Contouring of the Trunk

  • Onelio GarciaJr.


Liposuction is currently the second most common aesthetic surgical procedure reported by board certified plastic surgeons in the latest procedural statistics of the American Society of Plastic Surgeons. The trunk is the most common anatomical area for which patients seek liposuction. With few exceptions, circumferential contouring of the trunk typically yields a more harmonious aesthetic result than spot liposuction. The author’s preferred method for contouring the trunk involves VASER-assisted liposuction (VAL), which is associated with less postoperative bruising and edema. Lipoabdominoplasty is a surgical procedure with its own distinct set of technical components: extensive sub-Scarpa’s liposuction throughout abdomen and flanks, limited paramedian dissection in the upper abdomen, and dissection at Scarpa’s fascia level lateral to the rectus muscle fascia. The procedure is associated with lower seroma rates and better overall postoperative contour than standard abdominoplasty techniques.


VASER-assisted liposuction Circumferential liposuction 360∗ liposuction Lipoabdominoplasty VASER-tummy tuck VASER lipo 

Supplementary material

Video 6.1

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  1. 1.
    The American Society for Aesthetic Plastic Surgery. Cosmetic Surgery National Data Bank, Procedural Statistics; 2017.Google Scholar
  2. 2.
    Rohrich RJ, Beran SJ, Kenkel JM. Abdomen. In: Rohrich RJ, Beran SJ, Kenkel JM, editors. Ultrasound-assisted liposuction. St. Louis: Quality Medical Publishing; 1998. p. 195–214.Google Scholar
  3. 3.
    Garcia O, Nathan N. Comparative analysis of blood loss in suction-assisted lipoplasty and third generation internal ultrasound-assisted lipoplasty. Aesthet Surg J. 2008;28:430–5.CrossRefGoogle Scholar
  4. 4.
    Garcia O. Comparison of blood loss in suction-assisted lipoplasty and third generation ultrasound-assisted lipoplasty. In: Shiffman MA, Di Giuseppi A, editors. Body contouring: art, science and clinical practice. Berlin: Springer; 2010. p. 565–73.CrossRefGoogle Scholar
  5. 5.
    Hoyos AE, Prendergast PM. Muscular and surface anatomy. In: Hoyos AE, Prendergast PM, editors. High definition body sculpting: art and advanced lipoplasty techniques. Berlin: Springer; 2014. p. 19–39.Google Scholar
  6. 6.
    Klein JA. The tumescent technique for liposuction surgery. Am J Cosmet Surg. 1987;4:263–7.CrossRefGoogle Scholar
  7. 7.
    Fodor PB. Wetting solutions in aspirative lipoplasty: a plea for safety in liposuction. (Editorial). Aesthet Plast Surg. 1995;19:379.CrossRefGoogle Scholar
  8. 8.
    Rohrich RJ, Beran SJ, Fodor PB. The role of subcutaneous infiltration in suction-assisted lipoplasty: a review. Plast Reconstr Surg. 1997;99:514–9.CrossRefGoogle Scholar
  9. 9.
    Garcia O. Liposuction of the upper and lower extremities. In: Aly A, Nahas F, editors. The art of body contouring: a comprehensive approach. New York: Thieme Medical Publishers; 2017. p. 361–95.Google Scholar
  10. 10.
    De Jong RH. Titanic tumescent anesthesia. Dermatol Surg. 1998;24:689–92.CrossRefGoogle Scholar
  11. 11.
    Trott SA, Stool LA, Klein KW. Anesthetic considerations. In: Rohrich RJ, Beran SJ, Kenkel JM, editors. Ultrasound-assisted liposuction. St. Louis: Quality Medical Publishing; 1998. p. 69–84.Google Scholar
  12. 12.
    Saldanha OR, Souza Pinto EB, Matos WN Jr, et al. Lipoabdominoplasty without undermining. Aesthet Surg J. 2001;21:518–26.CrossRefGoogle Scholar
  13. 13.
    Saldanha OR. Lipoabdominoplasty with selective and safe undermining. Aesthet Plast surg. 2003;27(4):322–7.CrossRefGoogle Scholar
  14. 14.
    Saldanha OR. Lipoabdominoplasty: the Saldanha technique. Clin Plast Surg. 2010;37:469–81.CrossRefGoogle Scholar
  15. 15.
    Graf R, Reis de Araujo LR, Rippel R, et al. Lipoabdominoplasty: liposuction with reduced undermining and traditional abdominal skin flap resection. Aesthet Plast Surg. 2006;30:1–8.CrossRefGoogle Scholar
  16. 16.
    Samra S, Sawh-Martinez R, Barry O, Persing JA. Complication rates of lipoabdominoplasty versus traditional abdominoplasty in high risk patients. Plast Reconstr Surg. 2010;125(2):683–90.CrossRefGoogle Scholar
  17. 17.
    Di Martino M, Nahas FX, Barbosa MVJ, et al. Seroma in lipoabdominoplasty and abdominoplasty: a comparative study using ultrasound. Plast Reconstr Surg. 2010;126(5):1742–51.CrossRefGoogle Scholar
  18. 18.
    Costa-Ferreira A, Rebelo M, Vazconez LO, Amarante J. Scarpa fascia preservation during abdominoplasty: a prospective study. Plast Reconstr Surg. 2010;125(4):1232–9.PubMedGoogle Scholar
  19. 19.
    Garcia O. Ultrasonic liposuction. In: Rubin JP, Jewell ML, Richter DF, et al., editors. Body contouring and liposuction. Philadelphia: Saunders; 2013. p. 543–58.Google Scholar
  20. 20.
    Garcia O. Liposuction for body contouring: discussion. In: Cohen MN, Thaller SR, editors. The unfavorable result in plastic surgery: avoidance and treatment. New York: Thieme Medical Publishers; 2018. p. 451–5.Google Scholar
  21. 21.
    Spring MA. Use of a lysine-derived urethane surgical adhesive as an alternative to progressive tension sutures in abdominoplasty patients: a cohort study. Aesthet Surg J. 2018;38:1318–29.CrossRefGoogle Scholar
  22. 22.
    Toledo LS, Mauad R. Complications of body sculpture: prevention and treatment. Clin Plast Surg. 2006;33(1):1–11.CrossRefGoogle Scholar
  23. 23.
    Garcia O, Schafer M. The effects of non-focused external ultrasound on tissue temperature and adipocyte morphology. Aesthet Surg J. 2013;33:117–27.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Onelio GarciaJr.
    • 1
  1. 1.Division of Plastic SurgeryUniversity of Miami, Miller School of MedicineMiamiUSA

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