[libribook.com] Traumatic Scar Tissue Management 1st Edition

Liposuction
Brief consideration is given here due to the commonality of problems which may
follow liposuction with incision scars, scars related to burns and subsequent
fibrosis.
Liposuction is one of the most popular cosmetic surgery procedures currently
performed by plastic surgeons around the world. The original concept of
removing excess fat from localized areas of the body is credited to Charles
Dujarrier who, in 1921, using a uterine curette, attempted to remove
subcutaneous fat from the calf and knees of a ballerina. Unfortunately, an injury
to the femoral vessels resulted in the amputation of the dancer’s leg (Dixit &
Wagh 2013).
Modern liposuction began in 1976 with the technique and instruments of Giorgio
and Arpad Fischer. An otolaryngologist, Julius Newman, first used the term
‘liposuction’ in 1983.
Liposuction is associated with a variety of complications classified as:
• Local: such as edema, ecchymosis, seroma, hematoma, asymmetry,
irregularities, skin necrosis, neural sequelae, fibrosis and adhesions
• Systemic: such as visceral perforation, DVT, infection, significant blood loss.
Local complications are more common than systemic.
Edema is considered a normal reaction to this trauma-by-appointment. Methods
commonly employed to effectively clear edema are compression garments for 4–
6 weeks post-procedure and manual lymphatic drainage in the early
postoperative period (Shiffman 2006, Dixit & Wagh 2013).
Under normal, non-complicating circumstances, tissues are expected to return to
normal feel and function 3 months post-procedure.
If brawny postoperative edema with heightened pain and discomfort persist
beyond 6 weeks it is suggested this may be due to excessive trauma to the tissues
(e.g. aggressive suctioning) and internal burn-like injury (Shiffman 2006). If this