OBJECTIVE: To compare the effectiveness of single-stage vascularized lymph node transfer (VLNT) combined with lymphaticovenular anastomosis (LVA) and liposuction (LS) (3L) versus LVA combined with LS (2L) for the treatment of moderate-to-late stage upper limb lymphedema following breast cancer surgery. METHODS: A retrospective analysis was conducted on the clinical data of 16 patients with moderate-to-late stage upper limb lymphedema after breast cancer surgery, treated between June 2022 and June 2024, who met the selection criteria. Patients were divided into 3L group (n=7) and 2L group (n=9) based on the surgical approach. There was no significant difference (P>0.05) in baseline data between the groups, including age, body mass index, duration of edema, volume of liposuction, International Society of Lymphology (ISL) stage, preoperative affected limb volume, preoperative circumferences of the affected limb at 12 levels (from 4 cm distal to the wrist to 42 cm proximal to the wrist), preoperative Lymphoedema Quality of Life (LYMQoL) score, and frequency of cellulitis episodes. The 2L group underwent LS on the upper arm and proximal forearm and LVA on the middle and distal forearm. The 3L group received additional VLNT in the axilla, with the groin serving as the donor site. Outcomes were assessed included the change in affected limb volume at 12 months postoperatively, and comparisons of limb circumferences, LYMQoL score, and frequency of cellulitis episodes between preoperative and 12-month postoperative. Ultrasound evaluation was performed at 12 months in the 3L group to assess lymph node viability. RESULTS: Both groups were followed up 12-20 months, with an average of 15.13 months. There was no significant difference in the follow-up time between the groups (t=-1.115, P=0.284). All surgical incisions healed by first intention. No adverse events, such as flap infection or necrosis, occurred in the 3L group. At 12 months after operation, ultrasound confirmed good viability of the transferred lymph nodes in the 3L group. Palpation revealed significant improvement in skin fibrosis and improved skin softness in both groups. Affected limb volume significantly decreased in both groups postoperatively (P<0.05). The reduction in limb volume significantly greater in the 3L group compared to the 2L group (P<0.05). Circumferences at all 12 measured levels significantly decreased in both groups compared to preoperative values (P<0.05). The reduction in circumference at all 12 levels was better in the 3L group than in the 2L group, with significant differences observed at 7 levels (8, 12, 16, 30, 34, 38, and 42 cm) proximal to the wrist (P<0.05). Both groups showed significant improvement in the frequency of cellulitis episodes and LYMQoL scores postoperatively (P<0.05). While the improvement in LYMQoL scores at 12 months did not differ significantly between groups (P>0.05), the reduction in cellulitis episodes was significantly greater in the 3L group compared to the 2L group (P<0.05). CONCLUSION The combination of VLNT+LVA+LS provides more durable and comprehensive outcomes for moderate-to-late stage upper limb lymphedema after breast cancer surgery compared to LVA+LS, offering an improved therapeutic solution for patients.
Humans ; Female ; Lipectomy/methods* ; Retrospective Studies ; Anastomosis, Surgical/methods* ; Lymphedema/etiology* ; Middle Aged ; Upper Extremity/surgery* ; Breast Neoplasms/surgery* ; Lymph Nodes/blood supply* ; Adult ; Lymphatic Vessels/surgery* ; Iliac Artery/surgery* ; Postoperative Complications/surgery* ; Perforator Flap/blood supply* ; Treatment Outcome ; Mastectomy/adverse effects* ; Quality of Life ; Aged

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.
Abdomen/ultrasonography ; Fasciitis, Necrotizing/etiology ; Hematoma/etiology ; Humans ; Lipectomy/*adverse effects ; Postoperative Complications/*etiology ; Pulmonary Embolism/etiology ; Tomography, X-Ray Computed ; Venous Thrombosis/etiology

OBJECTIVETo investigate the application of facial liposuction and fat grafting in the remodeling of facial contour.

METHODSFrom Nov. 2008 to Mar. 2014, 49 cases received facial liposuction and fat grafting to improve facial contours. Subcutaneous facial liposuction with tumescent technique and chin fat grafting were performed in all the cases, buccal fat pad excision of fat in 7 cases, the masseter injection of botulinum toxin type A in 9 cases, temporal fat grafting in 25 cases, forehead fat grafting in 15 cases.

RESULTSMarked improvement was achieved in all the patients with stable results during the follow-up period of 6 - 24 months. Complications, such as asymmetric, unsmooth and sagging were retreated with acceptance results.

CONCLUSIONCombination application of liposuction and fat grafting can effectively and easily improve the facial contour with low risk.

Adipose Tissue ; transplantation ; Botulinum Toxins, Type A ; administration & dosage ; Chin ; Face ; surgery ; Forehead ; Humans ; Injections, Intramuscular ; Lipectomy ; adverse effects ; methods ; Masseter Muscle ; Neuromuscular Agents ; administration & dosage

OBJECTIVETo study the mechanism of treatment of post liposuction seroma with Staphylococcal enterotoxin C injection.

METHODS64 cases with post liposuction seroma were treated with Staphylococcal enterotoxin C injection or routine procedures. The exudate of those patients was collected to analyze the ratio, pH value, cell species and numbers, and the value of TP, ALP, LDH, AST, ALT, gamma-GT, ADA, ApoB, TC.

RESULTSThe ratio, numbers of lymphocyte and mesothelial cells and TP, LDH, ADA, TC value in exudate in Staphylococcal enterotoxin C group were significantly higher than those in control group.

CONCLUSIONSThe effect of Staphylococcal enterotoxin C injection on the exudate of seroma may be related to the non-inflammation reaction.

Enterotoxins ; therapeutic use ; Female ; Humans ; Lipectomy ; adverse effects ; Postoperative Complications ; drug therapy ; metabolism ; Seroma ; drug therapy ; etiology ; metabolism

OBJECTIVETo investigate a new surgical method to treat unilateral limb lymphedem after radical mastectomy.

METHODS10 cases of upper limb lymphedema after radical mastectomy were treated using flap transfer (the lateral thoracic skin flap or latissimus dorsi musculocutaneous flap combined with liposuction).

RESULTSAfter the treatment, the upper limb perimeter reduced in varied degrees. Nuclear lymphatic radiography showed notable changes in lymphatic circulation. The effective results were steady during the follow-up of 3-18 months.

CONCLUSIONFlap transplantation combined with liposuction is a useful treatment for limb lymphedema from radical mastectomy.

Breast Neoplasms ; surgery ; Female ; Humans ; Lipectomy ; Lymphedema ; etiology ; surgery ; Mastectomy, Radical ; adverse effects ; Postoperative Complications ; surgery ; Surgical Flaps

OBJECTIVETo compare the effects of the external ultrasonic, the internal ultrasonic and simple negative pressure liposuction operations under tumescent anesthesia.

METHODSThe fat volume, operative time, complications and other indexes of liposuction in 276 cases were collected and compared.

RESULTSExternal ultrasonic liposuction rapidly emulsified the fat with the least complication. The effects of the internal ultrasonic liposuction was next to the external ultrasonic method while the simple negative pressure liposuction had the poorest effects.

CONCLUSIONThe external ultrasonic liposuction operation is a safe and effective method for local overweight reduction.

Adolescent ; Adult ; Female ; Humans ; Lipectomy ; adverse effects ; methods ; Male ; Middle Aged