Regional distribution and behavior of the subcutaneous tissue concerning selection and indication for liposuction

Avelar, Juarez M.; Fodor, Peter B.

doi:10.1097/00006534-199009000-00096

Cited by 12 publications

(17 citation statements)

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“…Markman and Barton studied the anatomy of the subcutaneous fat tissue in the trunk and extremities and confirmed the presence of a membranous layer in the thigh 44 . Others noted that the anatomy of the membranous layer varied with sex, adiposity, and body region 45 and that it was thicker in the lower compared with the upper extremity and on the posterior compared with the anterior aspect of the body 46 . Many anatomical studies have described the LFCN anatomy and its variations in relation to the ASIS, the approach for iliac crest bone harvesting, or the surgical management of meralgia paresthetica [19][20][21][22][23][24][25][26]40 .…”

Section: Course O F T H E Lat E R a L Femoral Cutaneous N E Rv E W I mentioning

confidence: 99%

The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

Rudin

Manestar

Ullrich

et al. 2016

The Journal of Bone and Joint Surgery

110

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BACKGROUND: Injury to the lateral femoral cutaneous nerve (LFCN) is a risk during the operative anterior approach to the hip joint. Although several anatomical studies have described the proximal course of the nerve in relation to the anterior superior iliac spine (ASIS) and the inguinal ligament, the distal course of the LFCN in the proximal aspect of the thigh has not been sufficiently studied. The aim of this cadaveric study was to examine the branching pattern of the nerve, with special consideration to the anterior approach to the hip joint. METHODS: Twenty-eight cadaveric hemipelves from 18 donors (10 paired and 8 unpaired specimens) were dissected. The LFCN branches were localized proximal to the inguinal ligament and traced distally into the area of the proximal aspect of the thigh. Distribution patterns of the nerve with respect to its relationship to the ASIS and the internervous plane of the anterior approach to the hip joint were recorded. RESULTS: We found 3 different branching patterns of the LFCN: sartorius-type (in 36% of the specimens), characterized by a dominant anterior nerve branch coursing along the lateral border of the sartorius muscle with no, or only a thin, posterior branch; posterior-type (in 32%), characterized by a strong posterior nerve branch; and fan-type (in 32%), characterized by multiple spreading nerve branches of equal thickness. In 50% of the specimens, the LFCN divided into 2 branches superior to the inguinal ligament. Sixty-two percent of the LFCN branches entered the proximal aspect of the thigh medial to the ASIS; 27%, above; and 11%, lateral to the ASIS. The LFCN consistently coursed within the deep layer of the subcutaneous fat tissue. CONCLUSIONS: Injury to branches of the LFCN cannot be avoided in approximately one-third of surgical dissections that use the anterior approach to the hip joint. To protect the anterior branch of the LFCN, the skin incision should be as lateral as possible. The posterior branch of the LFCN is most vulnerable in the proximal aspect of the anterior approach to the hip joint, where it can be expected to course within the deep layer of the subcutaneous tissue. Background: Injury to the lateral femoral cutaneous nerve (LFCN) is a risk during the operative anterior approach to the

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Section: Course O F T H E Lat E R a L Femoral Cutaneous N E Rv E W I mentioning

confidence: 99%

The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

Rudin

Manestar

Ullrich

et al. 2016

The Journal of Bone and Joint Surgery

110

View full text Add to dashboard Cite

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“…the arms or the lower legs, the contourgiving layer exists on its own; on the trunk, on the other hand, the subcutis tends to be in two layers. Recent anatomical studies have provided more detail on the structure of the subcutis in different parts of the body [1,10,11]. In clinical medicine, the "pinch test" gives an indication of the structure of the subcutis.…”

Section: Abstract: Anatomy Of the Subcutis-adipose Tissue -Liposuctimentioning

confidence: 99%

Aspiration lipectomy and adipose tissue injection pathophysiologic commentary

Smahel

1991

Eur J Plast Surg

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“…[21][22][23][24][25][26][27][28][29][30][31][32] There is considerable scientific data to validate this concept. [21][22][23]28,[32][33][34] We can speak of a trilaminar structure with superficial compartment dominance and a minor contribution of the deep fat compartment to the total thickness (less than 25%). 32 The superficial fat compartment is always the thickest regardless of the adiposity degree.…”

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confidence: 99%

Abdominoplasty With Scarpa Fascia Preservation

Costa‐Ferreira

Rebelo

Vásconez

et al. 2016

Annals of Plastic Surgery

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The plane of dissection used during a full abdominoplasty has been implicated on the seroma rate. Avoiding the classic plane of dissection on top of the rectus fascia and using a more superficial plane of dissection has been suggested as a strategy to improve recovery and lower the complication rate. The authors have been applying this principle in their practice for more than a decade, and they performed 2 prospective comparative studies to evaluate the clinical effects of using a more superficial plane of dissection (with Scarpa fascia preservation) during a full abdominoplasty.The technique is presented and explained along with the results of both comparative studies.The results of both studies are discussed particularly the effects on drain volume (total and daily), the duration of drain usage and the avoidance of "long drainers." These are very relevant advantages of the technique that have not been discussed in the literature. The results and surgical strategies used by other authors which apply a more superficial plane of dissection are presented.Controversy still exits on the manipulation of the deep fat compartment by liposuction or direct fat excision. No manipulation is another option which should be considered but it has been questioned due to the risk of aesthetic compromise. A morphometric study performed on the surgical specimens of 41 female patients submitted to a full abdominoplasty validates that option.Based on this evidence, the authors recommend that surgeons consider performing abdominoplasties using a more superficial plane of dissection in the infraumbilical area with total preservation of Scarpa fascia and the deep fat compartment. The classic plane of dissection, on top of the deep fascia, should be avoided in the lower abdomen.

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Regional distribution and behavior of the subcutaneous tissue concerning selection and indication for liposuction

Cited by 12 publications

References 0 publications

The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

Aspiration lipectomy and adipose tissue injection pathophysiologic commentary

Abdominoplasty With Scarpa Fascia Preservation

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