Patient History

A 41-year-old Hispanic female with Fitzpatrick skin type IV sought consultation for the treatment of excess fat in the abdomen and flanks areas. The appearance of her skin was soft and regular with excellent turgor and moderate fibrous fat zones. The patient appeared to be in great physical condition. Smartlipo was recommended as the most effective treatment due to the location of the fat areas and the need for skin tightening.

Sedative

The patient received 1 mg of Ativan PO 30 minutes prior to the surgery.

Anesthesia

Local anesthesia was delivered to multiple incisions with 3 mL of 2% lidocaine and epinephrine (1:100,000 ratio). 500 mL of tumescent solution (100 mL of 1% lidocaine plain with 1 mL of epinephrine [1:1000 ratio] in 1000 mL of Lactated Ringer’s solution) was then administered subcutaneously in the areas to be treated.

Laser Protocol

The areas were treated with a power of 10 watts at 40 Hz until the endpoint was reached. The endpoint was determined based on exclusion of resistance, skin temperature and skin turgor. A total energy of 9,396 joules was delivered to the abdomen and flanks.

After Aspiration

The liquefied fat cells of the abdomen were removed with the help of a 4.0 mm Double-Mercedes tip style cannula. As for the flanks, a 3.0 mm tri-port cannula with power-assisted aspiration was used. A total of 50 mL was aspirated in both treated areas, with 50% fat and 50% supernatant fluid. No sutures were used and wound was left open for drainage for a period of 2 days.

Postop Treatment

Postoperatively, the patient was instructed to wear an abdominal compression binder for 8 weeks. She was also prescribed Omnicef 300 mg tab PO BID for a total of 1 week, starting the night before the surgery. Patient was seen one day, one week and one month for postop evaluation. The day following the surgery, the patient had no bruising, minimal swelling and mild discomfort. At the one-week follow-up visit, she was very happy. She reported losing 1 inch around her waist and fitting better in her pants. The patient was encouraged to return to normal activity with the exception of exercising for a period of 2 weeks. However, being an aerobics instructor, the patient returned to work within 2 days following the procedure.