What is included in the dermatologic preoperative evaluation and management of liposuction?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

The preoperative consultation is essential for the patient seeking liposuction. The dermatologic surgeon must fully interview the patient. Inquiries about diet, exercise, weight stability, and familial body shape should be made. Patients should be asked about specific areas that they find cosmetically bothersome and about aspects of their body shape that seem refractory to caloric restriction or exercise expenditure.

At the time of the preoperative consultation, an assessment of weight stability is performed. Is the patient of normal weight for height or is he or she a little overweight? Liposuction is not a therapy for patients who are morbidly obese. Is the patient actively gaining weight and seeking liposuction to slow down his or her weight gain? Liposuction is best performed on the patient with a stable weight and a regular exercise routine. If a patient continues to gain weight after liposuction, he or she may feel that the procedure was ineffective. If a patient's weight varies by 10-20 lb, performing the procedure at the higher end of the weight fluctuations is better.

A psychological assessment is necessary for every patient undergoing a cosmetic procedure. Physicians should be aware that some patient's expectations for liposuction may be excessive. For example, patients may expect that liposuction of the thighs may correct their marital difficulties. Ensure that the patient is seeking liposuction for the right reasons.

A thorough physical examination of the body sites to be treated, overall physique, and body shape is required. Assessment for skin tone and elasticity must be carried out by the dermatologic surgeon. In general, good skin tone and elasticity are advisable because skin retraction and remodeling occurs around the debulked fatty tissue. Patients with poor skin elasticity must be warned that they may have some postoperative draping of the skin, which could require surgical correction following liposuction. Patients having rare syndromes with poor skin elasticity, such as Danlos syndrome or cutis laxa, should be identified.


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