Case Study
Uwe Wollina
Die Liposuktion der Infraglutealfalte führt bei Lipödem-Patientinnen nicht notwendigerweise zur glutealen Ptose – ein Paradoxon?
Liposuction of the infragluteal fold in female lipedema patients does not necessarily induce gluteal ptosis – a paradoxon?
(NACH CARE-LEITLINIE)
Keywords | Summary | Correspondence | Literature
Keywords
fibrosis, gluteal ptosis, infragluteal fold, lipedema, liposuction
Schlüsselworte
Fibrose, gluteale Ptose, infragluteale Falte, Lipödem, Liposuktion
Summary
Background: The gluteal region if of importance in esthetic medicine. A common adverse event in esthetic liposuction of the thigh and the infragluteal fold (“banana fold”) is gluteal ptosis. Patients and Methods: We analyzed our data on liposuction for female patients with lipedema grade II and III and liposuction of dorsal thighs and the infragluteal fold. Results: Surprisingly, most of our patients did not experience an aggravated gluteal ptosis after the procedure. Some of the patients even presented with a mild gluteal lift in the lateral view, despite no gluteal liposuction had been performed. Conclusions: There seem to be two factors contributing: (a) the chronic inflammation and fibrosis in lipedema and (b) the inflammatory response induced by liposuction. The latter is of temporary nature and obviously not sufficient to prevent ptosis.
Zusammenfassung
Hintergrund: Die Glutealregion ist in der ästhetischen Medizin von Bedeutung. Eine häufige Nebenwirkung der ästhetischen Liposuktion der Oberschenkel und der infraglutealen Falten (“banana fold”) ist die gluteale Ptose. Patienten und Methoden: Wir analysierten unseren Daten zur Liposuktion bei Patientinnen mit einem Lipödem Grad II oder III nach Liposuktion der Oberschenkel und der infraglutealen Falte. Ergebnisse: Überraschenderweise wies die Mehrzahl unserer Patientinnen keine verstärkte gluteale Ptose nach Liposuktion auf. Einige der Patientinnen boten in der Seitansicht sogar einen milden Gesäßlift obwohl keine gluteale Behandlung vorgenommen worden war. Schlußfolgerungen: Es scheint zwei Faktoren zu geben, die an diesem Ergebnis beteiligt sind: (a) die chronische Entzündung und Fibrose des Lipödems und (b) die Entzündungsantwort infolge des Eingriffes. Letztere ist temporärer Natur und offensichtlich nicht ausreichend, eine Ptose zu verhindern.
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Korrespondenz-Adresse
Prof. Dr. Uwe Wollina
Department of Dermatology and Allergology
Städtisches Klinikum Dresden
Academic Teaching Hospital
Friedrichstr. 41
DE-01067 Dresden, Germany.
Konklusion
Liposuction in tumescent anesthesia is a popular method in esthetic medicine. The technique is also used in liporeduction surgery in lipedema. In contrast to esthetic indications, liposuction in lipedema primarily aims to obtain pain relief and improved mobility. The SAT in lipedema shows structural and functional peculiarities different from healthy non-obese subjects and from obesity. There is a tendency to tissue fibrosis. This can explain, why liposuction of the dorsal thigh and the infragluteal fold in lipedema has a reduced risk for gluteal ptosis compared to healthy subjects. Further investigations are necessary.
Literatur
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