Surgeon(s): ***

‍Assistant Surgeon(s):  ***

‍Preoperative Diagnosis: ***

‍Postoperative Diagnosis: Same

‍Procedure(s): ***

‍Anesthesia: General

‍Implants: None

‍Specimen:***

‍Drains: None

‍Fluids: See anesthesia record

‍EBL: Minimal

‍Complications: None

‍Counts:  Correct x2

‍Indications: ​***

‍Findings: As expected

‍Procedure in Detail:

‍The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

Tumescent solution mixture was prepared by combining 50cc 2% lidocaine, 10cc TXA, 1cc of 1:1,000 epinephrine in 500cc of 0.9% normal saline. This preparation was injected into the left lateral thigh in the subcutaneous plane (500 cc); in the subperiosteal and subpericranial space of the forehead and scalp to the vertex and in the superficial temporal spaces bilaterally (500 cc); subcutaneous plane of the face and neck (500 cc); subcutaneous plane of the face and neck (500 cc). The surgical sites were again prepped with Chlorohexidine scrub and draped in the standard sterile fashion.

Autologous fat transfer:
An #11 blade was used to make a 7 mm access incision in the left lateral thigh. Liposuction was performed using a 3 mm single hole blunt cannula attached to the LipiVage syringe. Liposuction was completed with minimal pressure on the cannula ensuring parallel movement in all directions and staying in the subcutaneous plane. Increments of 5 cc were harvested, cleaned, compressed, and transferred into 1 cc syringes. A total of 15 cc of fat was harvested and the access port was closed with 4-0 plain gut.

Next, an #11 blade was used to make access incisions in the nasal alar bases bilaterally. The harvested fat was injected in a submuscular plane using a 1.2 mm two hole luer lock blunt tipped cannula into the bilateral midface, nasolabial folds,

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The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.

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