Abdominal and bowel perforations are reported as the second commonest lethal event (14.6%). To reduce the risk of perforation, the cannula tip has always to be accompanied by the palm, in particular in obese patients, in whom it is difficult to visualize the cannula, and the position should be hyperextension of the abdomen and severe abdominal pain should always suggest the occurrence of a possible perforation, which may require a laparotomy [2], [93], [94]. Liposculpture takes about two to four hours. The exact time depends on how many areas you need treated. Ultrasonic liposuction was embraced initially in South American and Europe and then largely rejected after experience with skin sloughs, burns, and seromas [34]. The current options for anesthesia are dry, wet, superwet, and tumescent. The essential differences between these techniques focus on the amount of infiltrating solution injected into the tissues and the resultant blood loss as a percentage of aspirated fluid. The dry technique involves no infused fluid and results in approximately 25–40 percent blood loss of the volume removed. Blood loss has been estimated to represent approximately 1 percent of the liposuction aspirate volume for both tumescent and superwet techniques [83], [84].

Diet and exercise, even if performed correctly, are not enough to reduce the disproportion between the upper and lower body. Indeed, sometimes, they make the anesthetic dispensation more noticeable, as the patient slides only in the upper body of the body [47], [48]. Skin and subcutaneous excision significantly improve the size and shape of the limbs; however, it may be associated with severe complications. Suction-assisted lipectomy may be a good surgical option given the diffuse nature of lipedema adipose hypertrophy and it may be combined with limited skin and subcutaneous tissue excision in cases of persistent redundant skin [48], [9]. With appropriate patient selection and minimally traumatic techniques, many complications can be avoided. Small incisions are performed in different places depending on the area to be treated, but always designed to hide the small surgical scar [16]. Petto: alcuni uomini possono accumulare grasso sottocutaneo nel petto, che può essere aspirato e usato, ad esempio, per riempire le rughe o le labbra, qualora le abbiano molto sottili e ciò rappresenti fonte di disagio.Laser-lipolysis began to spread after the publication of the studies about the interaction between laser and adipose tissue, conducted by Apfelberg [35] and Apfelberg et al. [36], [37] in 1992.

smettere di fumare nelle due settimane precedenti l’intervento, dal momento che il fumo ritarda i tempi di guarigione; Major risk factors for the development of severe complications are multiple procedures, poor standards of sterility, excessive infiltration and intoxication from lidocaine or adrenaline, excessive removal of adipose tissue with volume depletion in the third space, permissive postoperative discharge, and selection of unfit patients [92]. Lillis demonstrated that the Klein's tumescent technique offered significant reduction in blood loss, even in suction case of over 3L. He verified, also, that Klein's work demonstrating minimal plasma absorption of lidocaine when low concentration solutions were infused [22], [23].In this way, Zucchi tried to make aspiration easier and to preserve the neurovascular structures, which can be destroyed by the cannulas. In casi rari può anche verificarsi necrosi adiposa, cioè la morte delle cellule adipose superstiti nel sito di prelievo, dovuta alla riduzione dell’apporto di sangue e, con esso, di ossigeno e nutrienti. Collasso cardiocircolatorio. Liposcultura significa trasferire il grasso dalle zone in eccesso (liposuzione) a quelle in difetto (lipofilling), per rendere le forme più armoniose e far apparire più giovani, nel momento in cui il grasso viene usato per riempire le rughe e i contorni di viso e mani.