The Hamster as a Model for Human Ingestive Behavior
Ruth B.S. Harris in Appetite and Food Intake, 2017
Partial lipectomy is the surgical removal of individual fat depots that results in a reduction in total body energy stores but differs from fat loss caused by an energy deficit because the size of the fat cells in the remaining fat depots do not change. Over time, the animals correct for the loss of fat by enlargement of remaining depots (Hausman et al. 2004). Removal of two major fat depots (inguinal and epididymal) from Siberian hamsters (Wood and Bartness 1997) has been shown to increase hoarding but not change food intake in the lipectomized animals. Hoarding returns to control levels as body fat and body weight are restored. There is no relation between the amount of fat removed and hoard size, but loss of gonadal fat (epididymal) results in a greater increase in hoarding than removal of subcutaneous fat when the cost of foraging is increased (Dailey and Bartness 2008), suggesting that fat required for support of essential physiological functions such as reproduction may have a greater impact on appetitive behavior.
Surgical Rejuvenation of the Ageing Face
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
A wide variety of liposuction cannulas exists, ranging from flat to round-tipped with an array of suction port designs. Surface irregularities appear to be minimized with the use of smaller cannulas. We prefer pre-tunnelling with a 2 mm cannula followed by applied low suction. The cannula is inserted into the subcutaneous space between the dermis and platysma. The dominant hand controls movement of the cannula while the contralateral hand guides tip position. Pre-tunnelling involves limited dissection to facilitate passage of the larger cannula. Liposuction is performed by dissecting with the cannula in radial fashion away from the incision. One atmosphere (760 mmHg) of negative pressure is usually sufficient. The suction port should always be directed away from the skin to minimize dermal trauma and dimpling. Uniform suctioning is performed across the submental triangle down to the hyoid bone. Liposuction should be limited near the inferior border of the mandible to avoid injuring the marginal mandibular branch of the facial nerve. Periodic inspection of the skin using the ‘pinch and roll’ technique helps determine the degree and extent of liposuction required. A sufficient amount of fat should remain to preserve natural skin cushioning.
Vulvar cancer and post-vulvectomy complications
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
Suction-assisted protein lipectomy (SAPL) removes the excess solid volume remaining in the limb affected by lymphedema after the fluid component has been reduced with nonsurgical, conservative treatment. The procedure is performed under general anesthesia and excess fatty tissue from the affected area is aspirated using power-assisted liposuction cannulas. This particular technique has been shown to reduce large volumes of proteinaceous fatty tissue, with reductions in leg diameter of up to 86% after 1 year of follow-up (72). Moreover, some studies revealed further reductions over an 8–15-year period (93,129). The incidence of cellulitis is also decreased significantly (over 75%) after the SAPL procedure (72,130). After this approach, a specialized lymphedema therapist should be involved early on. Custom-fit compression garments must be placed immediately after the end of the surgical operation in the operating room. SAPL does not influence the pathophysiology of lymphedema and for this reason patients should continue compression in order to prevent lymphedema recurrence. Furthermore, custom-fit, flat-knit garments should always be re-measured as the volume decreases in the follow-up period. The safety of SAPL has been established and it has been shown that there is no further damage caused to the affected lymphatic flow area (131). Among the possible complications of SAPL are nerve damage, vessels disruption, and, rarely, further damage of lymphatic vessels (72).
Women’s experiences of living with lipedema
Published in Health Care for Women International, 2022
Catharina Melander, Päivi Juuso, Malin Olsson
Lipedema is a chronic, progressive disease with an unknown etiology that almost exclusively affects women. The disease is underdiagnosed and often misdiagnosed as obesity or primary lymphedema. In lipedema, abnormal depositions of subcutaneous fat cause bilateral swelling and enlargement of the buttocks and legs, which develop slowly and gradually. Lipedema is associated with discomfort, bruising, and severe pain in affected areas, as well as limited mobility. Typically, the disease starts during or soon after puberty, but it can also start in connection to pregnancy or menopause. Since the progression of lipedema varies to a great extent, it is difficult not only to predict the course of the disease but also to control it. There are no easy solutions to treat lipedema. Conservative therapy is often used, which focuses on patient education, weight control, manual lymphatic drainage therapy, and compression therapy. Surgery, such as liposuction, may also play a part in the management of the disease. Lipedema is associated with both physical and psychological morbidity, making it vital to provide adequate care and support (Buck & Herbst, 2016; Forner-Cordero et al., 2012; Langendoen et al., 2009). Lipedema concerns the women’s health and the disease has no known geographical boundaries. While the hidden statistics are probably large, epidemiological studies suggest an approximately 10–15% prevalence in the female population worldwide (Buck & Herbst, 2016; Forner-Cordero et al., 2012).
Liposuction for large facial involuted infantile hemangiomas in children: clinical evaluation and management strategies
Published in Journal of Dermatological Treatment, 2021
Wei Gao, Yajing Qiu, Yunbo Jin, Xiaoxi Lin
Infantile hemangioma (IH) is one of the most common benign tumor seen in infancy. What distinguishes IH from other benign tumors is their special proliferating and involution phases. Although administration of oral beta blockers has greatly improved the outcome, the residual deformities after involution, such as redundant, atrophied, wrinkled, or discolored skin with or without a variable amount of fibrofatty residue underneath, still plague surgeons (1). In our clinical experiences, common surgical techniques for the treatment of these sequelae are aggressive and leave scars. Liposuction is a less invasive procedure and commonly used in esthetic surgery of the body and facial outline. Some case reports (2,3) have also confirmed its feasibility for large involuted IH. However, the patient outcome is uneven. Therefore, we conducted a study to explore the affecting causes of the uneven outcome and provide a comprehensive overview of clinical evaluation and management strategies.
Development of large-scale manufacturing of adipose-derived stromal cells for clinical applications using bioreactors and human platelet lysate
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2018
Mandana Haack-Sørensen, Morten Juhl, Bjarke Follin, Rebekka Harary Søndergaard, Maria Kirchhoff, Jens Kastrup, Annette Ekblond
Liposuction (approximately 100–150 mL lipoaspirate) from abdominal subcutaneous fat was performed under local anesthesia, on three healthy volunteer donors, two female (age 41 and 46) and one male (age 48), that underwent cosmetic surgery (Printzlau Private Hospital, Virum, Denmark). The use of lipoaspirate has been approved by The National Committee on Health Research Ethics, protocol no. H-3-2009-119. All donors signed an informed consent. Lipoaspirate was processed as previously described, to obtain stromal vascular fractions (SVF) for ASC expansion [5,13]. Briefly, the adipose tissue was washed with phosphate buffered saline (PBS) (Gibco Life Technologies, Waltham, MA, USA), digested by incubation with collagenase NB4 (0.3 U/mL) (Serva GmbH), dissolved in Hank’s Balanced Salt Solution (10× HBSS + CaCl2 + MgCl2) (Gibco, Life Technologies), and diluted to a concentration of 2 mM Ca2+, followed by inactivation, filtration, and centrifugation.
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