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Lipo flaw fixing

Article-Lipo flaw fixing

Key iconKey Points

  • When cosmetic surgeons seek to correct imperfections from liposuction, the treatment of choice is typically fat transfer, also known as lipofilling
  • However, one surgeon believes that "liposhifting" is a better alternative

Liposhifting patient pre- (far left) and 4 months following (near left) the procedure; another patient pre- (near right) and 6 months post (far right) procedure. Photo credit: Ziya Saylan, M.D.
When faced with the task of correcting imperfections from liposuction, the treatment of choice for cosmetic surgeons is typically fat transfer, also known as lipofilling. But European cosmetic surgeon Ziya Saylan, M.D., tells Cosmetic Surgery Times that he believes there is a better alternative — liposhifting.

PARADIGM SHIFT Unlike lipofilling, liposhifting avoids the problem of fat tissue being damaged in the removal process and further compromised when it is taken out of the body and replaced, states Dr. Saylan, who developed liposhifting and has been performing the technique since 1996.

"Fat implantation, as commonly performed, is not a good method for correction of body contour deformities," he says. "In the process of harvesting, purification and reinjection of fat, there is damage to the fatty tissue due to the high vacuum pressure inside the syringe or the vacuum pump and exposure to the air."

To further underscore his point, Dr. Saylan quotes his mentor, liposuction pioneer Giorgio Fischer, M.D., on the subject, saying: "Every fat filling we are performing is also a fat killing." With liposhifting, small incisions are made and the fat is instead shifted under the skin using a cannula, without ever being removed from the body. This avoids a multitude of potential problems, explains Dr. Saylan, who is the medical director of Aesthetix Beauty Center in Istanbul, Turkey, and also has a practice in Dusseldorf, Germany.

In Dr. Saylans liposhifting technique, following tumescent infiltration of the defective area, a cannula is inserted to free fatty from connective tissue. The fatty tissue is then shifted into place using a 6 to 9 mm cannula held in both hands. A pressure tape and foam dressing is then applied above and below the shifted fat to help keep it in place. (Illustration credit: Ziya Saylan, M.D.)
CLOSED SYSTEM "The shifting of fat from the surrounding tissue into the hollow allows for correction without any air contact and aspiration," Dr. Saylan explains. "It is also not as painful and is permanent, whereas [transferred fat] can disappear after a few months [sometimes even faster than collagen]." In a 2001 study, he described his technique in detail. The procedure begins with a careful marking of the skin to determine the specific areas to be treated. This is followed by tissue infiltration with a tumescent solution with lidocaine, not only for anesthesia, but also to help loosen the fatty tissue and allow for molding.

"We have seen very good results after molding the place to be treated," he wrote. "I believe that the fatty tissue is set free by means of molding so that a larger amount of fat can be shifted." Dr. Saylan then suggests pushing a cannula (26-cm long) under the skin in multiple incisions and in a criss-cross technique to release the fat.

"Windshield-wiper movements should be avoided in order to prevent damage to subcutaneous connective tissue and a loosening of the skin," according to Dr. Saylan.

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