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IMCAS World Congress 2020
Program

FOCUS ON S260

Contributed talks - Body surgery

Room: Room Passy - level 1
Date: Saturday 1 February 2020 at 11:30 to 12:30
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Prof Apirag CHUANGSUWANICH

Plastic Surgeon

Thailand

Dr Ashish DAVALBHAKTA

Plastic Surgeon

India

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
11:30	Dr Muhammad Zeeshan AHMED	Abdominoplasty using modified quilting technique and suture drain technique: day-stay combined procedures	View	96243
11:38	Dr Foued HAMZA	Subcutaneous buttock fat augmentation - What is more important: retention of fat or retention of shape?	View	97877
11:46	Dr Wael Naeem Thabet Aziz GHEBERY	Outcome of combined gluteal lipofilling with silicon cohesive implants for gluteal enhancement	View	96100
11:54	Dr Sherif Ali MAHER ABO EL MATY	Appraisal of closed active surgical drainage in high-definition torso sculpting	View	98855
12:02	Dr Bartlomiej JUZA	Ultrasound guided liposuction, first results of full leg liposculpting and macro fat reduction	View	98944
12:10	Dr Mario MENDANHA	Composite gluteal and breast augmentation - The importance of combining implants and fat grafting	View	99520
12:18	Dr Huseyin KANDULU	Advanced body liposculpting: which is true for permanent results - By leaving fat or revealing patients own musculature?	View	99840
12:26		Q&A		100406

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Buttocks (surgical)

Liposculpture

Liposuction

Body contouring (surgical)

Thighs & legs (surgical)

Dr Muhammad Zeeshan AHMED

Plastic Surgeon

New Zealand

Other author(s) : Winston McEwan

Abdominoplasty using modified quilting technique and suture drain technique: day-stay combined procedures

Objectives: Abdominoplasty performed alone or in combination with breast reduction/mastopexy or with liposuction to arms/thighs is a safe day case procedure. Effective use of LA for infiltration and nerve blocks make recovery quicker and comfortable.

Introduction: Day stay combined aesthetic procedures are increasing getting common. Often abdominoplasty can be combined with other aesthetic procedures to achieve the desired results under one anesthesia. Abdominoplasty is one of the commonest aesthetic procedure and still it continues to evolve and improve. Innovations are meant to improve patient comfort, reduce the complication rates and provide greater patient satisfaction. As with other aesthetic procedures, it’s important to have proper patient selection, risk identification and safe and effective execution of surgery to achieve optimal results.

Materials / method: The aim of the study was to review all combined procedures/abdominoplasties carried out between March 18-August 19. All cases were performed under GA combined with tumescent LA infiltration (18-20 mg/kg lidocaine) at the incision line, peri umbilicus, in and underneath the flaps, flanks and for nerve blocks (subcostal, lateral lumbar, Para rectus).
Standard abdominoplasty technique was used combined with liposuction and rectus plication. Modified 4-6 sutures quilting was used on medial and lateral rectus to reduce the dead space.
We also used suture drain in the midline wound.

Results: 200 cases were performed from March 2018 to August 2019. The mean age was 46 years and 98% were females. 94 % of these were day cases. Most of these abdominoplasties (86%) were combined procedures with other procedures; liposuction (96%), breast reduction or mastopexy (60%), medial thigh lifts and brachioplasty (12%).
The mean weight of excision was 1.4 kg. The mean surgery time was 60 min.
All patients were overall satisfied with the outcome. 1 patient had post-operative bleed(Von Willebrand’s disease). 5% had significant wound infections, 3%requiring wash out and all these required IV Abs.

Conclusion: Abdominoplasty performed alone or in combination with breast reduction/mastopexy or with liposuction to arms/thighs is a safe day case procedure. Effective use of LA for infiltration and nerve blocks make recovery quicker and comfortable. We noted in our cases that modified quilting and suture drain technique are effective in reducing the seroma formation rate.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Foued HAMZA

Plastic Surgeon

France

Other author(s) : Foued Hamza

Subcutaneous buttock fat augmentation - What is more important: retention of fat or retention of shape?

Objectives: Subcutaneous-only gluteal fat grafting is now increasingly recommended over intramuscular injection to improve safety .Despite the perception that subcutaneous injection results in less volume retention, this study shows that it can be as effective as intramuscular fat injection in retaining buttocks volume, because for the long term result it is more the retension of shape that we give to the body than the amount of the grafted fat.

Introduction: According to the latest American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery data augmentation gluteoplasty continues to gain popularity in the U.S. International Society of Aesthetic Plastic Surgery data also confirm that buttock augmentation is a fast growing trend globally

Materials / method: We have performed a retrospective analysis on the results of 500 cases on female patients who underwent liposuction surgery followed by sub-dermal lipoinjection in the gluteal area over a period of eight years from January 2010 to January 2018.

During the patient selection process, it is important to identify the patient’s goals and have a thorough discussion about the degree of augmentation possible and to set realistic contouring expectations based on the patient’s anatomic morphology

Results: The follow-up period ranges from 6 months to 4 years and differs with every patient.
In all patients liposuction was also done in areas other than those treated for gluteal improvement
To improve gluteal shape, liposuction of the lumbosacral area was done in all patients
In all patients, the same amount of fat injected in the Gluteus in each side.
The amount of fat transerred per group of patients are indicated in TABLE I
Complications from the procedure are as follows. 45 patients had a skin irregularties in the liposuctionned areas that lead to a second session for crrection under local

Conclusion: Many studies focused on the process of harvesting, processing, and injection, and the effect on the transient ischemia, that could be stressful to adipocytes can lead to cell death and volume loss. This is the first study to examine the evaluation of the long term retension of shape with the powerfull reshaping of the body contour with the liposuction that the unpredictable retension of the amount of the grafted fat

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Wael Naeem Thabet Aziz GHEBERY

Plastic Surgeon

Egypt

Other author(s) :

Outcome of combined gluteal lipofilling with silicon cohesive implants for gluteal enhancement

Objectives: A butt augmentation with implants and fat transfer is a great option for patients that want the maximum amount of projections, improve their overall shape and still want to have a natural feel to their buttock

Introduction: Buttock augmentation is a challenging issue in atrophied buttocks related to personal variation of women. Here, we describe a modification combining gluteal implants and fat grafting to obtain a successful outcome without implant edge visibility and palpability
The buttock implant is used for the overall projection and volume of the buttock. This is great for patients that have a limited amount of fat available for transfer or what a significant amount of projection and size to their buttock.
The combination of butt implants and fat transfer can make a dramatic difference for patients in terms

Materials / method: Twenty women with small buttocks underwent gluteal augmentation over a 2-year period. The gluteal implants were placed in the intramuscular plane to obtain optimal filling and expansion of small buttocks. Autologous fat grafting was performed above the gluteal thigh sulcus to prevent implant visibility and palpability due to insufficient soft tissue coverage

Results: The results of buttock augmentation are immediately visible; however, we did not see our final results until 3-6 months after the surgery, as it takes a while for the fat to "take." This procedure offers natural looking and feeling results, but the projection of the buttocks may decrease over time. Some of the initial volume we experience after our fat grafting procedure will fade as the fat is absorbed by our body ( on the average patients will retain 60-80% of the transferred fat, in some cases more in others less). Satisfaction with their new image should continue to grow as they recover

Conclusion: Gluteal filling can be combined with silicone implant for gluteal enhancement,safely
Also liposclupure of flanks give better shap and profection tighter with use of fat for filling the infragluteal and lateral areas
Still we need more study to get better results

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Sherif Ali MAHER ABO EL MATY

Plastic Surgeon

Egypt

Other author(s) :

Appraisal of closed active surgical drainage in high-definition torso sculpting

Objectives: Seroma formation is one of the most common complications of (VAHDL)that should be prevented to preserve sculpting results. There is nearly a consensus in literature about the active role of the surgical drainage in preventing this complication; however the type of this surgical drainage remains an issue of. Most of the previous studies have depended on the open drainage with many regards about the need for frequent dressing change. This study was designed to do an appraisal on the closed active drainage as a more convenient substitute for torso HDL patients.

Introduction: HDL has been surrounded by a many types of avoidable complications .acute fluid collection due to the traumatic irritation of the tissues is one of those common complications which can occur especially with torso liposculpting and should be prevented to preserve sculpting results .
The value of surgical drainage as one of the acute fluid collection preventing measures which guards the HDL results comes; however drainage system type remains an issue of dispute that is still subjected to literature evaluation.

Materials / method: A prospective case series study was carried out on 120 VAHDL patients presented with limited torso areas of fat accumulation.After finishing the steps of infiltration and emulsification and liposculpture and framing of the muscles and final contour closed suction drains (Surgivac) were left in the lower dependent incisions for 2 to 5 days (amount less than 50 cc per day) together with the use of mild-compression garment for at least 4 weeks. Postoperative follow up was scheduled at 1, 4, 8, 12 and 24 weeks for all patients to evaluate its effect and rate of reduction of incidence of seroma.

Results: Many advantages, closed active drainage has achieved in the current study; it eliminates the dead space, prevents fluid accumulation,decrease seroma to 1.6% enables accurate volume recording, eliminates the need for frequent dressing , achieved less postoperative pain, ecchymosis, time needed for wearing garments and gives more advanced results than the other studies that adopt open drainage regarding seroma formation and rapid recovery of postoperative edema and unmasking of sculpting aesthetics.
On the other hand there was a problem of the clogged drains in few numbers of the patients.

Conclusion: Current study has done an appraisal on the closed active drainage as a more convenient substitute for torso HDL patients.with less rate of complications and incidence of seroma and better results.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Bartlomiej JUZA

Plastic Surgeon

Poland

Other author(s) :

Ultrasound guided liposuction, first results of full leg liposculpting and macro fat reduction

Objectives: The purpose of the presentation is to present ultrasound guided liposuction and macro fat reduction. In particular, author has focused on the treatment of lipedema - fat edema of the lower limbs and pelvis. The basic question asked by the author of the presentation is whether it is possible to effectively reduce the rich vascularized area of the lower limbs.
The effects of the treatments carried out so far are presented and the postoperative recovery procedure of the patient is described together with postoperative procedures in order to achieve the best visual effects.

Introduction: Lipedema is a chronic condition that occurs almost exclusively in women and manifests as symmetrical buildup of painful fat and swelling in the limbs, sparing the hands and feet.
If the distribution of fat tissue is incorrect - "fat and painful legs" in relation to the rest of the body - we can recognize lipedema - fatty swelling of the lower extremities, pelvis and buttocks.

Materials / method: Author of the presentation is presenting 1 year treatment feedback results. Presentation is showing author's own procedure protocol based on 65 patients.

Results: Results are being showed on the pictures before/after. The range of changes after the treatment occurs as decreasing of the fat tissue thickness from 1 cm to 6,5 cm, circumference difference from 1,5 to 18 cm depending on the level of the lower limb.

Conclusion: For patients after lower limb liposculpting there is not only change in the external appearance and life comfort
but also this treatment has a decisive impact on improving patients well-being,
self-esteem and self-confidence
which can be seen in the total change of the patient's image and dressing style.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Mario MENDANHA

Plastic Surgeon

Portugal

Other author(s) :

Composite gluteal and breast augmentation - The importance of combining implants and fat grafting

Objectives: Understand the importance of both projection and shape in buttocks surgery and breast surgery. Understand the differences and similarities between the evaluation of these anatomical regions. Understand the role of implants to treat projection and fat grafting to treat shape.

Introduction: Projection and shape are two different characteristics to take into consideration when we want to access the gluteal and the breast regions of the female body. When considered in a limited perspective, the results are suboptimal. Combining liposculpture of the adjacent region of both gluteal and breast regions with implant and fat grafting, we can achieve superior results.

Materials / method: The author analysis the importance of combining fat grafting with stable polyurethane covered breast implants in Composite Breast Augmentation. Taking the same principles in consideration, the author analysis the impact of combining liposculpture of the gluteal region with submuscular smooth small implants and subcutaneous fat grafting in Composite Gluteal Augmentation.

Results: The achieved results with these approaches are superior than using implants or fat grafting alone. The surgical time is not substantially increased, when we compare the different possible results with these techniques.

Conclusion: Composite Breast and Gluteal Augmentation share the same principles, but use different technical approaches. The results are superior than using implants or fat grafting alone and the complication rates are lower.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Huseyin KANDULU

Plastic Surgeon

Turkey

Other author(s) :

Advanced body liposculpting: which is true for permanent results - By leaving fat or revealing patients own musculature?

Objectives: In the field of plastic surgery liposuction succeeded in becoming the most frequently performed cosmetic surgery procedure during the last decade in both man and women. First liposuction was described with curettage technique and then dry , wet and superwet techniques performed as suction assisted liposuction (SAL). The first aim with liposuction is removing exces fat and making body smaller. On the otherhand in last years everything was changed and liposuction techniques are become different due to understanding fat anatomy under the skin.

Introduction: In order to get better results all innovative plastic surgeons need more superficial liposuction with less complication, so more dynamic liposuction or liposculpture techniques was essential.

When we want to get shaping on the body we have to do more superficial liposuction. In this point plastic surgeons needs to get experience about dynamic zones , transition zones , positive and negative spaces. This zones provide us as a key what will be go and what will be left. Advanced body liposculpting provides more attractive and more successfull results.

Materials / method: As we are aware the ideal male body form is V shape and the ideal female body form is S shaped therefore this technique focused to succeed this body forms. In order to achieve the ideal body form ,deltoids, pectorals , latissimus, abdominal rectus muscle and external oblique muscles are the most important dynamic parts in males. Between this muscle groups have transition and negative zones. Also we have positive zones that fat stays above the muscles. The most important regions in females are tummy , waist, thighs , as weel gluteal area.

Results: Some surgeons keep the fat on positive zones and thinks they can achive more definition , this however is not the case. In order to achive permanent , attractive and naturel results most important part of surgery is patient selection. Even if you use the best technique you can not achive best results if your patient is not eligible. Patient selection depends on the BMI, degree of skin excess, skin elasticity, patient's sportive history.Between December 2010- August 2019 , More than 1700 Patient have undergone liposculpture. 40% cases were male and 60% cases were female.

Conclusion: All patients satisfied with aesthetic results of their liposculpture within the time of follow-up. Seroma rates were %7, unsatisfied definition rates were %1 due to patient selection, hematoma rates were %1, skin necrosis did not occured.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
Yes
Please specify entities (individual, company, society): In this field ı provide advanced courses last 4 years to my colleagues. I provide this courses to my colleagues because of my experiences , ı have not any collobaration with some companies.

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS World Congress 2020 Program

FOCUS ON S260

Contributed talks - Body surgery

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2020
Program