Deep Liposuction: Analysis of 962 Patients with a Natural Definition of the Abdomen

BACKGROUND: High-definition liposuction represents an evolution of traditional liposuction in body contouring surgery. This study was conducted to determine whether extensive liposuction of the deep (lamellar) layer with preservation of the superficial (areolar) layer results in a naturally defined abdomen without the stigma of liposuctioned skin and is associated low rates of early and late complications. METHODS: This cross-sectional, retrospective study was conducted between May of 2015 and April of 2022. A total of 962 patients underwent trunk liposuction surgery, including 864 women (89.8%) and 98 men (10.2%). Surgical strategies were standardized and described in the following stages: surgical marking, infiltration plan, liposuction plan, and postoperative care. All patients underwent vibroliposuction on the back and suction-assisted liposuction on the abdomen. Early and late complications and patient satisfaction rates were also analyzed. RESULTS: The mean patient age was 26 years. Early complications included pulmonary embolism (0.3%), infection (0.5%), epidermolysis (0.6%), deep vein thrombosis (0.8%), anemia (13.1%), and seroma (14.9%). Late complications included contour irregularities (1.2%), localized fat accumulation (1.5%), cutis marmorata (1.7%), hyperpigmentation (2.6%), and transient fibrosis (3.2%). No cases of mortality, fat embolism, intra-abdominal injury, or skin necrosis were reported. The majority of patients (96%) were satisfied with the results. CONCLUSIONS: Liposuction exclusive to the deep (lamellar) layer was associated with a reduction in early and late complications, except for anemia, and resulted in natural abdominal definition and high patient satisfaction. These findings support the safety and aesthetic benefit of this technique.