SEBASTIEN GARSON M.D
This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.
• DEFINITION OBJECTIVES AND PRINCIPLES
As soon as the first liposuction were performed, Plastic Surgeons had the idea to reuse the extracted fat and to reinject it into another part of the body, for the purpose of filling.
This technique reinjection of autologous fat called lipo-filling, has long been disappointing: the reinjected fat tended to absorb a significant proportion, making random and ephemeral results.
However Plastic Surgeons does not stop at these early disappointments and tried to understand the reasons for these failures. Stage by stage, the results improved, but especially from 1995 reinfusion of autologous fat, also called Lipostructure has become a truly reliable method (S. COLEMAN).
The principle is to achieve true self-grafting of fat cells by reinjection of the patient taken from the fat itself.
Lipostructure can be applied to a large number of depressions (troughs) natural or post-traumatic. We can summarize the objectives and directions of this type of intervention as follows:
1. Indications for aesthetic:
- Filling and mitigation of some wrinkles, especially on the face,
- The restoration of "fullness" of a thin face or in the early stages of facial aging.
- The restoration of volumes and shapes of the face: it may include the restoration of a gaunt face with aging.
- An additional associated with certain head and neck facelifts to improve facial harmony.
-Secondarily, after a first facelift to improve the contour of the middle third of the face without the need for a new facelift.
2. The indications restorative and reconstructive surgery:
- The filling of tissue depression following trauma,
- Correction of secondary irregularities liposuction bad conduct,
-The correction of fat fonts after HAART tasks the HIV + patients.
It should be borne in mind that lipostructure must always be regarded as a true surgical procedure that must be performed by a competent and qualified plastic surgeon, trained specifically for this type of technology and working in a surgical context..
• BEFORE THE OPERATION
We have performed a thorough study, clinical and photographic corrections to be made. Particularly in terms of lipostructure facial rejuvenation, it will be studied on photographs
youth, compared to the current state, the terms of aging.
A preoperative assessment is carried out according to regulations.
The anesthesiologist will be seen in consultation at least 48 hours before surgery.
No medication containing aspirin should be taken within 10 days before surgery.
• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION
Type of anesthesia:
Lipostructure is usually performed under local anesthesia depth by tranquilizers administered intravenously (anesthesia "vigil"). One can also use a local anesthetic or even anesthesia
General. The choice between these techniques is the result of a discussion between you, the surgeon and the anesthetist.
Terms of admission:
This surgery is almost always performed on an outpatient basis, the input and output by the same day. It is necessary to return an hour before the scheduled
intervention, being fasted for 6 hours. The output will generally take three to five hours after the end of the intervention.
Each surgeon adopts a technique of its own and it adapts to each case to obtain the best results. However, it may hold common basic principles:
We begin by making precise identification of areas of fat removal, as well as sites of feedback.
Removal of the adipose tissue is performed by an atraumatically microincision hidden in natural folds, using a very thin suction cannula.
We have chosen a discrete area where there was a reserve, or excess fatty tissue.
This is followed by centrifugation for a few minutes to separate intact fat cells, which are grafted, elements that are not transplantable.
Reinjection of the fat tissue is made from 1 mm incisions using micro-cannulas.
One proceeds to injection of micro particles of fat in different planes and in multiple different directions and to increase the contact surface between the implanted cells and the recipient tissue, which will ensure the survival of the transplanted fat cells . Insofar as it is a true transplant living cells, and provided that the technique is good and making effective graft and grafted cells remain alive in the body, which is technical lipostructure a final technical as well grafted fat cells live as long
that fabrics that are around them.
The duration of the procedure depends on the amount of grease is fed back and the number of locations to be treated. It can vary from 30 minutes to 2 hours in case of isolated lipostructure.
AFTER THE INTERVENTION: THE OPERATING SUITES
In the postoperative course, the pain is generally low. Tissue swelling (edema) occurs during the first 48 hours after surgery and will usually 5 to 15 days to be fully absorbed.
Bruising (blue) appear in the first few hours at the areas of regenerative fat: they are absorbed within 10 to 20 days after surgery.
Thus, if the physical recovery is usually rapid due to the light and superficial nature of the intervention, it will be necessary to carefully consider the importance of social embarrassment driven by the swelling and bruising to adapt his life family, professional and social. It should not be exposed to sunlight or UV regions operated at least 4 weeks before, implying the risk of permanent pigmentation. After absorption of edema phenomena and bruises, the result begins to appear within 2 to 3 weeks after surgery.
• THE RESULT
It is appreciated within 3 to 6 months after surgery.
It is usually satisfactory, whenever the indication and technique were correct: the depressions are generally filled and recovered volumes.
Insofar as the grafting of fat cells actually taken, we have seen that these cells remained alive as long as remain living tissue in which they were grafted.
However, the result will gradually deteriorate because of the natural continuation of the same tissue aging.
• FAULTS OF THE RESULT
We have seen that most often lipostructure properly indicated and performed a real service rendered to the patient (s), with obtaining a satisfactory and consistent with what was expected result.
In some cases, localized imperfections can be observed (not that they are real complications): hypo-localized correction, slight asymmetry irregularities.
They are generally accessible to further treatment: small "touch" lipostructure under local anesthesia from the 6th postoperative month, the patient has been informed of the potential opportunity to improve the result.
• POSSIBLE COMPLICATIONS
Lipostructure, although carried out mainly for aesthetic reasons, are nevertheless a real surgery, which involves the risks associated with any medical procedure, however small it may be.
We must distinguish the complications of anesthesia and those related to the surgery.
For anesthesia, during the consultation, the anesthetist inform himself the patient anesthetic risks. You should know that anesthesia in the body sometimes unpredictable, and more or less easy to control: the fact of using a fully qualified anesthetist, working in a surgical context, that the risks are now almost statistically insignificant. You should know, indeed, that the techniques, anesthetics and monitoring methods have made tremendous progress over the past twenty years, providing maximum security, especially when the operation is performed outside of the emergency and in a healthy person.
Regarding surgery: choosing a qualified and competent plastic surgeon, trained in this type of surgery, you limit these risks, without removing them completely. In fact, the real complications are rare after lipostrusture quality: a great rigor in the placement of the surgical indication and implementation must ensure, in practice, an efficient and effective prevention, including mosses cannulas respect the skin, blood vessels and nerves. The infection is normally prevented by the prescription of antibiotics before and after surgery.
The most common complication after lipostructure is a hyper-correction, it is related to the re-injection of an excessive amount of fat and results in an excess correction responsible for excess volume which can be unsightly.
This overcorrection quickly becomes permanent and treatment is difficult because it can not readily be achieved generally by a simple liposuction: most often, in fact, only one reoperation with a real surgical removal of excess fat will correcting such overcorrection.
In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.
These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.
Phone : + 33344282959
7 impasse de la Passerelle 60300 SENLIS
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