Patient selection
For how long should a patient be at a stable weight prior to liposuction?
6 months
The best way to mitigate contour irregularities is:
to use a smaller cannula
Tumescent solution uses how many mL of lidocaine per 1mL aspirate?
2-3 mL lidocaine per 1 mL aspirate
Most common complications after liposuction
Seroma formation
The sensory nerve at greatest risk during a facelift is the
great auricular nerve
What is the minimum pinch test value in the abdomen and in the thighs for a patient to be a good candidate for liposuction?
At least 3 cm for abdomen/hips/subtrochanteric areas
At least 2 cm for calves and ankles
Ultrasound-assisted liposuction has an increased rate of what complication?
seroma formation
What is the EBL associated with the following types of liposuction (% of aspirated volume)?
Dry
Wet
Superwet
Tumescent
Dry: 50%
Wet: 30%
Superwet: 1-4%
Tumescent: 1%
Number 1 most common cause of death after liposuction
DVT/PE
The interdomal angle of divergence in the nose should be:
30-60 degrees
A case can be done outpatient if the following criteria are met:
Volume aspirate < _______ cc
Case is under ____ hours
ASA Class ______
BMI less than ______
Can/cannot combine liposuction with other procedures
Cases should end by _____
Volume aspirate < 5000 cc
Case is under 6 hours
ASA Class 1 or 2
BMI less than 35
Can combine liposuction with other procedures
Cases should end by 3PM
Describe the location of Reserve fat of Illouz and why it is a good target for liposuction?
Deep to Scarpa's
It has less risk for focal contour abnormalities and improves overall contour
To minimize risk of toxicity, the wetting solution lidocaine dose should be less than: ___ mg/kg
<35 mg/kg
The risk of pulmonary fat embolism after liposuction can be increased in patients with what lab finding pre-operatively?
Low serum albumin pre-op
Nerves associated with the frontal migraine trigger site are:
supraorbital and supratrochlear nerves
Cellulite of adiposity results from hypertrophied superficial fat and responds to weight loss.
Cellulite of laxity results from generalized soft tissue redundancy and laxity and does not respond to weight loss. It is only correctable surgically.
Laser assisted liposuction has a higher rate of this complication, and should not be combined with what procedure?
Higher risk of skin burns, should not be combined with skin resection
Peak plasma concentrations of lidocaine are reached how long after administration?
6-12 hours
What is the treatment for lidocaine toxicity? What if there's cardiac involvement?
Benzos and supportive care
Can add lipids if bupivacaine was used of if there's cardiac involvement
Name the eyebrow depressors
Depressor supercilli
Oblique head of the corrugator supercilli
Orbicularis
Procerus
Name any 7 risk factors yielding points to a patient's Caprini Score
Describe the mechanics of ultrasound assisted lipsuction
Cavitation is created by pulsatile waves of ultrasonic energy, which preferentially liquefies adipocytes during suctioning.
How long after liposuction can postoperative hypovolemia (secondary to fluid shifts) occur?
12-36 hours
Name at least two signs each of early, intermediate, and late lidocaine toxicity
Early signs
Circumoral numbness
Drowsiness
Tinnitus
Intermediate signs
shivering
muscle twitches
AV dissociation
death
Late signs
Seizure
coma
death
What medications can you give a patient who is returning to the OR for a retrobulbar hematoma evaluation after a blepharoplasty? (Name 3)
Mannitol, Steroids, Acetazolamide
Can also elevate HOB and perform a bedside canthotomy