Background: Over the past year, both the media and the professional literature have given significant attention to the inherent risks of large-volume liposuction procedures. Objective: A practice plan is presented that addresses the majority of concerns regarding the risks involved with large-volume liposuction procedures. An alternative approach that is safe and affordable and provides consistent results is described. Methods: Patients are first screened for nutritional and exercise patterns. The concept of a dietary program combined with exercise and repeated small-volume liposuction, with Endermologie following each procedure, is presented. Budgetary issues are reviewed. Liposuction procedures are performed in a traditional office setting through use of superficial syringe suctioning, local anesthesia, and infiltration solution. The maximum volume of total aspirate removed per procedure is arbitrarily set at 1500 mL. Endermologie is provided by an aesthetician postoperatively at 3 weeks and for at least 3 visits. Results: This alternative approach was used in 45 cases in 1997. There were no significant complications except for one small seroma, which required a single aspiration. All but two patients reported a high degree of satisfaction. Conclusions: A program incorporating complete medical evaluation, nutrition, exercise, small-volume liposuction, and Endermologie can be a sound alternative to large-volume procedures.
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