9906-1868 Frick
Frick A, Hoffmann JN, Baumeister RG, Putz R.
Liposuction technique and lymphatic lesions in lower legs: anatomic study to
reduce risks.
Plast Reconstr Surg. 1999 Jun;103(7):1868-73; discussion 1874-5. PMID: 10359247
Department of Surgery, Klinikum Grosshadern, and the Institute of Anatomy,
University of Munich, Germany. africk@gch.med.uni-meunchen.de
Liposuction is a standard procedure in plastic surgery. Especially, lipectomy
with suction of the lower extremities has been of greater interest in recent
years. Until now, however, there was no definite information about the integrity
of epifascial lymph collectors during this procedure. To study the effect of
liposuction devices on lymph vessel injury, postmortem lymphatic preparations
were done in five human cadavers (10 lower extremities). Conventional
liposuction with a blunt 4-mm cannula and a dry technique was used. Adiposuction
was performed either in parallel to the extremity axis and, therefore, in
parallel to the superfascial lymph vessels or transversally in an 80- to
90-degree angle to the extremity. Careful surgical preparation of the regions
followed. A specific macroscopic lymph vessel injury score was applied to
differentiate 3 degrees of lymph vessel lesions according to the extravasation
of patent blue. In all lower extremities, postmortem lymph flow occurred as
indicated by patent blue staining of the lymph vessels. Lymph vessel injury was
more severe in areas where liposuction was performed transversally, vertical to
the extremity's axis, than in those after a longitudinal procedure. The
difference was statistically significant (p < 0.01). The volumes of
adipoaspirate and of the compared regions were comparable between both groups,
verified by circumference measurements. Longitudinal liposuction of the lower
extremities is unlikely to cause major lesions of epifascial lymph vessels and,
therefore, should be preferred in comparison to liposuction vertical to the
extremity.
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