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This article charts the progress and evolution of ‘liposculpture’ over an 18-year period, the surgical journey of over 5000 patients included in the paper. The senior author highlights the technical changes made over the period and how these have led to better postoperative outcomes and statistically lower complication rates.

The landscape of liposuction has changed dramatically over the last two decades. Previously, a procedure utilised by the overweight patient cohort, liposculpture has seen a paradigm shift to patients with normal fat volumes. There has been a move away from pure removal of fat to a more sculpted appearance to reveal, and on occasion enhance, the anatomy below.

Three groups of patients are chronologically identified from different periods – the first from 2002-5 where suction-assisted liposuction was used, the second from 2006-10 where vibration amplification of sound energy at resonance (VASER) high-definition liposuction was used and the third from 2011 where the technique is described as ‘Dynamic definition liposculpture’. The latter involves the adding bulk to ‘power’ muscles and highlighting ‘definition’ muscles.

The paper also explains adjuncts that have been introduced in an effort to reduce complications, namely pre and intraoperative warming and tranexamic acid. Comprehensive analysis of postoperative outcomes shows that these have had a positive impact as demonstrated in this table. The trend being to a greater volume of aspirate with an overall lower complication rate.



Overall, this paper would benefit from more information on preoperative assessment and planning as well as details on intraoperative technical steps but perhaps this is purposeful. The ‘total definer’ three-day course run by the senior author currently costs $24,000 to attend. Nevertheless, the development of new techniques and change in practice with associated risk reduction is commendable.

High-Definition Liposculpture 18-Year Evolution: Patient Safety and Aesthetic Outcomes.
Hoyos AE, Cala LC, Perez ME, et al.
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James ET Wokes

University Hospital North Durham, UK

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