Background: Gynecomastia (GM) is the increased fibroglandular tissue in the male breast by more than 2 cm, which is palpated under the nipple and areola. An ideal surgical approach aims to reduce the breast size, reach an acceptable breast shape, resect excessive glandular tissue, fatty tissue, and skin fatty tissue and excess skin, relocate the nipple-areolar complex, and avoid scars. Based on its importance, we aimed to compare outcomes of LIPOSUCTION with and without periareolar incision in patients with GM. Materials and Methods: This was a randomized clinical trial on patients referred for plastic surgery. Patients with GM were allocated into two treatment groups. Group A underwent LIPOSUCTION without any areolar skin incision and group B had LIPOSUCTION with the areolar skin incision. Patients were followed-up after surgery. Data were analyzed by Statistical Package for the Social Sciences (SPSS) version 20. Results: Sixty patients aged between 20 and 27 years old participated in this study. Three hematomas, two surgical site infections, one nipple hypopigmentation after surgery, and one seroma formation were noted in group B. On the other hand, one hematoma and one seroma formation were noted in group A. The patients in group A were highly satisfied after the LIPOSUCTION without skin incision procedure compared with group B (P = 0. 01). Conclusions: The management of GM by LIPOSUCTION, either with the periareolar excision technique or without skin incision, allows the effective removal of fat and glandular tissue of the male breast. Although there was no significant difference regarding postoperation complications between groups, patients' satisfaction should be considered.

Introduction: Cervical suction lipectomy (CSL) procedures result in practically inevitable complications after the operation, such as facial edema and bruise. Photobiomodulation therapy (PBMT) can be used for analgesia, modulation of inflammatory processes, and improved tissue healing. Case Report: We have reported two cases of patients in which this therapy was used to manage complications related CSL. As they had already been medicated and still had these side effects, the PBMT was proposed for local analgesia, nerve repair, and modulation of the inflammatory process. Within 72 hours after a single PBMT session, there was an important reduction in the severity of all situations. Conclusion: PBMT seems safe and effective in managing pain and edema-related CSL.

There is no agreement as to appropriate fluid resuscitation in patients undergoing LIPOSUCTION 1. Large-volume infiltrations and aspirations may introduce potential complications such as hypovolemia and fluid overload. Hence, this study was designed to determine intravenous fluid replacement in tumescent LIPOSUCTION. In this clinical trial study, 50 healthy patients undergoing LIPOSUCTION using a tumescent technique with sedation were investigated. Our guidelines for fluid resuscitation were as follows 2: Group I: Volume aspirations &4 liters: 4, 2, 1 rule. Group II: Volume aspirations >4 liters: 4, 2, 1 rule plus 0.25 ml of IV crystalloid per cc of removal after 4 liters. All patients were monitored preoperatively via monitoring systolic, diastolic and mean arterial blood pressure, pulse rates, respiratory rates and SaO2. Then, these data were analyzed statistically. Mean absolute value of pulse rates 6 hours after operation was significantly less than mean absolute values before operation. Mean absolute value of SaO2 during operation was significantly more than before operation. Mean variations of respiratory rates in patients who underwent volume aspiration equal or less than 4 liters during and after operation were significantly more than the group with aspiratory volume >4 liters. The results achieved in candidates of tumescent LIPOSUCTION operation under sedation matched thoseobtained in patients undergoing LIPOSUCTION operation with superwet technique by general anesthesia. In this method, however, none of the patients manifested transient hypotension. Heart rates, respiratory rates and SaO2 were normal in all patients.

INTRODUCTION: LIPOSUCTION is a surgical procedure effective in reducing body fat, with growing application in conjunction with diet and exercise therapy in the treatment of obesity. In view of the positive effect of weight reduction on cardiovascular disease (CVD) risk factors, such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), systolic and diastolic pressure, lipid profile, fasting blood sugar, insulin resistance, inflammatory markers (e.g. chronic reactive protein: CRP), antioxidant capacity, fibrinogen and lipoprotein A (Lpa), this study was conducted to assess the effect of LIPOSUCTION as a therapeutic procedure in the treatment of obesity. METHODS: A total of 24 non-diabetic obese women (BMI>30) with a mean age of 48.7±7.3 years were studied. Before LIPOSUCTION, the subjects filled out questionnaires obtaining demographic information. Complete physical examination, measurement of waist and hip circumference, height, weight and calculation of WHR and BMI were performed. Fasting blood samples were taken to measure fasting blood glucose, total cholesterol, highdensity lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), fibrinogen, antioxidant capacity, CRP, lipoprotein A, serum insulin, and insulin resistance. All measurements and physical examinations were repeated 12-14 weeks after LIPOSUCTION. Data were analyzed with SPSS11 software using paired t-test and repeated measure ANOVA. RESULTS: WHR, BMI and LDL decreased significantly following LIPOSUCTION (P<0.05). Other parameters, however, did not change significantly, although there were signs of positive changes. DISCUSSION: LIPOSUCTION decreases BMI, WHR and LDL within 12-14 weeks of LIPOSUCTION. Providing these reductions are maintained, LIPOSUCTION may prove valuable in reducing CVD risk factors, besides offering a means for obesity control.      

Background: Tumescent local anaesthesia with prilocain can lead to clinically significant methemoglobin levels. New generation multiple wavelength pulse oximeters (e. g. Masimo Radical 7®, ) can measure methemoglobin levels. Methods: In this prospective observational study we compared the venous methemoglobin levels and the corresponding pulse oximetric values of the Radical 7®,in patients undergoing tumescent local anaesthesia for LIPOSUCTION procedures. The measurements were performed in Hanseklinik, Luebeck, Germany between 2008 and 2011. Results: In 133 patients, we measured a maximum methemoglobin level of 18 per cent. In a Bland-Altman analysis we found a mean bias of +2. 2 % (-4. 1 to 8. 4 limits of agreement) for pulse oximetric values compared to hemoximetry. Conclusion: Pulse oximetric measurement of methemoglobin is an early-warning tool for the detection of clinically significant methaemoglobinemia in patients with tumescent local anaesthesia.