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Table 1: Summary of references
Chronic disease Number of patients Author
Dercum’s disease 114 Hansson et al. [16]
2 De Silva and Earley [18]
Subcutaneous 16 Al-Basti and
lipomas El-Khatib [19]
Posttraumatic 23 Aust et al. [20]
a b lipomas
Figure 6: Right‑hand reconstruction using perforator muscle skin flap. Lymphoedema 200 Kissin et al. [22]
(a) Six months postoperative and (b) immediate postliposuction images 136 Segerström et al. [23]
54 Werngren-Elgström
and Lidman [24]
POSTIRRADIATED SKIN 134 O’Brien et al. [25]
N/A Brorson [26]
Radiation dermatitis results from prolonged exposure of skin Axillary 88 Ottomann et al. [29]
to ionizing radiation. It can be seen in patients receiving hyperhidrosis 43 Seo et al. [28]
[33]
radiation therapy, with or without adjuvant chemotherapy. [34] Postablative An online review of 60 Claro Jr et al. [32]
reconstruction articles, 4601 patients
Inflammation of the skin after exposure to the 17 Coleman [35]
radiotherapy (radiodermatitis) can be classified to three N/A Lazzeri et al. [31]
specific types of radiodermatitis: acute radiodermatitis, Radiodermatitis N/A Bernier et al. [34]
chronic radiodermatitis, and eosinophilic, polymorphic, 68 Sarfati et al. [38]
and pruritic eruption associated with radiotherapy. Debulking of flaps 16 flaps in 15 patients Reuben et al. [40]
Radiation therapy can also cause radiation skin cancer. 8 flaps in 7 patients Hallock [41]

Radiodermatitis can be successfully treated by Multiple systemic- N/A Bassetto et al. [14]
lipomatosis
El-Khatib
[13]
implantation of fat graft harvested from liposuction. The
lipofilling procedure was first performed by Coleman. [35‑37] N/A: Not available
After radiation treatment, breast reconstruction with an for recontouring bulky skin flaps. Most papers recommend
implant carries a high risk of failure and complication. debulking three months after initial procedure.
Clinical and experimental studies have demonstrated
that adipose tissue graft (lipofilling) in the irradiated area
enhances skin atrophy. Sarfati et al. [38,39] reported the use COMPLICATIONS OF LIPOSUCTION
of lipofilling to the irradiated skin before the implant
breast reconstruction. Safarai claimed that the lipofilling Severe complications have been reported and include
[45]
will decrease the risk of breast Implant exposure. necrotizing fasciitis, [44] toxic shock syndrome,
perforation of inner organs, and pulmonary embolism.
[47]
[46]
DEBULKING OF FLAPS These complications were mostly due to inappropriate
patient selection, use of excessive local anesthesia during
mega‑liposuction (tumescent technique) and inadequate
Patients often complain about an enlarged or bulky
appearance after fasciocutaneus and myocutaneus flap postoperative surveillance based on literature review,
the complication rate usually reflects a lack of medical
reconstruction.
experience.
Conventional liposuction can be used to debulk the skin Liposuction has gained popularity and has become the most
flap without fear of tissue necrosis [Figure 6].
frequent esthetic procedure for adipose tissue reduction
Single‑stage debulking of flaps using suction‑assisted and treatment of lipedema. Liposuction is also a suitable
lipectomy combined with skin excision is a safe and treatment for chronic medical conditions like lymphedema,
reliable procedure with results comparable to conventional benign adipose tissue diseases, radiodermatitis,
multistaged surgical techniques. In 2010, Reuben re‑contouring skin flaps from previous procedures and
et al. reported on the efficacy and safety of power breast reconstruction. This intervention is not without risks
[40]
assisted suction lipectomy for debulking fasciocutaneus and requires extensive knowledge and training to prevent
flaps in upper and lower extremity. Reuben operated on irreversible medical or esthetic complications.
16 lower extremity flaps of 15 patients and recommended
the use of liposuction as an adjunct in debulking and REFERENCES
contouring skin flaps.

Hallock [41‑43] reported successful use of traditional 1. Charlotte B. Exploring funerary, beliefs and mummification. In: Charlotte B,
liposuction for debulking perforator muscle flaps, and free editor. The Ancient Egyptians for Dummies. England: John Wiley and Sons;
2011. p. 189.
flaps elsewhere. 2. Teimourian B, Fisher JB. Suction curettage to remove excess fat for body
contouring. Plast Reconstr Surg 1981;68:50‑8.
Overall, literature review [Table 1] showed good outcomes 3. Fournier PF, Otteni FM. Lipodissection in body sculpturing: the dry procedure.
for suction‑assisted lipectomy as an adjuvant procedure Plast Reconstr Surg 1983;72:598‑609.

Plast Aesthet Res || Vol 2 || Issue 1 || Jan 15, 2015 5