Thigh and Knee Liposuction Workup

  • Author: John A Grossman, MD; Chief Editor: Al Aly, MD, FACS   more...
 
Updated: Nov 21, 2011
 

Laboratory Studies

Every patient must undergo an appropriate complete medical history and physical examination. A perfunctory examination and limited laboratory studies for a young and apparently healthy patient are inappropriate. Laboratory tests should include the following:

  • CBC
  • Urinalysis
  • Electrolytes (if patient is taking diuretics)
  • Chest radiograph (when none has been performed for more than 1 year or if patient has history of cigarette smoking)
  • Electrocardiogram (for men older than 40 years and women older than 50 years, unless there is a history of hypertension, stroke, arrhythmias, diabetes, cigarette smoking)
  • Pregnancy test in women of childbearing age
  • HIV and hepatitis testing
  • Accurate weight (and date of that weight) as well as measurements of the areas to be liposuctioned (If the patient's personal physician or an outside physician other than the surgeon is performing the physical examination, record weight and measurements at the surgeon's office. Patients are notorious for providing inaccurate reports of their weight and dimension measurements.)
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Imaging Studies

Other than a routine chest radiograph where indicated by age, smoking history, or history of prior disease, no imaging studies are necessary in the preoperative liposuction patient. Ultrasound examinations of the fat layer before and after suctioning are interesting but expensive and unnecessary.

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Histologic Findings

Histologic findings are not relevant, as surgeons are not working with tissue pathology; however, research studies pertaining to histologic changes following liposuction have been performed. Carpaneda in 1996 reported that "Histologic studies [postliposuction] disclosed extensive amounts of dead adipocytes and free fat within the aspirated area. The pockets left behind were filled with serum hemorrhagic material and evolved to the healing process. Collagen synthesis increased initially then followed by gradual decrease and a remodeling process. Our findings suggest that liposuction techniques preserve some vessels and nerves, but the final resolution may take several months or years, depending on the amount of tissue damage."[7]

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Contributor Information and Disclosures
Author

John A Grossman, MD  Clinical Instructor of Plastic Surgery, University of Colorado Health Sciences Center; Private Practice, Plastic and Reconstructive Surgery

John A Grossman, MD is a member of the following medical societies: American Burn Association, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Laser Medicine and Surgery, American Society of Plastic Surgeons, Colorado Medical Society, Lipoplasty Society of North America, and Pan-Pacific Surgical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Gregory Caputy, MD, PhD, FICS  Chief Surgeon, Aesthetica Plastic and Laser Surgery Center, Inc

Gregory Caputy, MD, PhD, FICS is a member of the following medical societies: American Society for Laser Medicine and Surgery, Canadian Medical Association, International College of Surgeons, International College of Surgeons US Section, Pan-Pacific Surgical Association, and Wound Healing Society

Disclosure: Syneron Corporation Salary Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Alan Matarasso, MD, FACS, PC  Clinical Professor of Plastic Surgery, Albert Einstein College of Medicine; Immed Past President of New York Regional Society of Plastic and Reconstructive Surgery

Alan Matarasso, MD, FACS, PC is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Medical Association, International College of Surgeons US Section, New York Academy of Medicine, New York County Medical Society, Pan American Medical Association, and Pan-Pacific Surgical Association

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Al Aly, MD, FACS  Clinical Professor of Plastic Surgery, University of California, Irvine, School of Medicine

Disclosure: Ethicon Consulting fee Consulting; QMP Royalty Book royalty; Insorb Stapler Consulting fee Consulting; Insorb Stapler Ownership interest None; Angiotech Consulting fee None

References

  1. Illouz YG. Body contouring by lipolysis: a 5-year experience with over 3000 cases. Plast Reconstr Surg. Nov 1983;72(5):591-7. [Medline].

  2. Courtiss EH. Suction lipectomy: a retrospective analysis of 100 patients. Plast Reconstr Surg. May 1984;73(5):780-96. [Medline].

  3. Grazer FM, de Jong RH. Fatal outcomes from liposuction: census survey of cosmetic surgeons. Plast Reconstr Surg. Jan 2000;105(1):436-46; discussion 447-8. [Medline].

  4. Klein J. The tumescent technique for liposuction surgery. Am J Cosmetic Surg. 1987;4:263.

  5. Fodor PB. Defining wetting solutions in lipoplasty. Plast Reconstr Surg. Apr 1999;103(5):1519-20. [Medline].

  6. Kolker AR, Xipoleas GD. The circumferential thigh lift and vertical extension circumferential thigh lift: maximizing aesthetics and safety in lower extremity contouring. Ann Plast Surg. May 2011;66(5):452-6. [Medline].

  7. Carpaneda CA. Postliposuction histologic alterations of adipose tissue. Aesthetic Plast Surg. May-Jun 1996;20(3):207-11. [Medline].

  8. Klein JA. Tumescent technique for local anesthesia improves safety in large-volume liposuction. Plast Reconstr Surg. Nov 1993;92(6):1085-98; discussion 1099-100. [Medline].

  9. Ibrahim AE, Dibo SA, Hayek SN, Atiyeh BS. Reverse tissue expansion by liposuction deflation for revision of post-surgical thigh scars. Int Wound J. Dec 2011;8(6):622-631. [Medline].

  10. Albin R, de Campo T. Large-volume liposuction in 181 patients. Aesthetic Plast Surg. Jan-Feb 1999;23(1):5-15. [Medline].

  11. Bradbury E. The psychology of aesthetic plastic surgery. Aesthetic Plast Surg. Summer 1994;18(3):301-5. [Medline].

  12. Cardenas-Camarena L, Tobar-Losada A, Lacouture AM. Large-volume circumferential liposuction with tumescent technique: a sure and viable procedure. Plast Reconstr Surg. Nov 1999;104(6):1887-99. [Medline].

  13. Cárdenas-Camarena L, González LE. Large-volume liposuction and extensive abdominoplasty: a feasible alternative for improving body shape. Plast Reconstr Surg. Oct 1998;102(5):1698-707. [Medline].

  14. Daane SP, Rockwell WB. Analysis of methods for reporting severe and mortal lipoplasty complications. Aesthetic Plast Surg. Sep-Oct 1999;23(5):303-6. [Medline].

  15. Grazer FM. Associate Clinical Professor, Department of Surgery, University of California, Irvine, College of Medicine, Irvine, California. Atlas of Suction Assisted Lipectomy in Body Contouring. 1992;1-65.

  16. Grazer FM. Atlas of Suction Assisted Lipectomy in Body Contouring. 1992.

  17. Grazer FM. Suction-assisted lipectomy, suction lipectomy, lipolysis, and lipexeresis. Plast Reconstr Surg. Nov 1983;72(5):620-3. [Medline].

  18. Hunstad, JP. Liposuction For Obesity. Operative Techniques In Plastic & Reconstructive Surgery. 1996;124.

  19. Pitman G. Tumescent liposuction: operative technique. Operative Techniques in Plastic and Reconstructive Surgery. 1996;3(2):88.

  20. Pitman GH. Clinical Associate Professor of Surgery (plastic), Institute of Reconstructive Plastic Surgery, New York University School of Medicine. Liposuction and aesthetic surgery. 1993;415.

  21. Troilius C. Ten year evolution of liposuction. Aesthetic Plast Surg. May-Jun 1996;20(3):201-6. [Medline].

 
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Cabot high-pressure infusion pump for infusing tumescent fluid.
Standard liposuction machine.
VASER ultrasonic liposuction machine including tumescent infiltrator, ultrasound generator, and suction with some aspirate in container.
Ultrasonic VASER probe.
Highly emulsified fat with high fat-to-fluid ratio with UAL VASER and standard tumescent SAL.
Liposuction, thigh and knee. Mercedes tip design liposuction cannulas.
Liposuction, thigh and knee. Infusion solution formulas.
Liposuction, thigh and knee. Making incisions for tumescent infusion.
Liposuction, thigh and knee. Infusing tumescent fluid.
Liposuction, thigh and knee. Introducing the cannula.
Before and after views of liposuction of thighs.
Before and after views of liposuction of thighs as well as hips and abdomen.
Before and after views of liposuction of thighs and knees.
Before and after liposuction of knees (front view).
Before and after liposuction of knees (posterior view).
 
 
 
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