Contents

Part I Art and Science
1 The Human Form as Art: Contours, Proportions,
and Aesthetic Ideals 3
Introduction . 3
Art and Anatomy . 4
Liposuction Technology and Body Art . 6
Human Form . 7
Symmetry and Proportions . 8
Aesthetic Ideals and the Science of Beauty 11
References . 18
2 Muscular and Surface Anatomy 19
Introduction . 19
Trunk Muscles . 19
Rectus Abdominis 19
External Oblique . 22
Serratus Anterior 23
Pectoralis Major 24
Latissimus Dorsi . 25
Erector Spinae 25
Multifidus . 27
Shoulder and Arm . 27
Deltoid 27
Triceps 28
Biceps . 29
Brachialis 30
Thighs and Hips 30
Gluteus Maximus 30
Gluteus Medius . 31
Iliopsoas 31
Quadriceps 32
Hamstrings 34
Sartorius 34
Adductor Group 35

Lower Leg . 36
Gastrocnemius 36
Soleus . 36
Fat Distribution . 36
References . 39
3 The Concept of Human Sculpting: Light, Shadow,
and Form 41
Introduction . 41
Lipoplasty as Sculpting . 41
Removal vs. Revealing 42
Chief Lines 42
Light and Shadows 42
Contours and Form . 43
Positive and Negative Spaces 44
Advanced Lipoplasty Techniques . 44
Infiltration . 45
Emulsification . 45
Aspiration . 46
Controlled Deformities . 46
Fat Grafting . 47
References . 48
4 Preoperative Assessment and Preparation
for High-Definition Body Sculpting . 49
Introduction . 49
Consultation 49
History . 50
Physical Examination and Assessment . 52
General . 52
Abdomen and Torso 52
Chest . 54
Arms . 55
Buttocks, Thighs, and Calves . 55
Patient Selection 56
Preparation 56
References . 64
5 Anesthesia: Tumescent, MAC, and General . 65
Introduction . 65
Preanesthesia . 65
Medical Record 65
Tumescent Anesthesia . 67
Monitored Anesthesia Care (MAC) 70
General Anesthesia . 70
Premedication and Indications . 71
Surgical Management . 71
Postsurgical Anesthetic Management . 72
References . 72

6 VASER Technology for Ultrasound-Assisted
Lipoplasty 73
History . 73
Principles of UAL and VASER . 74
VASER® Technology and Instrumentation . 76
VASER® Technique . 78
Advantages 80
References . 80
7 Fat Anatomy, Metabolism, and Principles
of Grafting . 83
Liquid Gold . 83
Fat Metabolism and Endocrinology 84
Fat Anatomy: The Subcutaneous Tissue
and Superficialis Fascia . 85
Equipment . 86
Technique 86
Donor Site . 87
Harvesting . 87
Graft Processing 88
Injection Procedures 89
References . 90
Part II The Male Patient: Technique
8 Male Abdomen and Torso 95
Introduction . 95
Stealth Incisions 96
The Use of Drains . 96
Markings . 97
Deep Markings . 97
Framing . 97
Negative Spaces 99
Procedure 100
Infiltration . 100
Emulsification . 100
Extraction . 101
Defining the Rectus Abdominis 102
Midline . 104
Postoperative Care 104
References . 107
9 Male Chest . 109
Introduction . 109
Stealth Incisions 111
The Use of Drains . 111
Markings . 111
Deep Markings . 111

Framing . 111
Negative Spaces 112
Procedure 112
Infiltration . 113
Emulsification . 113
Extraction . 113
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Postoperative Care 114
References . 117
10 Male Arms . 119
Introduction . 119
The Arm Has Curves 119
The Youth Angle . 119
Stealth Incisions 120
The Use of Drains . 121
Markings . 121
Deep Markings . 121
Framing . 121
Negative Spaces 123
Procedure 123
Infiltration . 123
Emulsification . 123
Extraction . 123
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Postoperative Care 126
References . 127
11 Male Torso and Back 129
Introduction . 129
Stealth Incisions 129
The Use of Drains . 129
Markings . 130
Deep Markings . 130
Framing . 130
Negative Spaces 131
Procedure 132
Infiltration . 132
Emulsification . 133
Extraction . 133
Postoperative Care 136
References . 136
12 Male Buttocks and Thighs 137
Introduction . 137
Stealth Incisions 138
The Use of Drains . 138
Markings . 139
Deep Markings . 139
Framing . 139
Negative Spaces 139
Procedure 140
Infiltration . 140
Emulsification . 140
Extraction . 140
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Postoperative Care 141
References . 143
Part III The Female Patient: Technique
13 Female Abdomen and Torso 147
Introduction . 147
Stealth Incisions 148
The Use of Drains . 148
Markings . 148
Deep Markings . 148
Framing . 148
Negative Spaces 149
Procedure 150
Infiltration . 150
Emulsification . 150
Extraction . 150
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Postoperative Care 151
References . 155
14 Female Dorsum, Flanks, and Hips 157
Introduction . 157
Stealth Incisions 157
The Use of Drains . 158
Markings . 158
Deep Markings . 158
Framing . 158
Negative Spaces 158
Procedure 160
Infiltration . 160
Emulsification . 160
Extraction . 160
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Postoperative Care 161
References . 163
15 Female Buttocks 165
Introduction . 165
Stealth Incisions 166
The Use of Drains . 166
Markings . 166

Deep Markings . 166
Framing . 166
Negative Spaces 167
Procedure 170
Infiltration . 170
Emulsification . 170
Extraction . 171
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Postoperative Care 172
References . 176
16 Female Breasts . 177
Introduction . 177
Stealth Incisions 178
The Use of Drains . 178
Marking . 178
Deep Markings . 178
Framing . 178
Negative Space . 178
Procedure 178
Infiltration . 178
Emulsification . 179
Extraction . 179
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
References . 185
17 Female Arms 187
Introduction . 187
Stealth Incisions 187
The Use of Drains . 187
Markings . 188
Deep Markings . 188
Framing . 188
Negative Spaces 188
Procedure 189
Infiltration . 189
Emulsification . 189
Extraction . 189
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Postoperative Care 191
References . 191
18 Female Lower Limb: Thighs and Calves 193
Introduction . 193
The Ideal Leg 193
Stealth Incisions 194
The Use of Drains . 195
Markings . 195
Deep Markings . 195

Framing . 197
Negative Spaces 197
Procedure 198
Infiltration . 198
Emulsification . 198
Extraction . 198
Fat Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Postoperative Care 200
References . 203
Part IV Postoperative Considerations
19 Postoperative Care 207
Targets of Postoperative Care . 207
Drainage 207
Compression . 208
Ambulation 210
CARE System of Postoperative Care 211
Manual Lymphatic Drainage . 212
External Ultrasound (US) . 214
Physiological and Therapeutic Effects
of External Ultrasound . 214
Precautions Using External Ultrasound 215
Pressotherapy 215
Physiologic and Therapeutic Effects of Pressotherapy 215
Contraindications to Pressotherapy 216
Energy-Based Therapies . 216
Diathermy . 216
Wet Heat 217
Carboxytherapy . 217
References . 217
20 Complications of High-Definition Body Sculpting . 219
Introduction . 219
General Liposuction Complications . 219
Bleeding 219
Infection 220
Necrosis 220
Seroma 221
Thromboembolism . 221
Pulmonary Edema 221
Lidocaine Toxicity 222
Perforation 222
Fat Embolism 223
Specific Energy-Assisted Liposuction Complications 223
Complications Related to High-Definition
Body Sculpting . 223
Contour Irregularities . 224
Skin Retraction . 225

Asymmetry . 225
Unnatural Appearance 226
Fibrosis and Nodularity 227
Unsightly Scars . 227
Loose Skin 228
Burns . 228
References . 228
21 New Developments in High-Definition
Lipoplasty . 231
Introduction . 231
Mini-abdominoplasty with Definition . . . . . . . . . . . . . . . . . . . . . . 231
Full Lipoabdominoplasty with Definition . 233
The Initial Concepts of Dynamic Definition . 233
Post-Bariatric Surgery Patient . 233
High-Definition Breast Enhancement with Enriched Fat . 236
Cellulite and Secondary Fibrosis Patients . 236
Defining the Future . 237
Index . 239