Liposuction volume

At present, it is customary to distinguish small volume liposuction (with removal to 1.5-2.5 liters of fat), a large volume (2.5-5 liters of fat) and an extra-large volume (more than 5 liters of fat).

Liposuction of small volume can be performed under local anesthesia and in outpatient settings. Liposuction of large volume requires hospitalization of the patient for 1-3 days.

With extra-large liposuction, hospitalization times can be increased and determined individually.

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

In the postoperative period, intensive infusion therapy and autoblood recovery were performed.

An alternative to "superoperations" is the performance of liposuction in an amount that does not cause significant anemia, is relatively easy to tolerate by the patient and does not create conditions for the development of severe general and local complications. Both approaches have their advantages and disadvantages.

Single-stage large operation. Despite the fact that the risk of general anesthesia is low, according to some authors, a series of two or three small liposuction creates a general anesthesia risk in general compared to one large operation. In addition, preliminary blood exfusion with its transfusion after surgery helps to prevent the risk of severe anemia. Finally, a one-stage operation reduces the patient's financial costs and, what is very important, the loss of time.

Serial liposuction. Their advantages include the highest possible safety of interventions and the possibility of conducting them on an outpatient basis or with hospitalization of a minimum duration. The results of treatment are achieved gradually. If necessary, adjustments may be made in the course of subsequent operations. At the same time, serious disadvantages of this approach are considered to be significantly higher costs for the patient, along with an increase in the total cost of treatment.

The experience of more than 800 operations performed in the Center for Plastic and Reconstructive Surgery showed the following. Based on the fact that the amount of blood in the exfusate averages about 2 5%, the volume of fat removed in patients with local obesity is generally not more than 3000 ml. In patients obese, with a body weight of more than 100 kg can remove up to 5000 ml of adipose tissue.

It should be emphasized that these values are very approximate and depend to a large extent on the amount of solution introduced into the tissue, the degree of tolerance of tissues to adrenaline, the density of fatty tissue, the weight of the patient, the total area of treatment of the zones, etc. In recent years, safe removal of large volumes of adipose tissue with ultrasonic liposuction.

Ultimately, each surgeon decides 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 make two relatively safe operations than one really dangerous for the life and health of the patient.

Observance of this rule is especially important in cases when the surgeon meets a patient who has widespread local fat deposits of particularly significant thickness. Most often it happens on the hip, where all three types of local obesity can be combined with practically circular deposition of fatty tissue. In these cases, the surgeon should remember not only the area of the wound surface remaining after liposuction, but also the depth of mechanical damage to the tissues. Here the usual scheme for calculating the number of zones to be processed is inapplicable. And not only because they are difficult to determine.

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

[1], [2], [3], [4], [5]