1. 2011 World Congress Female & Male Genital Cosmetic Surgery

2. Liposuction & Autologous Fat Transfer

3. Marco A. Pelosi, III, MD FACOG, FACS, FICS, FAACS

4. CME Disclosure The Faculty reports no significant financial relationships or other relationships with the manufacturers of any commercial products and/or providers of commercial services discussed in this educational presentation and with any commercial supporters of this activity. Furthermore, no off- label or investigational uses of products will be discussed without explicit notification thereof.

5. Terminology Lipolysis Lipolysis Lipoplasty Lipoplasty Liposuction Liposuction Liposculpture Liposculpture Suction lipectomy Suction lipectomy Suction-assisted lipectomy (SAL) Suction-assisted lipectomy (SAL)

6. Terminology Small-volume (<100 mL fat) Small-volume (<100 mL fat) Medium-volume (<1500 mL fat) Medium-volume (<1500 mL fat) Large-volume (<4000 fat mL/ 5000 mL total) Large-volume (<4000 fat mL/ 5000 mL total) Megaliposuction Megaliposuction – CA Speier Bill: >5000 mL “unprofessional” – FL: 4000 mL limit

7. Terminology Dry = nothing infiltrated Wet= saline/hyaluronidase

8. Superwet Solution 1,000 ml 10 ml 1 ml 25 ml

9. Tumescent Local Anesthesia 1,000 ml 10 ml 1 ml 100 ml

10. Generally Accepted Lidocaine Limits Intravenous: 7 mg/Kg Intravenous: 7 mg/Kg Tumescent w/o liposuction: 25 mg/Kg Tumescent w/o liposuction: 25 mg/Kg Tumescent w/ liposuction: 45 – 55 mg/Kg Tumescent w/ liposuction: 45 – 55 mg/Kg – Thin = 45 – Avg = 50 – Heavy = 55 Florida Law: cannot exceed 50 mg/Kg

11. Terminology Manual Liposuction Manual Liposuction Power-Assisted Liposuction Power-Assisted Liposuction Ultrasound-Assisted Liposuction (UAL) Ultrasound-Assisted Liposuction (UAL) – Internal – External Laser-Assisted Liposuction Laser-Assisted Liposuction – Internal: “Hot” laser – External: “Cold” laser Disruption-Assisted Liposuction Disruption-Assisted Liposuction

12. The Tools

13. Aspiration Equipment Suction pump -100 kPa max Suction pump -100 kPa max Syringe for small volume Syringe for small volume

14. Liposuction Cannulas

16. Fat Transfer Cannulas

17. Lips Type 3

18. NLF V-Dissector Type 1

19. Non Lines Type 2

20. Hands Type 2

21. Buttocks Type 2

22. Labia Type 2

23. Augmentation Labia Majoraplasty

24. Typical Process Patient is consented, marked & photographed Patient is consented, marked & photographed NIBP, ECG, SpO2 monitors are placed NIBP, ECG, SpO2 monitors are placed Hep-lok is inserted Hep-lok is inserted Knee-high SCDs applied Knee-high SCDs applied

25. Punch or scalpel

26. Always Parallel

27. Reverse Jackknife Postion Abdominal Lipo

28. Long strokes

29. Multi-Directional Contouring

30. Nondominant Hand Control

33. Blend margins

34. Avoid superfical layer 5mm No-Suck Zone

35. EBL = 5mL/liter of total aspirate

36. Regional Applications

37. High Definition Liposuction Etching Pectoral Abdominal Manual, Laser, Vaser Ideal < 15% Body Fat

38. Pectoral Etching

39. Access

40. Abdominal Etching

41. Leaner = Better Result

45. Flanks & Back Strategies

48. Arms Liposuction

49. Access: Post

50. Medial

51. Lateral

53. Legs Liposuction Outer Thighs Outer Thighs Inner Thighs Inner Thighs Posterior Thighs Posterior Thighs Anterior Thighs Anterior Thighs Knees Knees Calves & Ankles Calves & Ankles

56. Access

57. Inner Thighs & Knees

61. Breast Liposuction

62. 9 months F cup D cup

63. Fat Transfer Techniques

64. 2.5 - 3mm

66. 1-2 L

67. Harvest Setup 1 1 2 3 3 4 5

68. From patient Topump

69. Gravity x 15:00 or centrifuge discard

72. Light Infiltration of Recipient Site

74. 600 cc

75. 500cc superficial & deep

76. 500cc

77. 200cc

78. Augmentation Mammaplasty

79. Peri-glandular

81. Augmentation Labia Majoraplasty

120. LVR + Augmentation

121. Questions

122. End mpelosi3@gmail.com www.ISCGYN.com www.ISCGMedia.com