Golpanian Samuel, Rahal George A, Rahal William J
Aesthet Surg J. 2023 Oct 13;43(11):1310-1324. doi: 10.1093/asj/sjad164.
Currently, the definition of large-volume liposuction is the removal of 5 L or more of total aspirate. Higher volumes of lipoaspirate come into consideration with higher BMIs, because more than 5 L is often required to achieve a satisfactory aesthetic result. The boundaries of what lipoaspirate volume is considered safe are based on historical opinion and are constantly in question.
Because to date there have been no scientific data available to support a specific safe maximum volume of lipoaspirate, the authors discuss necessary conditions for safe high-volume lipoaspirate extraction.
This retrospective study included 310 patients who had liposuction of ≥5 L over a 30-month period. All patients had 360° liposuction alone or in combination with other procedures.
Patient ages ranged from 20 to 66 with a mean age of 38.5 (SD = 9.3). Average operative time was 202 minutes (SD = 83.1). Mean total aspirate was 7.5 L (SD = 1.9). An average of 1.84 L (SD = 0.69) of intravenous fluids and 8.99 L (SD = 1.47) of tumescent fluid were administered. Urine output was maintained above 0.5 mL/kg/hr. There were no major cardiopulmonary complications or cases requiring blood transfusion.
High-volume liposuction is safe if proper preoperative, intraoperative, and postoperative protocols and techniques are employed. The authors believe that this bias should be modified and that sharing their experience with high-volume liposuction may help guide other surgeons to incorporate this practice with confidence and safety for better patient outcomes.
目前,大容量吸脂的定义是吸出总量达5升或更多。随着体重指数(BMI)升高,需要吸出更多脂肪量,因为通常需要吸出超过5升脂肪才能达到满意的美学效果。吸脂量的安全界限基于以往观点,一直备受质疑。
由于迄今为止尚无科学数据支持特定的安全最大吸脂量,作者讨论了安全进行大容量吸脂的必要条件。
这项回顾性研究纳入了310例在30个月内接受≥5升吸脂手术的患者。所有患者均单独接受360°吸脂或与其他手术联合进行。
患者年龄在20至66岁之间,平均年龄为38.5岁(标准差=9.3)。平均手术时间为202分钟(标准差=83.1)。平均总吸出量为7.5升(标准差=1.9)。平均输注静脉液体1.84升(标准差=0.69),肿胀液8.99升(标准差=1.47)。尿量维持在每千克体重每小时0.5毫升以上。未发生重大心肺并发症或需要输血的病例。
如果采用适当的术前、术中和术后方案及技术,大容量吸脂是安全的。作者认为这种偏见应予以纠正,分享他们大容量吸脂的经验可能有助于指导其他外科医生自信且安全地采用这种手术方式,从而为患者带来更好的治疗效果。