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The didactic portion along with the clinical hands-on
exposure will allow attendees to gain a comprehensive
understanding of the procedure. The format used in this
activity is an effective method for knowledgeable
physicians to expand their surgical abilities safely.
Office-based Liposuction using local tumescent anesthesia
learning objectives:
1. Discuss the history of liposuction and how it has
transcended into an office-based procedure.
2. Explain the clinical aspects of the procedure, including
patient selection, safe dosing limits of lidocaine in
tumescent anesthesia, and proper surgical methods &
techniques.
3. Apply the procedure into the existing office
setting from a marketing standpoint.
4. Use the most efficient lay-out in a facility to perform
the procedure.
5. Calculate the start-up costs and instrument set-up for
the procedure.
6. Define issues of medical malpractice and how it relates
to the physicians.
7. Assess the financial benefit of the fee-for-service
cosmetic procedure.
8. Describe effective methods to manage patients
dissatisfied or challenging.
Course Outline
DAY ONE
7:00 7:30 am Registration, Welcome, and Breakfast
7:30 7:45 am History of the procedure How it got started and
by whom!
7:45 8:00 am The Overview: Office base liposuction using local
tumescent anesthesia
8:00 8:15 am Anatomy review Break it down
8:15 9:00 am Identifying potential patients then consent &
exam
9:00 9:10 am Patient preparation & preoperative medications
9:10 9:30 am Patient markings fat deposits (topography
format)
9:30 10:00am Local tumescent anesthesia preparation
10:00 10:15am Identifying safe limits of lidocaine & side
effects
10:15 10:45am Keys to pre/post operative photography
10:45 11:00am Morning break (food & drink available)
11:00 11:15am Room set-up, instrument selection & layout, and
surgical dressing
11:15 11:45am Infiltration methods of infusing local tumescent
anesthesia using infiltration cannulas or spinal needles
11:45 1pm First case of live surgery with hands-on
opportunity: upper and lower abdomen
12:00 12:30pm Aspiration methods utilizing SAL and/or PAL
12:30 12:40pm Recovery, post operative treatment, and
potential complications involving touch-up
1:00 1:30pm Working Lunch
1:45 5:00pm Second live surgery with hands-on opportunity:
upper & lower abdomen with flanks (beginning liposuction)
5:00 6:00pm Overall review, question and answer session
6:00 pm Adjourn
DAY TWO
7:00 7:30 am Breakfast
7:30 12:00 pm Live surgery with hands-on opportunity. Two
cases both upper & lower abdomen with flanks (beginning
liposuction)
12:00 1:00 Lunch
1:00 1:30 pm Malpractice Considerations
1:30 2:00 pm Business model for implementing liposuction into
your practice
2:30 3:00 pm Marketing this cosmetic procedure into your
practice both internally & externally
3:00 3:15 pm Afternoon break (food & drink available)
3:15 3:45 pm Establishing a fee schedule for the procedure
3:45 4:00 pm Discussing physical space requirements: ideal
set-up for your liposuction suite
4:00 4:30 pm Instrument selection and O/R set-up, costs of
getting started
4:30 5:00 pm Managing patients who are challenging &
unsatisfied with the results
5:00 5:30 pm Overall review, question and answer session
5:30 pm Adjourn
Frequently
Asked Questions:
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What is
tumescent liposuction?
This is the
method developed by dermatologist which dramatically changed the
nature of liposuction treatment. The tumescent technique is
based upon filling the fatty layer of skin with a dilute
solution of local anesthesia and other medications prior to
removing excess fat. The tumescent method allows the surgeon to
safely and efficiently remove both deep and superficial excess
layers of fat with no discomfort, no significant blood loss,
very rapid healing, and improved cosmetic results.
-
How is
the procedure performed?
Before
starting, markings are made with a pen to define the areas to be
suctioned. The tumescent procedure is then initiated by
injecting large volumes of a dilute anesthetic solution directly
into the areas of the fatty deposits which shrinks blood vessels
and minimizes blood loss.
After a small
incision is made in the skin, a narrow tube, called a cannula,
which is connected to a vacuum machine, is inserted under the
skin in the area to be treated. Using back and forth movements,
the fat is suctioned into the tubing in a sterile collection
system. When the liposuction procedure is complete, and elastic
compression garment is worn to help the skin contract and heal.
The result is a sculpting of bulging areas laden with fat into
more attractive contours.
-
What are
the benefits of tumescent liposuction under local anesthesia?
Tumescent
liposuction using local anesthesia offers the benefits of fewer
skin irregularities, less bleeding, reduced bruising, and a
faster recovery.
Tumescent
liposuction is performed in an office so the expense of
hospitalization and the risks of general anesthesia are
avoided. The procedure is much safer when only local anesthesia
is employed. Because the patient is awake, he or she is able to
sit or stand during the conclusion of the procedure, allowing
the surgeon to check the status of patient and the progress in
achieving the desired contouring.
The surgeon may
complete the procedure with the patient standing up, or remark
the patient for additional suctioning on the procedure table.
-
What
happens before surgery?
Before surgery,
a complete medical history, physical examination and lab tests
are performed. During the consultation, the physician will
describe the procedure and what results can be expected.
The doctor will
also review alternative treatment options and the possible risks
and complications of the surgery. Photographs will be taken
during the preoperative consultation and consent for the surgery
will be obtained.
-
What
happens after surgery?
At the end of
the case, the patient is wrapped up with absorbent garments
because a lot of drainage is expected in the first two days.
The local anesthesia injected into the tissues provides
excellent pain relief for the first 24 hours.
After tumescent
liposuction, most patients are alert and awake and able to eat a
regular diet. Patients are encouraged to walk around and to
shower on the evening after surgery. Most patients may return
to work in two – three days and physical exercise may be resumed
within one week.
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