Large-volume liposuction and extensive abdominoplasty: a feasible alternative for improving body shape

Forty-two female patients underwent liposuction of large volumes and extensive abdominoplasty during an 18-month period, with an average follow-up period of 9 months. Fifty-two percent of the patients underwent a third surgical procedure, which was basically aesthetic. The average age was 40 years; weight varied between 51 kg and 113 kg, with only 11 percent of the patients at their ideal weight. The tumescent technique was used for performing liposuction, which was done on the loins, trochanters, lumbar, upper scapular, and upper lateral abdominal regions, avoiding liposuction of the abdominal flap in all cases except for one. The abdominoplasty was extensive with detachment to the xiphoid process without detaching liposuctioned areas. Volumes of 1600 ml to 11,200 ml were obtained through liposuction, with an average of 4230 cc, and minimal blood loss. Fatty dermal tissue was removed through abdominoplasty and it varied between 400 g and 5000 g with an average of 1300 g. Only the two heaviest patients required an autologous blood unit, because they underwent breast reduction at the same time. All the other patients were managed exclusively with intravenous crystalloids solutions. No major complications arose, and only five patients had minor complications. Based on these results, we consider it to be feasible to combine the liposuctioning of large volumes with abdominoplasty to improve body shape, even with the addition of a third surgical procedure. Nevertheless, it is essential to use the tumescent technique for liposuction to reduce bleeding to a minimum and to allow us to perform other procedures.