The practice of massive liposuction for the treatment of patients with
large lipodystrophies has already been reported. The safety of this t
echnique lies in proper fluid and blood replacement. Blood conservatio
n techniques are therefore needed to avoid or minimize homologous tran
sfusion. The use of a combination of predeposited autologous blood and
acute intraoperative normovolemic hemodilution in the management of 1
50 patients requiring massive liposuction is reported. Since it is pos
sible to anticipate the amount of blood loss in liposuction, a formula
is proposed to monitor the hematocrit of the patient during the proce
dure and therefore predict the need for homologous transfusion. The te
chnique reported enabled us to aspirate up to 11 liters in a single st
age. Homologous transfusion was either avoided or markedly reduced. Th
e degree of patient satisfaction was high, with no mortality or morbid
ity reported.