Experience with "lipolysis": the Illouz technique of blunt suction lipectomy in North America.

"Lipolysis" or blunt suction lipectomy for modest to moderate deformities of localized fatty deposits has been carried out on a series of North American patients. The American patients were felt to be larger than the French patients with whom the procedure was developed, and thus required larger removals. Many patients showed a substantial drop in hematocrit levels following this procedure. Drains may add 400 ml to the blood loss. An obvious third space shift occurred into the operated area and can be of noteworthy magnitude. This often required hospitalization and colloid replacement. It should be anticipated that blood may have to be given. On the basis of our experience in North American patients, we have lowered our expectation for ambulatory discharge to patients undergoing removals of 650 ml or less. This may prove to be too optimistic on occasion. The "lipolysis" technique did not cause any seroma formation in patients as reported for other suction-assisted lipectomy techniques. All patients sensed early anxiety and then disappointment at the lack of "instant" results, and worry over uneven areas during weeks 2 through 6 and required constant reassurance. Prolonged massage therapy bridged this period both physically and psychologically, lightening the burden of both surgeon and patient.