NSOCP - National Society of Cosmetic Physicians

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Awake Liposuction

22 AMA PRA Category1 Credits™
Maximum of 6 attendees for every workshop to assure adequate hands-on opportunity for all attendees
2 Live Surgery cases per Workshop

Covered Topics:
* History of Liposuction
* Proper patient selection & management
* Preoperative & postoperative photography and patient marking
* Room setup
* Liposuction techniques
* Hands on training of infiltration and liposuction
* Marketing and business model
* Malpractice Insurance
* Patient safety

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 – 10:00 am	Local tumescent anesthesia preparation
10:00 – 10:15 am	Identifying safe limits of lidocaine & side effects
10:15 – 10:45 am	Keys to pre/post operative photography
10:45 – 11:00 am	Morning break (food & drink available)
11:00 – 11:15 am	Room set-up, instrument selection & layout, and surgical dressing
11:15 – 11:45 am	Infiltration methods of infusing local tumescent anesthesia using infiltration cannulas or spinal needles
11:45 – 1 pm	First case of live surgery with hands-on opportunity: upper and lower abdomen
12:00 – 12:30 pm	Aspiration methods utilizing SAL and/or PAL
12:30 – 12:40 pm	Recovery, post operative treatment, and potential complications involving touch-up
1:00 – 1:30 pm	Working Lunch
1:45 – 5:00 pm	Second live surgery with hands-on opportunity: upper & lower abdomen with flanks (beginning liposuction)
5:00 – 6:00 pm	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 pm	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:

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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