연구논문 : 미용체형 성형수술 후 신체상과 자기존중감 및 만족도 변화연구

김영주 ( Young Joo Kim ) 한국미용학회 2007 한국미용학회지 Vol.13 No.3

The purpose of this study was to determine effects of having liposuction on physical appearance and self-esteem by evaluating patients` satisfaction with outcomes and their plastic surgeon. Study subjects were recruited from those who visited two different plastic surgery clinics based in Seoul for liposuction. Among those who decided to undergo liposuction, 110 agreed to enroll in the study. All subjects underwent liposuction during the period from May 2005 through November 2005. A questionnaire was administered to 110 respondents before when they visited the respective hospital and 30 days after surgery. The Multidimensional Body-Self Relations Questionnaire (21 assesment items), translated by Ji Tae-Ok (1997), was used as the instrument to assess physical appearance. (The instrument containing 10 assessment items, developed by Rosenberg (1962) and translated by Jeon Byung-Jae, was used to measure self-esteem. Each item was measured on a 5-point Likert scale. A SPSS program was used for statistical analysis. The t-test was performed to evaluate the frequence of having liposuction and changes in physical appearance and self-esteem. Multivariate analysis was used to evaluate patients` responses to the surgery. In summary, most of the respondents decided on their own to undergo liposuction. And 77.30% of total respondents citied their dissatisfaction with physical appearance as the main reason for undergoing liposuction. Of total respondents, 62.7 agreed that they were able to increase self-confidence significantly after surgery and 30% said they could increase self-confidence moderately after surgery. Also, 75.5% of total respondents reported significant improvement in their psychological stability after surgery, and 20.95 reported moderate improvement. Self-esteem in respondents increased given the mean scores of 3.72 before surgery and 4.12 after surgery. Respondents` perception of their physical appearance also improved showing the Overall, most of the respondents were young women in their 20s. They underwent liposuction to enhance their physical attractiveness. The level of satisfaction in patients was closely related to the response of people around them to outcomes and their own personality, in addition to general characteristics. Thus liposuction had a positive impact on patients by helping them enhance physical appearance and eventually increase their self-esteem. Such a positive effect was correlated to patients` clear motivation for having liposuction, their own positive attitude and support from people around them. Based on these variables, effective counselling or psychological intervention programs can be developed to improve outcomes in patients who considered liposuction due to their dissatisfaction with their physical appearance and consequent low self-confidence.

레이저 지방흡입술의 효과에 대한 경험적 고찰

김수철,옥재진,윤상엽 대한미용성형외과학회 2007 Archives of Aesthetic Plastic Surgery Vol.13 No.1

The 635-nm low-level laser therapy was reported to "liquefy" or release stored fat in adipocytes by causing a transitory pore in the cell membrane to open, which permitted the fat content to go from inside to outside the cell. But some data do not support the belief that low-level laser therapy treatment before lipoplasty procedures disrupts tissue adipocyte structure. The purpose of this study was to determine the effectiveness of low-level laser- assisted liposuction. The use of low-level laser-assisted lipoplasty was evaluated in a series of 90 cases. There were 2 treatment groups in the clinical study. Subjects in the test group(39 patients; 31 thighs and 17 abdomen) received only liposuction on one side and laser-assisted liposuction on the other side during early 1liter aspiration time. 51 patients in the operated group received laser-assisted liposuction on both side. After adequate infiltration was obtained in all targeted body areas, a 635-nm electric diode laser was applied to the targeted areas for 12 to 15 minutes to liquefy the fat which was extracted immediately after laser treatment. On the side which received laser-assisted liposuction of the 39 test-group patients, we could gain much fat component(71±7.2 vs 63±8.6%) and it took short time(26±5.7 vs 31±7.7 minutes). Postoperative recovery was rapid, and complications were minimal. Low-level laser-assisted lipoplasty can be a valuable adjunctive tool for the performance of lipoplasty.

Fat and muscular necrosis after liposuction

( Soo Hyun Kwon ),( Jee Woong Choi ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Liposuction is one of the most popular cosmetic surgery procedures. Although liposuction is considered a safe procedure if fundamental principles are always respected, several scientifically published papers indicate that it can cause significant sequelae if these principles are not followed. Herein, we report a case of fat and muscular necrosis after liposuction. A 60-year-old male presented with a history of a solitary asymptomatic subcutaneous mass on the right lower abdomen for over 3 years. The patient received liposuction on both sides of the abdomen 15 years ago. 4mm-punch biopsy was done primarily, which showed “thickening of collagen fibers in the deep dermis and mild septal panniculitis with features of lipoatrophy”. Moreover, abdominal CT revealed a 4.1 cm mass between the muscular layer and subcutaneous layer of the right anterior abdominal wall with internal calcification and thick enhancing wall. Therefore, we performed complete excision of the mass. Excision specimen showed fat necrosis with chronic nonspecific inflammation. The hypothesis is that liposuction can produce extensive areas of fat necrosis by facilitating the proliferation of inflammatory cells that incorporate free fat into granulation tissue, yielding so-called fat cysts that may persist and become surrounded by connective tissue and become calcified. Therefore, dermatologists should be aware of these unfavorable outcomes of “Liposuction”.

진동형 지방흡입술과 유륜절개를 통한 풀아웃법 이용한 여성형 유방의 치료

양해원,강민구,윤상엽,서상원,장충현 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.2

Gynecomastia is an abnormal increase in the volume of the male breast. Surgical techniques include a variety of incisions, excisions, suction-assisted lipopectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods. The purpose of this article is to introduce the authors` method of using power-assisted liposuction and periareolar pull-out technique. Six men were treated from June 2005 through August 2008 for gynecomastia. Fatty breast tissue is removed by power-assisted liposuction. The periareolar pull-out technique is then performed to glandular enlargement. A mean of 120cc of breast tissue was aspirated, and 18.3g of glandular tissue were excised per breast. There were no complications such as skin flap necrosis or hematoma. The cosmetic outcome was good in all and the patients' satisfaction was high. Power-assisted liposuction in combination with periareolar pull-out technique effectively corrects gynecomatia. This combination has little morbidity, minimize scars, and leads to good cosmetic results.

지방흡입술 후 초기 대사성 변화 및 고찰

양해원,조종제,서상원,장충현,이은정,심형보,홍윤기 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.1

Purpose: Advanced techniques now make it possible to remove considerable amounts of subcutaneous adipose tissue more safely with minimum blood loss. However, few have analyzed the metabolic consequences of liposuction. The purpose of this study was to identify the early effects of the surgical removal of subcutaneous fat on metabolic changes in patients who have undergone liposuction.Methods: Nineteen patients were evaluated from June 2005 to December 2005. Preoperative body weight, serums levels of lipids, apolipoprotein A1, dehydroepiandrosterone(DHEA), uric acid, insulin, and glucose were evaluated. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR), which is based on fasting glucose and insulin concentrations. All of these data were remeasured in 1 and 4 weeks postoperatively. Tumescent fluid was infiltrated using the superwet technique. The liposuction device used was a Liposlim power-assisted unit. Results: Average volumes of infiltrate and aspirate were 3,268mL and 2,892mL, respectively. Results in 1 week postoperatively demonstrated a significant difference in high-density lipoprotein(HDL) cholesterol, apolipoprotein A1, insulin, and HOMA-IR levels. However, all values were within normal limits and returned to baseline in 4 weeks postoperatively.Conclusion: This study provides little to support the presumed therapeutic effect of liposuction. And, it is unclear whether liposuction can prevent or be used to treat the metabolic complications of obesity. However, the results of the present study lead us to believe that liposuction is a metabolically safe procedure.

Treatment of lipomas assisted with tumescent liposuction

Choi, CW,Kim, BJ,Moon, SE,Youn, SW,Park, KC,Huh, CH Elsevier 2007 Journal of the European Academy of Dermatology and Vol.21 No.2

<P>Abstract</P><P>Background </P><P>Lipoma is a common soft-tissue tumour of mature fat cells. Although surgical excision is effective, treatments that are less invasive and not associated with disfigurement of scar would be ideal for the treatment of lipomas. Recently, tumescent liposuction has been used for the treatment of lipomas.</P><P>Objective </P><P>To evaluate the efficacy of tumescent liposuction in lipoma treatment, we reviewed our experience of lipoma treatment by tumescent liposuction.</P><P>Methods </P><P>A total of 21 patients presenting with 31 lipomas were treated with tumescent liposuction. After liposuction, remaining stromas were removed by a haemostat through the small incision. Tumour size and post-operative complications were recorded before and after treatment.</P><P>Results </P><P>A total of 31 lipomas of 21 patients were treated by tumescent liposuction. The size of lipomas ranged between 1.2 and 11 cm (mean size, 4.1 cm). In 23 cases, there were no complications. However, remnant lipomas, bruise, haematoma and immediate dimpling were found as complications.</P><P>Conclusion </P><P>Tumescent liposuctions with extracting remnant fat tissue and fibrous tissue through the opening for liposuction can be an effective treatment technique in lipoma treatment in the efficacy and cosmetic outcomes and this method can be a substitute for excision in treating large lipomas.</P>

복부 지방흡입술을 시행받은 환자에서 횡복직근피판술을 이용한 유방재건 치험 2례

강병수,이택종 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.2

Purpose: TRAM flap reconstruction has settled down as a common method for breast reconstruction after mastectomy. There are a few surgical contraindication in TRAM flap surgery. Previous abdominal liposuction has been a relative contraindication in TRAM flap surgery. The authors present 2 patients of successful breast reconstruction using pedicled TRAM flaps, who previously underwent abdominal liposuction.Methods: Case 1: A 48-year-old woman with a right breast cancer visited for mastectomy and breast reconstruction. Her past surgical history was notable for abdominal liposuction 15 years ago. Skin sparing mastectomy and breast reconstruction with a pedicled TRAM flap was performed. Case 2: A 45-year-old woman with a left breast cancer visited us for mastectomy and autologous breast reconstruction. 3 years ago, she had an abdominal liposuction and augmentation mammaplasty in other hospital. Nipple sparing mastectomy and breast reconstruction was done using pedicled TRAM flap. Results: One year after the reconstruction, partial fat necrosis was developed in one case but there was no skin necrosis or donor site complication in both patients.Conclusion: As aesthetic surgery becomes more popular, increasing numbers of patients who have a prior abdominal liposuction history want for autologous tissue breast reconstruction. In these patients, TRAM flap surgery will be also used for breast reconstruction. But, the warning of fat necrosis and the use of preoperative Doppler tracing to evaluate the abdominal perforator may be beneficial to patients who had abdominal liposuction recently.

여성형유방증 치료에 있어서 절제술 전 초음파 지방흡입술의 역할

강대일,박상우,최재훈,Kang, Dae-Il,Park, Sang-Woo,Choi, Jae-Hoon 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.6

Purpose: The method of using ultrasound-assisted liposuction and excision of the remaining glandular tissue is the preferred method for treating gynecomastia and is currently used worldwide. Herein, this article described the role of ultrasound-assisted liposuction before a surgical excision in the treatment of gynecomastia. The cosmetic results were objectively evaluated. Methods: 11 patients (22 breasts) underwent ultrasoundassisted liposuction and suction-assisted lipectomy between April 2007 and January 2009. At the end of the liposuction, the remaining glandular tissue was removed through the incision used for liposuction. We evaluated the cosmetic results using ordinary scale methods on the basis of four categories (recurrence, symmetry, contour irregularity, and scar). Results: The volume of aspirates ranged between 50 and 200 cc per breast and the average weight of tissue removed by excision was 65g per breast. No complications were recorded. Regarding the cosmetic evaluation, the recurrence, contour irregularity, and scar were excellent, the symmetry was good, and the overall results represented all those cases were mostly excellent. Conclusion: Ultrasound-assisted liposuction has many advantages in the treatment of gynecomastia. When excising the remaining glandular tissue, bleeding is decreased by the use of a tumescent technique. The glandular tissue is easily mobilized and excised after being "morselized" with ultrasound-assisted liposuction. The glandular tissue is simply dissected via the suction surface. Compared the residual mound of glandular tissue beneath the nipple and areola to the periphery, it facilitates precise control of the excision.

Detection of Dermis and Fascia on Skin Layers for Liposuction Surgery Robot using Texture and Geometric Information

Sangha Song,Yo Kobayashi,Masakatsu G. Fujie 제어로봇시스템학회 2012 제어로봇시스템학회 국제학술대회 논문집 Vol.2012 No.10

Despite the fact that liposuction is one of the most common types of cosmetic surgery, it causes skin surface irregularity as a side effect because of the procedure’s lack of systemicity and objectivity in measuring the process of regional suction. To determine a more systematic and quantitative liposuction process, the surgeon requires access to a surgical robotic system for liposuction. The first consideration in such a system, is navigation of subcutaneous fat, especially detection of the dermis and fascia skin layers. Therefore, this paper presents a method for detecting the dermis and fascia in the skin structure using an ultrasound image that could assist the surgeon"s procedure during liposuction. The method proposed in this paper includes the following three steps. 1) Using the Gabor filter bank, extract the texture feature from the ultrasound image. 2) Using a k-means clustering algorithm, extract cluster areas from the texture feature, such that cluster areas contain similar texture features. 3) Detect the dermis and fascia from each cluster’s geometric information as the feature after training a multi-class SVM. Using the proposed algorithm, the performance results for precision and recall for dermis are 96% and 100%, respectively. In the case of fascia, the precision is 71.11% and recall is 86.49%. The proposed algorithm would be useful as the navigation system in the development of a surgical robot for liposuction in the near future.

Imaging Findings of Liposuction with an Emphasis on Postsurgical Complications

유제성,정용은,백송이,정성필,김명진 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.6

Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.