Liposuction volume

Currently, it is customary to distinguish between small-volume liposuction (removing up to 1.5-2.5 liters of fat), large-volume liposuction (2.5-5 liters of fat), and super-large volume liposuction (more than 5 liters of fat).

Small volume liposuction can be performed under local anesthesia and on an outpatient basis. Large volume liposuction requires hospitalization of the patient for 1-3 days.

In case of extra-large liposuction, the hospitalization period may be increased and is determined individually.

What is the maximum amount of fat that can be removed during surgery without increasing the risk of the intervention to a dangerous level? This question, the answers to which are highly controversial, is most relevant primarily for patients with unstable body weight and those suffering from obesity of II-IV degree. In 1993, a group of Egyptian doctors reported the possibility of removing up to 11 liters of fat during one operation. This intervention was preceded by serious preoperative preparation, including preliminary blood exfusion.

In the postoperative period, intensive infusion therapy and autologous blood return were performed.

An alternative to "superoperations" is to perform liposuction in such a volume that does not cause significant anemia, is relatively easily tolerated by the patient and does not create conditions for the development of severe general and local complications. Both approaches have their advantages and disadvantages.

One-stage major surgery. Although the risk of general anesthesia is low, some authors believe that a series of two or three minor liposuctions creates a greater anesthetic risk overall compared to one major surgery. In addition, preliminary blood exfusion with its transfusion after surgery helps prevent the risk of severe anemia. Finally, a one-stage surgery reduces the patient's financial costs and, very importantly, time loss.

Serial liposuctions. Their advantages include the highest possible safety of interventions and the possibility of their implementation in outpatient conditions or with minimal hospitalization. Treatment results are achieved gradually. If necessary, adjustments can be made during subsequent operations. At the same time, serious disadvantages of this approach are considered to be significantly greater time expenditures by the patient, along with an increase in the overall cost of treatment.

The experience of more than 800 operations performed at the Center for Plastic and Reconstructive Surgery has shown the following. Based on the fact that the amount of blood in the exfusate is on average about 2.5%, the volume of fat removed in patients with local forms of obesity should generally not exceed 3000 ml. In patients suffering from obesity, with a body weight of more than 100 kg, it is possible to remove up to 5000 ml of adipose tissue.

It should be emphasized that these values are very approximate and largely depend on the volume of solution injected into the tissue, the degree of tissue tolerance to adrenaline, the density of adipose tissue, the patient's weight, the total area of treatment zones, etc. In recent years, there have been reports of the possibility of relatively safe removal of large volumes of adipose tissue using ultrasound liposuction.

Ultimately, each surgeon makes a decision on the scope of the operation, based primarily on his personal experience. But the golden rule of surgery has no alternative: it is better to perform two relatively safe operations than one that is truly dangerous to the patient's life and health.

Compliance with this rule is especially important in cases where the surgeon encounters a patient with widespread local fat deposits of particularly significant thickness. Most often, this occurs on the thigh, where all three types of local obesity can be combined with almost circular deposits of fat tissue. In these cases, the surgeon must remember not only the area of the wound surface remaining after liposuction, but also the depth of mechanical tissue damage. Here, the usual scheme for calculating the number of zones to be treated is not applicable. And not only because they are difficult to determine.

With the same number of zones, increasing the depth of tissue treatment leads to an increase in the severity of the operation.

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