Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty
Identifieur interne : 002373 ( Main/Exploration ); précédent : 002372; suivant : 002374Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty
Auteurs : Uwe Wollina [Allemagne] ; Birgit Heinig [Allemagne] ; Andreas Nowak [Allemagne]Source :
- Clinical, Cosmetic and Investigational Dermatology [ 1178-7015 ] ; 2014.
Abstract
Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome.
We report on a tailored combined approach to improve advanced lipedema in elderly females with multiple comorbidities. Microcannular laser-assisted liposuction of the upper legs and knees is performed under tumescent anesthesia. Medial thigh lift and partial lower abdominoplasty with minimal undermining are used to correct skin laxity and prevent intertrigo. Postsurgical care with nonelastic flat knitted compression garments and manual lymph drainage are used.
We report on three women aged 55–77 years with advanced lipedema of the legs and multiple comorbidities. Using this step-by-step approach, a short operation time and early mobilization were possible. Minor adverse effects were temporary methemoglobinemia after tumescent anesthesia and postsurgical pain. No severe adverse effects were seen. Patient satisfaction was high.
A tailored approach may be useful in advanced lipedema and is applicable even in elderly patients with multiple comorbidities.
Url:
DOI: 10.2147/CCID.S56655
PubMed: 24489474
PubMed Central: 3904776
Affiliations:
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Physical Therapy and Rehabilitative Medicine, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Centre of Physical Therapy and Rehabilitative Medicine, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Nowak, Andreas" sort="Nowak, Andreas" uniqKey="Nowak A" first="Andreas" last="Nowak">Andreas Nowak</name><affiliation wicri:level="3"><nlm:aff id="af3-ccid-7-035">Department of Anaesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, 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type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Heinig, Birgit" sort="Heinig, Birgit" uniqKey="Heinig B" first="Birgit" last="Heinig">Birgit Heinig</name><affiliation wicri:level="3"><nlm:aff id="af2-ccid-7-035">Centre of Physical Therapy and Rehabilitative Medicine, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Centre of Physical Therapy and Rehabilitative Medicine, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Nowak, Andreas" sort="Nowak, Andreas" uniqKey="Nowak A" first="Andreas" last="Nowak">Andreas Nowak</name><affiliation wicri:level="3"><nlm:aff id="af3-ccid-7-035">Department of Anaesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author></analytic><series><title level="j">Clinical, Cosmetic and Investigational Dermatology</title><idno type="eISSN">1178-7015</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome.</p></sec><sec><title>Methods</title><p>We report on a tailored combined approach to improve advanced lipedema in elderly females with multiple comorbidities. Microcannular laser-assisted liposuction of the upper legs and knees is performed under tumescent anesthesia. Medial thigh lift and partial lower abdominoplasty with minimal undermining are used to correct skin laxity and prevent intertrigo. Postsurgical care with nonelastic flat knitted compression garments and manual lymph drainage are used.</p></sec><sec><title>Results</title><p>We report on three women aged 55–77 years with advanced lipedema of the legs and multiple comorbidities. Using this step-by-step approach, a short operation time and early mobilization were possible. Minor adverse effects were temporary methemoglobinemia after tumescent anesthesia and postsurgical pain. No severe adverse effects were seen. Patient satisfaction was high.</p></sec><sec><title>Conclusion</title><p>A tailored approach may be useful in advanced lipedema and is applicable even in elderly patients with multiple comorbidities.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Child, Ah" uniqKey="Child A">AH Child</name></author><author><name sortKey="Gordon, Kd" uniqKey="Gordon K">KD Gordon</name></author><author><name sortKey="Sharpe, P" uniqKey="Sharpe P">P Sharpe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suga, H" uniqKey="Suga H">H Suga</name></author><author><name sortKey="Araki, J" uniqKey="Araki J">J Araki</name></author><author><name sortKey="Aoi, N" uniqKey="Aoi N">N Aoi</name></author><author><name sortKey="Kato, H" uniqKey="Kato H">H Kato</name></author><author><name sortKey="Higashino, T" uniqKey="Higashino T">T Higashino</name></author><author><name sortKey="Yoshimura, K" uniqKey="Yoshimura K">K 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