Thigh and Knee Liposuction Workup
- Author: John A Grossman, MD; Chief Editor: Zubin J Panthaki, MD, CM, FACS, FRCSC more...
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:
- 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.)
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.
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."
Illouz YG. Body contouring by lipolysis: a 5-year experience with over 3000 cases. Plast Reconstr Surg. 1983 Nov. 72(5):591-7. [Medline].
Moreno-Moraga J, Trelles MA, Mordon S, Unglaub F, Bravo E, Royo de La Torre J, et al. Laser-assisted lipolysis for knee remodelling: a prospective study in 30 patients. J Cosmet Laser Ther. 2012 Apr. 14(2):59-66. [Medline].
Courtiss EH. Suction lipectomy: a retrospective analysis of 100 patients. Plast Reconstr Surg. 1984 May. 73(5):780-96. [Medline].
Grazer FM, de Jong RH. Fatal outcomes from liposuction: census survey of cosmetic surgeons. Plast Reconstr Surg. 2000 Jan. 105(1):436-46; discussion 447-8. [Medline].
Klein J. The tumescent technique for liposuction surgery. Am J Cosmetic Surg. 1987. 4:263.
Fodor PB. Defining wetting solutions in lipoplasty. Plast Reconstr Surg. 1999 Apr. 103(5):1519-20. [Medline].
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. 2011 May. 66(5):452-6. [Medline].
Carpaneda CA. Postliposuction histologic alterations of adipose tissue. Aesthetic Plast Surg. 1996 May-Jun. 20(3):207-11. [Medline].
Klein JA. Tumescent technique for local anesthesia improves safety in large-volume liposuction. Plast Reconstr Surg. 1993 Nov. 92(6):1085-98; discussion 1099-100. [Medline].
Fischer JP, Wes AM, Serletti JM, Kovach SJ. Complications in Body Contouring Procedures: An Analysis of 1,797 Patients From the 2006-2010 ACS-NSQIP Databases. Plast Reconstr Surg. 2013 Sep 4. [Medline].
Ibrahim AE, Dibo SA, Hayek SN, Atiyeh BS. Reverse tissue expansion by liposuction deflation for revision of post-surgical thigh scars. Int Wound J. 2011 Dec. 8(6):622-631. [Medline].
Armijo BS, Campbell CF, Rohrich RJ. Four-step medial thighplasty: refined and reproducible. Plast Reconstr Surg. 2014 Nov. 134 (5):717e-725e. [Medline].
Albin R, de Campo T. Large-volume liposuction in 181 patients. Aesthetic Plast Surg. 1999 Jan-Feb. 23(1):5-15. [Medline].
Bradbury E. The psychology of aesthetic plastic surgery. Aesthetic Plast Surg. 1994 Summer. 18(3):301-5. [Medline].
Cardenas-Camarena L, Tobar-Losada A, Lacouture AM. Large-volume circumferential liposuction with tumescent technique: a sure and viable procedure. Plast Reconstr Surg. 1999 Nov. 104(6):1887-99. [Medline].
Cárdenas-Camarena L, González LE. Large-volume liposuction and extensive abdominoplasty: a feasible alternative for improving body shape. Plast Reconstr Surg. 1998 Oct. 102(5):1698-707. [Medline].
Daane SP, Rockwell WB. Analysis of methods for reporting severe and mortal lipoplasty complications. Aesthetic Plast Surg. 1999 Sep-Oct. 23(5):303-6. [Medline].
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.
Grazer FM. Atlas of Suction Assisted Lipectomy in Body Contouring. 1992.
Grazer FM. Suction-assisted lipectomy, suction lipectomy, lipolysis, and lipexeresis. Plast Reconstr Surg. 1983 Nov. 72(5):620-3. [Medline].
Hunstad, JP. Liposuction For Obesity. Operative Techniques In Plastic & Reconstructive Surgery. 1996. 124.
Pitman G. Tumescent liposuction: operative technique. Operative Techniques in Plastic and Reconstructive Surgery. 1996. 3(2):88.
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.
Troilius C. Ten year evolution of liposuction. Aesthetic Plast Surg. 1996 May-Jun. 20(3):201-6. [Medline].