Reply: Concomitant Liposuction Reduces Complications of Vertical Medial Thigh Lift in Massive Weight Loss Patients

Schmidt, Manfred M.D.; Duscher, Dominik M.D.; Huemer, Georg M. M.D., M.Sc., M.B.A.

Plastic & Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 1020e–1021e
doi: 10.1097/PRS.0000000000003198
Letters

Section of Plastic, Aesthetic, and Reconstructive Surgery, Department of General Surgery, Kepler University Hospital, Linz, Austria

Correspondence to Dr. Huemer, Section of Plastic, Aesthetic, and Reconstructive Surgery, Kepler University Hospital Linz, Krankenhausstrasse 9, A-4020 Linz, Austria, ghuemer@drhuemer.com

Article Outline
Back to Top | Article Outline

Sir:

We would like to thank Drs. Knotts and Hunstad for their favorable comments on our article about liposuction-assisted medial thigh lifts.1 We consider liposuction-assisted procedures in combination with avulsion techniques a breakthrough in body contouring surgery. Because of the drastic reduction of complications, we feel that these techniques should be used as the gold standard in this patient population. Already increasingly used in the extremities, this technique may also be an interesting option in trunk contouring procedures such as lipoabdominoplasty or belt lipectomy.

We have indeed been inspired by the article by Knotts et al.2 to apply the avulsion technique, initially described for brachioplasty, to our thigh-lift procedures. We have the impression that avoiding the additional thermal tissue damage induced by skin removal by means of electrosurgery adds to preserving wound edge blood supply and lymphatic microvasculature. The recently published article about avulsion thighplasty3 by Hunstad et al. was not available at the time we wrote our article, and we are delighted to see that this approach is gaining more widespread use.

It has been shown that laser-assisted liposuction indeed damages tissue at the cellular level,4 whereas ultrasound-assisted liposuction spares cell functionality.5 Although currently not formally assessed, we are experiencing very favorable results using third-generation ultrasound-assisted liposuction for additional thigh contouring without encountering further problems. As outlined in our article, we specifically focus on the proximal medial thigh, the inner aspect of the knee, and the mediodorsal aspect of the thigh to achieve optimal thigh contouring.

Because of local health insurance policy, the majority of postbariatric surgery is fully covered in Austria. This leads to inpatient procedures as a standard treatment. However, we certainly agree with Drs. Knotts and Hunstad that liposuction-assisted avulsion thighplasty can be performed in an outpatient setting, which is especially useful in private practice. We want to thank Drs. Knotts and Hunstad again for their kind comments and appreciation of our article to increase safety for patients undergoing medial thigh lifts.

Back to Top | Article Outline

DISCLOSURE

The authors have no financial interest to declare in relation to the content of this communication. No funding was received for this work.

Manfred Schmidt, M.D.

Dominik Duscher, M.D.

Georg M. Huemer, M.D., M.Sc., M.B.A.

Section of Plastic, Aesthetic, and Reconstructive Surgery

Department of General Surgery

Kepler University Hospital

Linz, Austria

Back to Top | Article Outline

REFERENCES

1. Schmidt M, Pollhammer MS, Januszyk M, Duscher D, Huemer GMConcomitant liposuction reduces complications of vertical medial thigh lift in massive weight loss patients. Plast Reconstr Surg. 2016;137:1748–1757.
2. Knotts CD, Kortesis BG, Hunstad JPAvulsion brachioplasty: Technique overview and 5-year experience. Plast Reconstr Surg. 2014;133:283–288.
3. Hunstad JP, Kortesis BG, Knotts CDAvulsion thighplasty: Technique overview and 6-year experience. Plast Reconstr Surg. 2016;137:84–87.
4. Chung MT, Zimmermann AS, Paik KJ, et alIsolation of human adipose-derived stromal cells using laser-assisted liposuction and their therapeutic potential in regenerative medicine. Stem Cells Transl Med. 2013;2:808–817.
5. Duscher D, Atashroo D, Maan ZN, et alUltrasound-assisted liposuction does not compromise the regenerative potential of adipose-derived stem cells. Stem Cells Transl Med. 2016;5:248–257.
Back to Top | Article Outline

GUIDELINES

Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article’s publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.

Letters submitted should pose a specific question that clarifies a point that either was not made in the article or was unclear, and therefore a response from the corresponding author of the article is requested.

Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS’ enkwell, at www.editorialmanager.com/prs/.

We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

The Journal requests that individuals submit no more than five (5) letters to Plastic and Reconstructive Surgery in a calendar year.

©2017American Society of Plastic Surgeons