Blood and fluid replacement for lipoplasty procedures.

Lipoplasty procedures have been performed safely since 1977. Evaluation of patients to rule out bleeding disorders, low serum albumin level, anemia, and systemic diseases is mandatory. A well-planned procedure involves estimation of the amount of removal and the percentage of body surface area involved in the "internal burn." This allows a clinical prediction of the amounts and type of fluid resuscitation required. The maintenance of a near normal circulating albumin level is of at least as great importance as maintaining adequate circulating red cell mass. The goal should be normal intravascular volume with a postoperative hematocrit well above 30 per cent and an albumin level above 3 g. Careful preoperative assessment and planning, the use of Hespan, and, especially, autologous blood transfusions allow the safe removal of localized fatty tissue on an outpatient basis.