Surgical Techniques and Outcomes of Abdominal Liposculpting in Male Patients: A Systematic Review
Joseph M. Escandón1, Krishna S. Vyas2, Oscar J. Manrique1
1Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, USA, 2Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
Background: Lipoplasty has undergone a series of refinements throughout history. It is now possible to apply superficial suction to enhance the outline of a muscle in order to improve the results of aesthetic lipoplasty in males. Herein, we summarized the available literature on methods used for abdominal high-definition lipoplasty (HDL) in male patients.
Methods: A comprehensive search was conducted across PubMed MEDLINE, Web of Science, SCOPUS, and Ovid MEDLINE(R) through February 2021. Data regarding the number of patients, age, body mass index (BMI), preoperative markings, tumescent solution, types of cannula, liposuction technique, lipoaspirate volume, fat grafting technique, closure of incisions, surgical outcomes, and complications were extracted.
Results: Overall, 13 studies comprising 1280 patients fulfilled the inclusion criteria. The age of patients ranged from 18 to 71 years. The average BMI ranged from 18.8 to 38 kg/m2. The follow-up ranged from 2 weeks to 10 years. Preoperative markings were performed exclusively in the standing position in ten studies, while two series reported preoperative markings performed in different positions. Preoperative markings were limited to the anterolateral abdominal wall in six studies, while preoperative markings beyond liposculpting of the anterior and lateral abdominal wall muscles were reported in seven studies. Four studies used tumescent solution with diluted epinephrine, while nine studies used tumescent solution diluted with local anesthetic and epinephrine. The liposculpting concepts reported were abdominal etching, high-definition (HD), muscular sculpture, and Dynamic Definition (HD2). Four studies used conventional liposuction, three used VASER-assisted liposuction, and six studies used power-assisted liposuction. Nine articles reported the use of fat grafting as an adjunct to liposuction to improve outcomes of aesthetic lipoplasty. All studies reported the use of postoperative garments and a well-established wound protocol. Overall satisfaction ranged from 90% to 100%. The mean operative time ranged from 155 to 230 minutes, reported in two articles. The average lipoaspirate using abdominal etching was 3325-cc (range 100-10200cc) and the mean lipoaspirate following HDL and HD2 was 4925.77-cc (range of means, 500-9700cc). The most common complications reported were fluid collection (n=60), hyperpigmentation (n=53), contour irregularities (n=11), anemia (n=6), and dehiscence (n=6).
Conclusion: A wide variety of techniques are available to perform HDL with a variable degree of definition. A careful patient selection is critical for successful results, as HDL cannot be applied as a standardized procedure to every patient. Finally, Proper training and adequate knowledge of the superficial anatomy of bodies are necessary to avoid complications.
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