Liposuction'assisted excision cervicofacial lipomas of

A technique is described for use of liposuction-assisted removal of even large lipomas through small skin incisions. (OTOLARYNGOL HEAD NECK SURG 1995;I 13:401-3,) Cervicofacial lipomas are common tumors that can cause significant cosmetic deformities in the head and neck. Conventional surgical approaches require incisions almost the length of the tumor and may require dissection around nerves and vessels, trad-ing improved contour for a long scar. We have used liposuction-assisted surgery in five patients to re-move cervicofacial lipomas up to 20 cm in size through very small incisions. SURGICAL TECHNIQUE Tumor size and location are assessed, and incision placement is planned so that the incision falls in a preexisting skin crease or anatomic interface bound-ary and allows access to the entire tumor (Fig. 1). The margins of the tumor are established by ballot-ment, and the edges are marked with a surgical marking pen. The lipoma and surrounding area, including deep to the lipoma, are infiltrated with a local anesthetic. A small (1.5 to 3.0 cm) incision is made at the periphery of the mass, camouflaged as possible in a skin crease or anatomic boundary. Pretunneling between thelipoma and the overlying skin is performed with long-handled scissors, estab-lishing the plane of dissection. A cobra-tip suction cannula is introduced through the incision and used to separate the lipoma from the overlying skin (Fig. 2). Care is taken to avoid suctioning too long in one area and to keep the suction opening away from th