Plastic Surgeons Consider Skin Retraction, Not Just Fat Removal, As Technique Evolves

According to Two senior plastic surgeons in different parts of the world have shown that low complication rates and excellent results with liposucture of the hips, flanks, and thighs

In the report plastic surgeons Yixin Zhang, MD, PhD, of Shanghai JiaoTong University and Manuel Francesco Castello, MD, of Clinica Villa Salaria, Rome, conclude that, “based on our 20 years of experience and observations on three-dimensional liposuction, we can suggest it a reliable method with proven results.” In the report they and their coauthors describe and analyze their technique and outcomes of lower-body liposculpture in more than 4,000 patients.

They write that liposculpture “is a very sophisticated method that goes beyond the simple aspiration of adipose tissue [fat] and allows the surgeon to modify the shape of the body and recontour the profile.”

The key part of the technique is not only to remove underlying fat, but also to guide and promote skin retraction after fat removal. This includes thinning of the skin to allow it to retract and adapt to the new shape.

The new report outlines each step of the procedure, from initial evaluations, to preoperative marking, patient preparation and liposuction technique. Postoperative care includes compression garments and bandages to guide skin adaptation to the carefully sculpted underlying fat.

They note that their cosmetic results have been well-maintained during follow-up, including in patients with pregnancies or weight loss or gain. “If performed correctly, three-dimensional liposuction of trunk, hips and thighs can yield very satisfying outcomes because of the excellent contour and enhanced skin retraction provided by the thin cutaneous [skin] adipose flap,” they write.

Complications rates were low, with only one serious complication—an infection that responded to antibiotics—in more than 4,000 patients.

Drs Zhang and Castello and coauthors believe their experience demonstrates the excellent cosmetic results and safety record of three-dimensional liposculpture of the hips, flanks, and thighs—and highlights the role of techniques aimed at promoting good skin adaptation to the new shape.