Liposuction

Cell bio

1

100 points

If someone gains weight in adulthood, what is happening to the adipocytes?

They hypertrophy (don't really multiply) 

2

500 points

Superficial fat has what type of receptor?

Deep fat has what type of receptor?

Superficial fat has beta-1 receptors

Deep fat has alpha-2 receptors

3

100 points

This many wants lipo. What do you say and why?

Not a good candidate, most fat is intraabdominal (and we shall not liposuction your omentum)

4

200 points

The deep fat of Illouz is characterized by what? 

It's deep to sueprficial fat, has horizontal fibrous septa, better target for lipo

Lidocaine toxicity

1

300 Points

What are 3 EARLY signs of lidocaine toxicity?

Circumoral numbness

Drowsiness

Tinnitus

2

100 points (If you get the bonus you get to steal 500 points from someone else) 

What do you start in lidocaine toxicity to stabilize the cardiac membrane? 

BONUS: At what dose/regimen?

0.5 mL/kg BOLUS of 20% lipid emulsion → 0.25 mL/kg maintenance until patient stable

Monitor for 12h afterwards.

3

200 points

What cardiac anomaly is an intermediate sign of lidocaine toxicity?

AV dissociation

4

200 points

Peak plasma concentrations of lidocaine are reached how long after administration?

6-12 hours after adminsitration

Lipo adjuncts

1

200 points

What is SAFElipo?

A technique of pretunneling and posttunneling to redistribute fat

2

200 points

What do you need if using radiofrequency lipo?

Transcutaneous temperature monitoring

3

300 points

Ultrasound assisted liposuction is associated with increased rate of what negative finding and what positive finding?

Negative: seromas

Positive: better skin tightening

4

300 points

Laser assisted lipsuction can cause what? And what should it not be combined with?

Can cause burns, should not be combined with skin resection

Formuoli

1

200 points

What is the standard formula for Hunstad solution?

1 L LR

50 cc 1% lidocaine

1 amp epinephrine 

2

200 points

To minimize risk of toxicity, the dose of lidocaine in wetting solution dose should be what?

<35 mg/kg

3

Daily double

If you are using 50ml lidocaine in each 1L bag of tumescence, what is the max # of bags of tumescence you can use on a 90kg individual?

9.3 bags

(90kg x 35 mg/kg) = x

x / 500 mg lidocaine = max number of bags

4

400 points (100 pts each) 

What is the EBL associated with each type of lipo? Dry, Wet, Superwet, Tumescence

Dry = 50%

Wet= 30%

Superwet = 4%

Tumescence = 1%

Random

1

100 points

#1 cause of death after lipo?

DVT

2

200 points

What amount on pinch test is the minimum recommended for liposuction to calves? 

>2cm

3

600 points (100 for each of them) 

What criteria does a case/patient need to meet for liposuction to be done outpatient?

Guidelines for outpatient lipsuction

1) Volumes < 5000 cc total aspirate safe for outpatient

2) Case is under 6 hours

3) Cases end by 3PM

5) ASA Class 1 or 2

6) BMI < 35

4

150 poitns each (300 total) 

Superwet liposuction uses how many mL lidocaine/epi solution for every 1 mL aspirate?

Tumescent liposuction uses how many mL lidocaine/epi solution for every 1 mL aspirate?

Superwet liposuction uses 1 mL lidocaine/epi solution for every 1 mL aspirate (1:1)

Tumescent liposuction uses 2-3 mL lidocaine/epi solution per 1 mL aspirate (2-3:1)