In the Journals

Liposuction shows utility for multiple systemic lipomatosis, other chronic medical conditions

A literature review identified chronic medical conditions, such as multiple systemic lipomatosis, dercum’s disease and others, where liposuction has been shown to be effective in providing a stable cure.

Hamdy Abuelhassan El-Khatib, MD, conducted an online search of the Cochrane Library, MEDLINE, Embase and SciELO. A total of 47 original articles were identified that reported on the limitations of liposuction for treatment of noncosmetic and disabling medical conditions from 1982 to February 2014. The articles were selected based on their originality and their inclusion of a large sample size.

According to El-Khatib, the literature review revealed a broad agreement regarding the applicability and efficacy of liposuction for treating multiple systemic lipomatosis, dercum’s disease, chronic lymphedema and axillary hyperhidrosis.

With regard to adipose tissue diseases, El-Khatib reported traditional liposuction was shown to be the primary method of treatment.

For multiple systemic lipomatosis, the review revealed a study by Bassetto et al., in which ultrasound-assisted liposuction was used with favorable results compared with traditional lipectomy. This was due to a reduction of blood loss and reduction of effort produced by the surgeon.

In decrum’s disease, Hansson et al. suggested liposuction may alleviate pain; however, it was difficult to determine whether this was due to the actual surgery or to other factors, according to EL-Khatib. De Silva and Earley used liposuction in two decrum’s patients and recommended the treatment as it had a low morbidity and was well-tolerated in elderly patients.

Treatment of this condition is usually targeted on pain relief rather than lipoma removal. El-Khatib reported a lack of scientific data for treatment or prevention of decrum’s disease.

For subcutaneous lipomas, Al-basti and El-Khatib reported using traditional liposuction for the treatment of subcutaneous capsulated giant and moderate-sized lipomas. They reported no reoccurrence, and the cosmetic outcome was favorable.

For posttraumatic lipomas, Aust et al. used the simple excision method for 22 cases and liposuction method in one case and recommend both techniques, according to El-Khatib.

In chronic lymphedema, O’Brien et al. and Brorson first reported the use of liposuction to reduce the size of lymphedema of an extremity. Liposuction demonstrated significant and stable reduction of both upper and lower limbs lymphedema. The treatment was also recommended for acquired and congenital lymphedema.

Traditional liposuction was also shown to be safe in the debulking perforator muscle flaps and free flaps elsewhere. Additionally, suction-assisted lipectomy showed positive outcomes as an adjuvant procedure for recontouring bulky skin flaps, according to El-Khatib.

The author concluded that although severe complications have been reported, they are mostly due to improper patient selection, use of excessive local anesthesia and inadequate postoperative surveillance. – by Abigail Sutton

Disclosure: El-Khatib reports no relevant financial disclosures.

A literature review identified chronic medical conditions, such as multiple systemic lipomatosis, dercum’s disease and others, where liposuction has been shown to be effective in providing a stable cure.

Hamdy Abuelhassan El-Khatib, MD, conducted an online search of the Cochrane Library, MEDLINE, Embase and SciELO. A total of 47 original articles were identified that reported on the limitations of liposuction for treatment of noncosmetic and disabling medical conditions from 1982 to February 2014. The articles were selected based on their originality and their inclusion of a large sample size.

According to El-Khatib, the literature review revealed a broad agreement regarding the applicability and efficacy of liposuction for treating multiple systemic lipomatosis, dercum’s disease, chronic lymphedema and axillary hyperhidrosis.

With regard to adipose tissue diseases, El-Khatib reported traditional liposuction was shown to be the primary method of treatment.

For multiple systemic lipomatosis, the review revealed a study by Bassetto et al., in which ultrasound-assisted liposuction was used with favorable results compared with traditional lipectomy. This was due to a reduction of blood loss and reduction of effort produced by the surgeon.

In decrum’s disease, Hansson et al. suggested liposuction may alleviate pain; however, it was difficult to determine whether this was due to the actual surgery or to other factors, according to EL-Khatib. De Silva and Earley used liposuction in two decrum’s patients and recommended the treatment as it had a low morbidity and was well-tolerated in elderly patients.

Treatment of this condition is usually targeted on pain relief rather than lipoma removal. El-Khatib reported a lack of scientific data for treatment or prevention of decrum’s disease.

For subcutaneous lipomas, Al-basti and El-Khatib reported using traditional liposuction for the treatment of subcutaneous capsulated giant and moderate-sized lipomas. They reported no reoccurrence, and the cosmetic outcome was favorable.

For posttraumatic lipomas, Aust et al. used the simple excision method for 22 cases and liposuction method in one case and recommend both techniques, according to El-Khatib.

In chronic lymphedema, O’Brien et al. and Brorson first reported the use of liposuction to reduce the size of lymphedema of an extremity. Liposuction demonstrated significant and stable reduction of both upper and lower limbs lymphedema. The treatment was also recommended for acquired and congenital lymphedema.

Traditional liposuction was also shown to be safe in the debulking perforator muscle flaps and free flaps elsewhere. Additionally, suction-assisted lipectomy showed positive outcomes as an adjuvant procedure for recontouring bulky skin flaps, according to El-Khatib.

The author concluded that although severe complications have been reported, they are mostly due to improper patient selection, use of excessive local anesthesia and inadequate postoperative surveillance. – by Abigail Sutton

Disclosure: El-Khatib reports no relevant financial disclosures.