Investigation of the effect of liposuction on the perforator vessels using color Doppler ultrasonography

In this clinical study, the effect of conventional liposuction on musculocutaneous and fasciocutaneous perforator vessels was investigated. The perforator vessels in the abdominal and lateral and medial thigh regions in 7 patients and in the abdominal region in 3 patients (a total of 38 anatomic regions in 10 patients) were marked preoperatively by color Doppler ultrasonography. Following a standard liposuction procedure, the changes in the number of the perforators in those regions were detected by the same method postoperatively at 2 weeks and 3 months. The number of cannula passes employed and total volume of the aspirate for each region were also recorded. The results of the Doppler examinations showed that 57.8% of abdominal, 50.0% of lateral thigh and 53.8% of medial thigh perforators could not be detected at 2 weeks and 3 months (p < 0.01) postoperatively. Both the number and the locations of the perforators were found to be identical for each anatomic region at the two postoperative Doppler examinations at 2 weeks and 3 months. The changes in the number of the perforators did not show any type of correlation with the number of cannula passes and the aspirate volume. The results of this study have shown that conventional liposuction may have a traumatic effect on the perforator vessels passing from the deep fascia towards the overlying skin. This observation has led us to suggest that a history of previous liposuction should be an indication for preoperative evaluation of the perforators when a musculocutaneous or fasciocutaneous flap is planned in the suctioned regions. This may prevent problems related with flap viability.