Chicago, IL, USA
Farzin Kerendian DOPrivate Practice, Encino, CA, USA
List of Contributors
XXII
Marcella Kollmann MDDepartment of Dermatology, Medical School, University of Frankfurt, Frankfurt, Germany
Samuel M. Lam MDPrivate Practice, Director Lam Facial Plastic Surgery Center, Dallas, TX, USA
Rose M. Lopez de Vaughan PhDSpecial assistant to Dr. Kaminski, Finch University of Health Sciences, Chicago Medical School, Chicago, IL, USA
Bárbara H.B. Machado MDClinical Instructor Plastic Surgery, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil; Clinical Instructor, Carlos Chagas Institute of Post-Graduate Medical Studies, Rio de Janeiro, Brazil
Daniel Man MDPrivate Practice, Boca Raton, FL, USA
E. Antonio Mangubat MDPrivate Practice, Tukwila, WA, USA
Sid Mirrafati MDPrivate Practice, Tustin, CA, USA
Rodrigo Neira MDProfessor, Department of Plastic, Maxillofacial, and Hand Surgery, Pontifica Universidad Javeriana, Cali, Colombia
Rolf R. Olbrisch MDHead of the Department of Plastic Surgery, Florence Nightingale Hospital, Düsseldorf, Germany
Stephan S. Park MDAssociate Professor and Vice Chairman, Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health Systems; Director of Division of Facial Plastic and Reconstructive Surgery, Charlottesville, VA, USA
Timothy D. Parish MDPrivate Practice, Varicosis and Laser Center of Alabama, Hoover, AL, USA
Lina Valero Pedroza MDPrivate Practice, Santa Fe de Bogota, Colombia
Ivo Pitanguy MDHead Professor of Plastic Surgery, Pontifical Catholic University of Rio de Janeiro (PUC-Rio) and Carlos Chagas Institute of Post-Graduate Medical Studies, Rio de Janeiro, Brazil
Maurizio Podda MDAssistant Professor, Department of Dermatology, Medical School, University of Frankfurt, Frankfurt, Germany
List of Contributors
XXIII
Henrique N. Radwanski MDClinical Instructor Plastic Surgery, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil; Clinical Instructor, Carlos Chagas Institute of Post-Graduate Medical Studies, Rio de Janeiro, Brazil
Bernard I. Raskin MDAssistant Clinical Professor, Division of Dermatology, Department of Medicine, UCLA School of Medicine, CA, USA
Ângelo Rebelo MDPrivate Practice, Plastic, Reconstructive and Aesthetic Surgery, Clínica Milénio, Lisbon, Portugal
Pilar Rodríguez MDAttending Physician, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Marc A. Ronert MDPrivate Practice, Düsseldorf, Germany
Marzia Salgarello MDAssistant Surgeon, Plastic Surgery Department, Università Cattolica Del Sacro Cuore, Rome, Italy
Gerhard Sattler MDPrivate Practice, Rosenparkklinik, Darmstadt, Germany
Diego Schavelzon MDPrivate Practice, Plastic Surgery, Buenos Aires, Argentina
Melvin A. Shiffman MD, JDChairman Department of Surgery, Tustin Hospital and Medical Center, Tustin, CA, USA
Tetsuo Shu MDPrivate Practice, Director, Daikanyama Clinic, Tokyo, Japan
Robert A. Shumway MDPrivate Practice, The Shumway Institute of Laser and Cosmetic Surgery, La Jolla, CA, USA
Boris Sommer MDPrivate Practice, Center for Cosmetic Dermatologic Surgery, Rosenparkklinik, Darmstadt, Germany
Ahmed Ziah Taufig MDPrivate Practice, Facharzt für Chirurgie, Facharzt fur Plastische Chirurgie, Handchirurgie, Cologne, Germany
James W. Taylor MDAssociate Professor of Surgery, Department of Surgery, Division of Plastic Surgery, The University of Tennessee Medical Center, Knoxville, TN, USA
List of Contributors
XXIV
Luiz S. Toledo MDPrivate Practice in Plastic and Reconstructive Surgery, Professor of Post-Graduate Education in Aesthetic Plastic Surgery, São Paulo, Brazil
Jorge I. de la Torre MDAssociate Professor, Division of Plastic Surgery, University of AlabamaBirmingham, AL, USA
Stuart E. Van Meter MDAssociate Professor of Pathology, Department Chairman, Department of Pathology, The University of Tennessee Medical Center, Knoxville, TN, USA
Luis O. Vásconez MDProfessor and Chief, Division of Plastic Surgery, University of Alabama, Birmingham, AL, USA
Allan E. Wulc MDAssociate Clinical Professor of Ophthalmology, University of Pennsylvania, Drexel Hahnemann University, Philadelphia, PA, USA
Antonio Zambrano MDChief of Dermatology, Department of Dermatology, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Antonio Carlos Abramo MDHead Professor of Post-Graduate Course of Plastic Surgery, Division of Plastic and Reconstructive Surgery, General Hospital of Beneficência Portuguesa, São Paulo, Brazil
Antonio Ascari-Raccagni MDChief Assistant, Dermatology Department, Dermatology Oncology Unit G.B.Morgagni – L. Pierantoni: General Hospital, Forli, Italy
Dusica Babovic-Vuksanovic MDAssociate Professor, Medical Genetics, Mayo College of Medicine, Rochester, MN, USA
Srdan Babovic MDPrivate Practice, Plastic Surgery, Olmsted Medical Group, Rochester, MN, USA
Pier Antonio Bacci MDProfessor of Aesthetic Surgery, University of Siena, Siena, Italy; Chairman, Aesthetic Medicine and Surgery Center, Private Hospital S. Chiara, Florence, Italy
Paola Belardi RNVascular Nurse, Bacci Medical Center, Arezzo, Italy
Beatriz Berenguer MD, PhDAttending Physician, Division of Plastic Surgery, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Erik Berntorp MDProfessor, Department of Coagulation Disorders, Lund University, Malmö University Hospital, Malmö, Sweden
List of Contributors
XXV
Kerstin Berntorp MD, PhDAssociate Professor, Department of Endocrinology, University of Lund, University Hospital Malmö, Malmö, Sweden
Guillermo Blugerman MDPrivate Practice Plastic Surgeons, B&S Centro de Excelencia en Cirugia Plástica Buenos Aires, Argentina
Hakan Brorson MD, PhDFull Time Consultant Plastic Surgeon, Department of Plastic and Reconstructive Surgery, Lund University, Malmö University Hospital, Malmö, Sweden
Mireille Chae MDPrivate Practice, Plastic Surgery Consultants of Dupage, Wheaton, IL, USA
Jose A. Cohen MDPrivate Practice, San Jose, Costa Rica
Manuel E. Cornely MDPrivate Practice, Düsseldorf, Germany
Alberto Di Giuseppe MDAssociate Professor in Plastic and Reconstructive Surgery, Institute of Plastic and Reconstructive Surgery, School of Medicine, University of Ancona, Ancona, Italy
Angela Faga MD, FICSProfessor and Chairman of Plastic and Reconstructive Surgery, Chief of the Unit of Plastic and Reconstructive Surgery, University of Pavia, Pavia, Italy
Lawrence M. Field MD, FIACSInaugural International Chair of Dermatologic Surgery (International Society of Dermatologic Surgery); Department of Dermatology (Dermatologic Surgery), University of California, San Francisco, CA, USA; Department of Dermatology, Stanford University Medical Center, Stanford, CA, USA
Giorgio Fischer MDProfessor of Pathology, Via della Camiluccia, Rome, Italy
Pierre F. Fournier MDPrivate Practice of Plastic Surgery, Paris, France
Beatriz González MDDivision of Plastic Surgery, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Rafael González-Martínez MDPrivate Practice Plastic Surgery, Castellón, Spain
Shridhar Ganpathi Iyer MB, MS, FRCSRegistrar, Division of Surgery, National University Hospital, Singapore
Enrique Hernández-Pérez MDPrivate Practice, Center for Dermatology and Cosmetic Surgery, San Salvador, El Salvador
List of Contributors
XXVI
Takehiko Kaneko MDDirector, Department of Dermatology, Fraternity Memorial Hospital, Tokyo, Japan
Hassan Abbas Khawaja MDPrivate Practice, Center for Dermatology and Cosmetic Surgery, San Salvador, El Salvador
Martin Klöpper MDPrivate Practice, Privatklinik Northeim, Northeim, Germany
Herman Lampe MDPrivate Practice, Plastic Surgery, Frankfurt, Germany
Serena LeonardiPhysiotherapist, Private Hospital S. Chiara, Florence, Italy
Clara Lieberman MDPrivate Practice, San Jose, Costa Rica
Jane Lim MBBS, FRCS (Ed), FRCS (Glas)Consultant, Department of Surgery, National University Hospital, Singapore
Thiam Chye Lim MBBS, FRCS (Ed), FICSHead and Senior Consultant, Division of Plastic and Reconstructive Surgery, National University Hospital, Singapore
Sergio Mancini MDDirector Surgery, University of Siena, Siena, Italy
John S. Mancoll MDPrivate Practice, Fort Wayne, IN, USA
Michael Marschall MDPrivate Practice, Plastic Surgery Consultants of Dupage, Wheaton, IL, USA
Stephanie Marschall MDPrivate Practice, Plastic Surgery Consultants of Dupage, Wheaton, IL, USA
Jorge A. Martínez-Escribano MD, PhDMedical Staff, Dermatology Department, Virgen de la Arrixaca University Hospital., Murcia, Spain
Beniamino Palmieri MDAssociate Professor of Surgery, Department of Surgery, Universita Degli Studi di Modena e Reggio Emilia, Modena, Italy
Antonio Pérez Higueras MD, PhDDivision of Interventional Radiology, Fundación Himénez Díaz, Madrid, Spain
Pilar Rodríguez MDDivision of Plastic Surgery, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Rashi Rosenstock MDPrivate Practice, San Jose, Costa Rica
List of Contributors
XXVII
Javier Enríquez de Salamanca MDChief of Plastic Surgery, Universidad Autonoma of Madrid, Hospital «Niño Jesús”, Madrid, Spain
Lorenzo Scatolini MDNuclear Medicine, Private Hospital S. Chiara, Florence, Italy
Jose A. Seijo-Cortes MDPrivate Practice, Center for Dermatology and Cosmetic Surgery, San Salvador, El Salvador
Melvin A. Shiffman MD, JDChairman, Department of Surgery, Tustin Hospital and Medical Center, Tustin, CA, USA, e-mail: [email protected], Tel: +1-714-5441720, Fax: +1-714-544-6118
Ren-Yeu Tsai MDAssociate Clinical Professor, Department of Dermatology, Taipei Medical University, Director of Skin Laser Center, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan
Gabriel I. Uwaifo MDMedStar Research Institute,, Washington, DC, USA
Marianne Wolters MDPrivate Practice, Plastic Surgery, Frankfurt, Germany
Jack A. Yanovski MD, PhDUnit on Growth and Obesity, National Institutes of Health, Bethesda, MD, USA
Antonio Zambrano MDDepartment of Dermatology, Universidad Autonoma of Madrid, Hospital “Niño Jesús”, Madrid, Spain
Guido Zanetti MDDepartment of Plastic Surgery, Sant’Orsala Hospital, Bologna, Italy
List of Contributors
