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Contouring of the Extremities

  • Onelio GarciaJr.
Chapter

Abstract

The latest procedural statistics from the American Society of Plastic Surgeons rank liposuction as the second most common aesthetic surgical procedure performed by board certified plastic surgeons. In the author’s experience, 40% of liposuction cases involve the extremities and the great majority of these cases are carried out on female patients. Individuals who are close to their ideal body weight and have a disproportionately high distribution of fat in the lower extremities in relation to their trunk are still the best candidates for thigh liposuction. Poor patient selection and overextraction resulting in excessive skin laxity and contour deformities are the most common causes of inferior aesthetic results following contouring of the thighs. There are five zones of adherence in the thighs and these are areas that should be avoided during liposuction procedures: (1) the gluteal crease, (2) the posterior distal thigh above the popliteal crease, (3) the lower lateral thigh area of the iliotibial tract, (4) the lateral gluteal depression, and (5) the mid-medial thigh area. The author’s approach to thigh contouring involves the use of VASER-assisted liposuction since it is associated with less blood loss, good skin retraction, and a relatively comfortable postoperative course for the patient. Patients with significant skin laxity are best treated with thighplasty or VASER-assisted thighplasty depending on the degree of lipodystrophy present. Preoperative planning of upper extremity contouring involves a comparison of the relationship between the excess arm fat and the skin envelope of the arm. In cases of arm lipodystrophy with good skin tone, VASER-assisted liposuction allows for easier fat extraction with good skin retraction. Poor skin tone, regardless of the amount of arm fat, usually dictates that an open tightening procedure be performed in order to properly contour the arm. Patients with poor skin tone and a significant amount of excess arm fat are best treated by a VASER-assisted brachioplasty.

Keywords

VASER lipo VASER-assisted liposuction Arm liposuction Thigh liposuction Brachioplasty Thighplasty 

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Copyright information

© 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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