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:
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CBC
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Urinalysis
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Electrolytes (if patient is taking diuretics)
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Chest radiograph (when none has been performed for more than 1 year or if patient has history of cigarette smoking)
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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)
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Pregnancy test in women of childbearing age
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HIV and hepatitis testing
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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.)
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.
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." [11]
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Cabot high-pressure infusion pump for infusing tumescent fluid.
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Standard liposuction machine.
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VASER ultrasonic liposuction machine including tumescent infiltrator, ultrasound generator, and suction with some aspirate in container.
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Ultrasonic VASER probe.
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Highly emulsified fat with high fat-to-fluid ratio with UAL VASER and standard tumescent SAL.
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Liposuction, thigh and knee. Mercedes tip design liposuction cannulas.
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Liposuction, thigh and knee. Infusion solution formulas.
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Liposuction, thigh and knee. Making incisions for tumescent infusion.
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Liposuction, thigh and knee. Infusing tumescent fluid.
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Liposuction, thigh and knee. Introducing the cannula.
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Before and after views of liposuction of thighs.
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Before and after views of liposuction of thighs as well as hips and abdomen.
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Before and after views of liposuction of thighs and knees.
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Before and after liposuction of knees (front view).
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Before and after liposuction of knees (posterior view).
