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  1. 1. Cinch It © 2008 BioSculpture Technology, Inc. All rights reserved. ™
  2. 2. The Facts <ul><li>The U.S. obesity prevalence increased from 13% to 32% between the 1960s and 2004. </li></ul><ul><li>66% of U.S. adults were overweight or obese in 2003-2004 </li></ul><ul><li>Abdominal obesity as measured by waist circumference and waist hip ratio (WHR) is an independent predictor of mortality. </li></ul><ul><li>Marginally increased waist circumference is strongly associated with prevalent hypertension in normal-weight and overweight adults. </li></ul><ul><li>Although maintaining a healthy weight should continue to be a cornerstone in the prevention of chronic diseases and premature death, maintaining a healthy waist size should also be an important goal . </li></ul>
  3. 3. Metabolic Syndrome Any Three Risk Factors <ul><li>RISK FACTOR </li></ul><ul><li>Abdominal obesity </li></ul><ul><li>Triglycerides </li></ul><ul><li>HDL cholesterol </li></ul><ul><li>Blood Pressure </li></ul><ul><li>FBS </li></ul><ul><ul><li>DEFINING LEVEL </li></ul></ul><ul><li>Female >88 cm (>35”) </li></ul><ul><li>Men: >102 cm.(>40”) </li></ul><ul><li>≥ 150 ml/dl </li></ul><ul><li>Men < 40mg/dl </li></ul><ul><li>Women < 50 mg/dl </li></ul><ul><li>≥ 130/ ≥85 mm Hg </li></ul><ul><li>≥ 110 mg/dl </li></ul>Associated With Insulin Resistance and Increased risk of CHD
  4. 4. The Goal <ul><li>Achieve an improvement in the waist to hip ratios (WHR) of moderately obese patients with liposuction. </li></ul><ul><li>Document any improved metabolic status and BP of treated patients concurrent with improvement in the WHR. </li></ul><ul><li>Document the safety and reliability of twin cannula assisted liposuction (TCAL) for waistline reduction. </li></ul><ul><li>Measure patient satisfaction and evaluate the degree of skin contracture with TCAL. </li></ul>
  5. 5. Method <ul><li>Perform baseline BP, PE, waist and hip circumference measurements, total lipid profile, FBS, HbA1, and photos. </li></ul><ul><li>Perform TCAL liposuction on the abdomen and flanks sufficient to impact the waist hip ratios significantly (>10% waist reduction). </li></ul><ul><li>Repeat BP and WHR ratio measurements at 1, 3, 6 and 12 months after surgery. </li></ul><ul><li>Repeat photos at 6 months post-surgery </li></ul><ul><li>Repeat labs at 1, 3, 6, and 12 months after surgery. </li></ul><ul><li>Evaluate patient satisfaction, and skin contraction at 1,3,6, and 12 months postop. </li></ul><ul><li>Correlate data with change of WHR and evaluate metabolic significance. </li></ul>
  6. 6. Twin Cannula Liposuction (TCAL) <ul><li>Only the inner cannula moves, its aspirating hole aligned with a stationary outer cannula slot. </li></ul><ul><li>Eliminates the battering ram effect of reciprocating cannula on the patient </li></ul><ul><li>More precise, labor-free control of fat removal and pannus thinning. </li></ul><ul><li>Cannulas don’t get hot. </li></ul><ul><li>Removes fat cells as well as fat. </li></ul>
  7. 7. Treatment Records
  8. 8. Sponsors and Participants <ul><li>Airbrush Liposculpture ® of N.Y.C. </li></ul><ul><li>Airbrush Liposculpture ® of Palm Beach. </li></ul><ul><li>Airbrush Liposculpture ® of Los Angeles </li></ul><ul><li>Airbrush Liposculpture ® Centers, International </li></ul><ul><li>Rocin Foundation for Plastic Surgical Research </li></ul><ul><li>BioSculpture Technology, Inc . </li></ul>
  9. 9. References <ul><li>Skin Retraction after liposuction in patients over the age of 40. Bank DE, Perez MI Dermatol Surg. 1999 Sept:25(9): 673-6 </li></ul><ul><ul><li>Patients with an average age of 55 years obtained an average weight loss of 5 lbs and a waistline decrease of 3 “ 6 months after the procedure. </li></ul></ul><ul><ul><li>Tumescent liposuction of the abdomen, neck and arms is a safe alternative for contour improvement with good cosmetic results in patients over 40 years of age. </li></ul></ul>
  10. 10. References <ul><li>2. Blood loss in major liposuction procecdures: a comparison study using suction-assisted versus ultrasonically assisted lipoplasty. Karmo FR, Milan MF, Silbergleit A. Plast Reconstr Surg. 2001 Jul: 108(1) 241-9 </li></ul><ul><ul><li>The volume of whole blood loss was slightly higher in the liposuction aspirate, though insignificant when using ultrasound-assisted lipoplasty vs. suction-assisted lipoplasty. </li></ul></ul><ul><li>3. Powered liposuction. Coleman WP 3RD Dermatol Surg. 2000 Apr: 26(4): 315-8 </li></ul><ul><ul><li>Powered liposuction may provide the advantages of ultrasonic liposuction with fewer complications. </li></ul></ul>
  11. 11. References <ul><li>4. The benefits of powered liposuction versus traditional liposuction: a paired comparison analysis. Katz BE, Bruck MC, Coleman WP 3rd. Dermatol Surg. 2001 Oct:27(10): 863-7 </li></ul><ul><ul><li>Power liposuction cannulas produce significantly faster recovery times for patients, allow faster procedures times, and reduce surgeon fatigue, resulting in safer and more precise surgery. </li></ul></ul><ul><ul><li>A lower incidence of touch-up procedures is likely due to these benefits. </li></ul></ul>
  12. 12. References <ul><li>5. Improvements in cardiovascular risk profile with large-volume liposuction: a pilot study. Giese SY, Bulan EJ, Commons GW, Spear SL, Yanovski JA. Plastic Reconstr Surg. 2001 Aug: 108(2) 510-21 </li></ul><ul><ul><li>14 women with body mass indexes greater than 27 kg/m 2 underwent measurements of fasting plasma insulin, triglycerides, cholesterol, body composition by dual-energy X-ray absorptometry, resting energy expenditure, blood pressure before and after large-volume ultrasound-assisted liposuction. </li></ul></ul><ul><ul><li>Over a 4-month period, large-volume liposuction decreased weight, body fat mass, systolic blood pressure and fasting insulin levels without deterimental effects on lean body mass, bone mass, resting energy expenditure or lipid profiles. </li></ul></ul><ul><ul><li>Should these improvements be maintained over time, lipsouction may prove to be avaluable tool for reducing the comorbid conditions associated with obesity. </li></ul></ul>
  13. 13. References <ul><li>6. Large-volume liposuction and extensive abdominoplasty: a feasible alternative for improving body shape. Cardenas-Camarena L, Gonzalez LE Plast Reconstr Surg. 1998 Oct: 102(5): 1698-707. </li></ul><ul><ul><li>42 female patients underwent liposuction of large volumes and extensive abdominoplasty during an 18 month period with an average follow-up period of 9 months. </li></ul></ul><ul><ul><li>Their average age was 40 years and only 11% were at their ideal weight. </li></ul></ul><ul><ul><li>Tumescent liposuction was performed and followed by extensive abdomnoplasty. 52% of the patients underwent a 3rd cosmetic surgical procedure. </li></ul></ul><ul><ul><li>Volumes of 1600 ml up to 11,2000 ml were obtained through liposuction, with an average of 4230. Abdominoplasty removals averaged 1300 gm. </li></ul></ul><ul><ul><li>Only two of the heaviest patients required a unit of autologous blood because they underwent concurrent breast reduction. </li></ul></ul><ul><ul><li>Tumescent liposuction reduces bleeding enough to allow feasible combination of large volume liposuction with abdominoplasty. </li></ul></ul>
  14. 14. References <ul><li>7. Optimization of conscious sedation in plastic surgery. Marcus JR, Tyrone JW, Few JW, Fine NA, Mustoe TA. Plastic Reconstr Surg 1999 (Oct): 104(5) 1338-45. </li></ul><ul><ul><li>Conscious sedation followed a standardized administration protocol using incremental doses of two agents: midazolam (0.25 to 1 mg) and fentanyl (12.5 to 50 mcg). </li></ul></ul><ul><ul><li>Conscious sedation is an effective anesthetic choice for routine plastic surgical procedures many of which would be commonly performed under general anaesthesia. </li></ul></ul>
  15. 15. Airbrush ®