OBJECTIVE: To evaluate the safety and efficacy of suprapubic liposuction combined with modified Devine surgery in adult patients with concealed penis caused by obesity. METHODS: The clinical data of 26 adult patients with buried penis admitted to the Department of Urology of Peking University People' s Hospital and the Department of Surgery of Beijing Eden Hospital from September 2017 to June 2020 were analyzed retrospectively. The average age of the patients was (33.0 ± 5.7) years, the average body mass index (BMI) was (29.0±5.4) kg/m², and the penis length in the supine position was (2.9±1.3) cm. All the patients were treated with suprapubic liposuction combined with modified Devine operation. The improvement of penis length and complications were statistically analyzed after operation, and the satisfaction of the patients was followed up, 1 = dissatisfied; 2 = basically satisfied; 3 = satisfied; 4 = very satisfied. The measurement data were expressed in (mean±SD), nonparametric Friedman tests and multiplex analysis methods were used for data comparison. RESULTS: The average liposuction volume of the 26 patients was (450.0±90.2) mL. Immediately after operation: the penis length was (7.4±2.1) cm, increased by (4.5±1.6) cm compared with that before operation; three months after operation: the penis length was (5.3±1.8) cm, increased by (2.4±0.7) cm compared with that before operation. There was significant difference in penis length before operation, immediately after operation and three months after operation (P < 0.01). All the patients had no sexual intercourse disorder or dysuria. Postoperative edema occurred in 11 cases (42.3%), ecchymosis in 7 cases (26.9%), poor healing of prepuce wound in 2 cases (7.8%), hematoma in 1 case (3.8%), 5 cases (19.2%) without postoperative complications, and no patient had wound infection. Seventeen patients (65.4%) were very satisfied with the appearance and function of the penis, 6 patients (23.1%) were satisfied, 3 patients (11.5%) were basically satisfied, and no patients were dissatisfied. The average score of all the patients' satisfaction with postoperative penis appearance and function was (3.5±0.7). CONCLUSION Suprapubic liposuction combined with modified Devine operation is safe and effective in the treatment of adult-acquired buried penis.
Adult ; Humans ; Lipectomy/methods* ; Male ; Patient Satisfaction/statistics & numerical data* ; Penis/surgery* ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Treatment Outcome

Objective: To investigate the application of suprapubic lipectomy with a "Ω" incision to removal of the prepubic fat pad for the management of buried penis in obese adult patients. METHODS: We retrospectively analyzed the clinical data on 20 obese adult patients with buried penis treated by suprapubic lipectomy via a "Ω" incision between August 2016 and September 2019. RESULTS: The operations were successfully completed in all the cases, with a mean operation time of 3.7 ± 0.6 hours and an average hospital stay of 8.3 ± 3.3 days. There were no such severe surgery-related complications as hematoma, urethral injury, or fat embolism in any of the cases. Fat liquefaction-related superficial wound infection developed in 1 patient postoperatively, which was cured by combined topical and systemic antibiotic therapy. A 3-month follow-up showed a 95% satisfaction of the patients with the postoperative appearance of the penis and suprapubic incision, but no complications such as ED, abnormal penile sensation, or penile retraction. CONCLUSIONS Suprapubic lipectomy with a "Ω" incision to remove the prepubic fat pad is an effective surgical approach to the management of buried penis in obese adult males, which is an anatomy-based surgical correction and has the advantages of slight injury, rapid recovery and few complications./.
Adipose Tissue ; Humans ; Lipectomy ; Male ; Obesity/surgery* ; Penis/surgery* ; Retrospective Studies

The preaxillary mound (PAM) is an aesthetic unit that is often overlooked in breast surgery, although it is intimately associated with the outcomes of breast augmentation. Over 18 months, a series of 76 patients who underwent simultaneous PAM correction using liposuction through a breast augmentation incision were reviewed retrospectively to evaluate the effectiveness of this approach. The mean follow-up was 9 months. In total, 150 PAMs were treated with suction alone. The inframammary approach was used in 72 cases, and the periareolar approach was used in four cases. Satisfactory results were achieved in 99% of cases. One patient presented postoperatively with remaining tissue. The use of a breast augmentation incision to treat PAM is an effective and safe technique that eliminates the need for an additional suction cannula incision.
Breast ; Catheters ; Female ; Follow-Up Studies ; Humans ; Lipectomy ; Mammaplasty ; Retrospective Studies ; Suction

BACKGROUND: Barbed thread lifting is known to be a minimally invasive procedure compared with standard incisional surgery for facial rejuvenation. However, some studies have pointed out that the effects of thread lifting do not last long and disappear after several months. Therefore, the aim of this study was to evaluate the efficiency and duration of anchoring-type absorbable thread lifting combined with liposuction for facial rejuvenation. METHODS: A retrospective review of 27 cosmetic patients who underwent absorbable barbed thread lifting with liposuction between July 2013 and December 2015 was undertaken. The efficiency of facial rejuvenation was evaluated through a patient satisfaction score and the global aesthetic improvement scale (GAIS). RESULTS: Subjects were divided into two groups: thread lifting only and thread lifting combined with liposuction. The mean follow-up period of each group was 8.5 and 9.3 months, respectively. In the thread lifting-only group, the average patient satisfaction score was 2.36 (1=unsatisfied to 4=very satisfied), and the average GAIS score was 2.54 (1=very much improved to 5=worsen). In the thread lifting with liposuction group, the average patient satisfaction score was 3.06, and the average GAIS score was 1.85. CONCLUSIONS: Thread lifting combined with liposuction showed better patient satisfaction and GAIS results than thread lifting alone, even over a long follow-up period.
Follow-Up Studies ; Humans ; Lifting ; Lipectomy ; Patient Satisfaction ; Rejuvenation ; Retrospective Studies ; Suture Anchors

BACKGROUND: Because many cosmetic surgery clinics are not adequately equipped to handle emergent conditions, patients often come to a university hospital when problems occur during or after cosmetic surgery. However, few in-depth studies have been conducted of this issue. Therefore, we investigated emergency department visits due to complications associated with cosmetic surgery. METHODS: A retrospective chart review was conducted of 38 patients who visited the emergency department of the authors' institution due to complications associated with cosmetic surgery from July 2014 to June 2017. RESULTS: There were more women than men (30 women vs. 8 men). Their mean age was 32.4 years (range, 19–57 years). Upon presentation to the emergency department, patients' vital signs and mental status were usually normal (27 normal vs. 11 abnormal). The types of surgery included blepharoplasty, rhinoplasty, malar/orthognathic surgery, mammaplasty, liposuction, fat grafting, and filler and botulinum toxin injections. Most patients required hospitalization (26 admitted vs. 12 discharged). Eight of the hospitalized patients required intensive care unit care, of whom two died and three experienced brain death or had permanent neurologic sequelae. CONCLUSIONS: The complications were usually minor problems, despite the need for hospitalization, but some complications were life-threatening. We recommend close monitoring and maintaining an adequate injection capacity for intravenous sedative anesthesia. When any symptom or sign of a complication occurs, it is best to transfer the patient to a university hospital as soon as possible. Taking a careful medical history is always needed, even for minor procedures.
Anesthesia ; Blepharoplasty ; Botulinum Toxins ; Brain Death ; Cardiomyopathies ; Emergencies ; Emergency Service, Hospital ; Epinephrine ; Female ; Hospitalization ; Humans ; Intensive Care Units ; Lipectomy ; Male ; Mammaplasty ; Retrospective Studies ; Rhinoplasty ; Surgery, Plastic ; Transplants ; Vital Signs

Lipoma is the most frequent benign mesenchymal tumor. Giant intramuscular lipomas, defined by a measurement greater than 10 cm in any dimension, reside deep to the fascia and originate within the muscle layer. Traditionally, the length of the incision required for excision is equal to or greater than the diameter of the giant intramuscular lipoma. However, because of injury to the surrounding tissues from excessive traction and thermal injury from the energy delivered by the device, long and noticeable scars with a hypertrophic tendency develop, resulting in patient dissatisfaction. Although some esthetically-favorable methods have been reported, including liposuction and liposuction-assisted excision, these methods did not sufficiently excise lipomas, and led to a higher recurrence rate. In contrast, the ultrasonic harmonic scalpel can excise large and deep-seated lipomas with minimal scarring. The ultrasonic harmonic scalpel requires a shorter incision, and it provides a sufficient view of the surgical field, thereby avoiding unnecessary traction applied to the skin and reducing surrounding tissue injury trauma, which results in hypertrophic scars.
Cicatrix ; Cicatrix, Hypertrophic ; Fascia ; Humans ; Lipectomy ; Lipoma ; Recurrence ; Skin ; Traction ; Ultrasonics

Many studies have demonstrated that an autologous fat graft (AFG) can be a successful alternative to prosthetic breast augmentation; however, with the increasing use of this method, there are also increasing reports of complications. We report a case of severe infection after augmentation mammoplasty with a massive AFG. A 23-year-old woman had undergone primary AFG for breast augmentation. The remaining fat was reused for secondary graft 46 days after the primary transplantation. The patient was referred to our hospital with infectious signs on both breasts. Antibiotics were administered according to the bacterial culture result of the abscess aspirated with ultrasonography (US) guidance. During antibiotic treatment, two US-guided abscess aspirations were performed. Although follow-up magnetic resonance imaging demonstrated reduced abscess and fluid collection after aspiration, the skin of the lower pole of the right breast was perforated. We performed liposuction with real-time US guidance for abscess localization. The abscess and necrotic fat tissue were removed through liposuction. Thereafter, the symptoms, signs, and laboratory and radiologic findings demonstrated complete improvement. The patient was successfully treated while maintaining the breast contour through localized abscess removal, with a much smaller liposuction scar than would have resulted from aggressive excision or drainage.
Abscess ; Anti-Bacterial Agents ; Aspirations (Psychology) ; Breast ; Cicatrix ; Drainage ; Female ; Follow-Up Studies ; Humans ; Lipectomy ; Magnetic Resonance Imaging ; Mammaplasty ; Methods ; Skin ; Transplants ; Ultrasonography ; Young Adult

BACKGROUND: Lipomas are common benign soft tissue tumors composed of mature white adipocytes, with histological features including a well-circumscribed and lobular mass covered with a thin fibrous capsule. However, lipomas that are poorly demarcated from the surrounding fat are often encountered during surgery despite a postoperative histological diagnosis. We investigated the complications associated with different types of lipomas. METHODS: This retrospective study included 119 patients who underwent lipoma excision and computed tomography (CT) imaging at our clinic between January 2011 and August 2018. We classified the lipomas as encapsulated or nonencapsulated according to the histology, CT findings, and clinical criteria. Nonencapsulated lipomas were defined as relatively heterogeneous without a distinct capsule, whereas encapsulated lipomas were homogeneous with a distinct capsule. The analyzed complications included delayed wound healing, which can cause prominent scarring, hematoma or seroma, and recurrence. RESULTS: Encapsulated and nonencapsulated lipomas were diagnosed in 89 (74.8%) and 30 (25.2%) patients, respectively. Encapsulated lipomas occurred most commonly on the head, whereas nonencapsulated lipomas occurred most commonly on the neck and trunk (P=0.000, P=0.002, and P=0.031, respectively). The Fisher exact test showed a significantly higher incidence of delayed wound healing for nonencapsulated than encapsulated lipomas (P=0.014). CONCLUSIONS: Preoperative classification of lipomas using CT imaging is important for predicting the incidence of postoperative complications. Direct excision is adequate for removing encapsulated lipomas. However, nonencapsulated lipomas might require alternative methods, such as ultrasonic liposuction, to prevent postoperative complications. Our results will help reduce the incidence of scarring by providing guidance on surgical methods.
Adipocytes, White ; Cicatrix ; Classification ; Diagnosis ; Head ; Hematoma ; Humans ; Incidence ; Lipectomy ; Lipoma ; Neck ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Seroma ; Ultrasonics ; Wound Healing

Traumatic subcutaneous emphysema, which is the infiltration of air into subcutaneous tissues due to trauma, is caused by various factors such as chest and/or abdominal trauma, facial fractures, and barotrauma caused by mechanical ventilation. In this case report, a 32-year-old woman developed traumatic subcutaneous emphysema after undergoing abdominal liposuction at a local clinic. She was subsequently admitted to Busan Paik Hospital, and with early diagnosis and conservative treatment, she was discharged on the seventh day of hospitalization with no complications. However, because traumatic subcutaneous emphysema may accompany other injuries for various reasons, radiological examination and various tests should be performed to prevent serious complications and sequelae.
Adult ; Barotrauma ; Busan ; Early Diagnosis ; Female ; Hospitalization ; Humans ; Lipectomy ; Respiration, Artificial ; Subcutaneous Emphysema ; Subcutaneous Tissue ; Thorax

BACKGROUND: Gynecomastia is a common condition that can cause severe emotional and physical distress in both young and older men. Patients in whom symptomatic recalcitrant gynecomastia persists for a long time are potential candidates for surgery. METHODS: From January 2014 to January 2016, 15 patients underwent correction of gynecomastia through a single 3-mm incision at our institution. Only patients with true gynecomastia underwent surgery with this new technique. Through the small incision, sharp dissection was performed in a clockwise and counterclockwise direction describing two half-circles. Health-related quality of life and aesthetic outcomes were evaluated using a modified version of the Breast Evaluation Questionnaire (BEQ). RESULTS: The patients’ average age was 23.5 years (range, 18–28 years), and their average body mass index was 23.2 kg/m² (range, 19.2–25.3 kg/m²). One case was unilateral and 14 cases were bilateral. The weight of glandular tissue resected from each breast ranged from 80 to 170 g. No excess skin was excised. Bleeding was minimal. The mean operating time was 25 minutes (range, 21–40 minutes). No complications were recorded. All lesions were histologically benign. The patients’ average score was 3.5 (on a 5-point Likert scale) in all domains of the BEQ for themselves and their partners. CONCLUSIONS: In this study, we demonstrated the safety and reliability of a new technique that allows mastectomy through an imperceptible 3-mm incision. We obtained high patient satisfaction scores using our surgical technique, and patients reported considerable improvement in their social, physical, and psychological well-being after surgery.
Body Mass Index ; Breast ; Gynecomastia ; Hemorrhage ; Humans ; Lipectomy ; Male ; Mastectomy ; Outcome Assessment (Health Care) ; Patient Satisfaction ; Quality of Life ; Skin