Objectives: Tumescent local anesthesia (TLA) consists of infiltration of saline solution with lidocaine and epinephr- ine into the tissues to obtain regional anesthesia and vasoconstriction.From 2010 to 2017, 30 patients underwent primary intra-muscular gluteal augmentation with lipofilling under TLA and conscious sedation. The tumescent solution was prepared with 25 mL of 2% lidocaine, 8 mEq of sodium bicarbonate, and 1 mL of epinephrine (1 mg/1 mL) in 1000 mL of 0.9% saline solution. Firstly, the solution was infiltrated above the major gluteal fascia, and, secondarily, during surgery, intra-muscle.
Introduction: Gluteal augmentation is one of the most popular procedures in esthetic surgery even if its scenario has changed a lot over the past 5 years. The use of tumescent local anesthesia (TLA) is a technique developed in several surgical procedures but mainly in liposuction; it consists of infiltration of large volumes of saline solution with lidocaine and epinephrine in the surgical filed . In Gluteal augmentation , TLA has not been described yet . With TLA, in intragluteal augmentation, the time of surgery is shorter, the dissection is facilitated and bleeding and postoperative pain are reduced
Materials / method: From 2017 to 2020 , 30 patients underwent bilateral pri- mary intramuscular with lipofilling gluteal augmentation. All procedures were performed in accredited outpatient clinics. The surgical team was composed of a board-certified plastic surgeon, an assistant surgeon, an operating room nurse, and a board-certified anesthesiologist. Used gluteal implants had a silicone gel content, a smooth silicone surface round shape. Gluteal anesthesia consisted of two phases, one before the incision and the second one after gluteal major muscles fascia exposure. And Only at the end we performed lipofilling
Results: During a 3-year period, we analyzed 30 female patients who underwent intra-muscular gluteal augmentation with lipofilling. All surgical procedures were performed using the TLA tech- nique. No signs of adrenaline or lidocaine toxicity were reported. Conversion to general anesthesia was never required.The average period of time from infiltration to skin incision was 40 min and it was selected by analyzing the response time of patients treated, together with the anes- thesiologist. Starting the dissection before 40 min resulted in pain in most patients. All our patients had 1 year follow-up.
Conclusion: TLA represents a safe and efficacious technique for performing Gluteal augmentation with lipofilling surgery with implant positioning either in a intra-muscular pocket. This technique has proven to have a low incidence of postoperative side effects, with good pain control throughout surgery and the immediate postoperative period , usually related with greater pain. Patients were satisfied with the technique and no intraoperative complications were recorded.This anesthesia technique must be applied together with a correct surgical technique.
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