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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_511_Библиотеки_им_академика_М_И_Перельмана
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13 Hi-Def Liposuction inMales andFemales
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a
b
c
Fig. 13.5 (a–c) Ninja thumb is used to dene semilunaris diamonds and linea alba
a
Fig. 13.6 (a, b) Karate chop is used to dene inscriptions
b
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G. Hamlet and A. Mowlavi
a
c
b
d
Fig. 13.7 (a–d) Thumb-index nger arc is used to dene transitions between diamonds, semilunaris lines and inscriptions
a
Fig. 13.8 (a, b) Finger push is used to sculpt inscriptions when your thumb gets tired
b
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ies. The optimization of fat harvesting is another critical
component of HDL body contouring as traditional liposuction techniques have been associated with suboptimal fat
take. Resorptions of 40% at 6 months are frequently
expressed by patients. This is because traditional liposuction
technique that requires ripping out of semisolid fat likely
results in substantial injury to individual fat cell membranes
and subsequent death and resorption following injection. In
contrast, utilization of ultrasound-assisted liposuction allows
for fat removal techniques that have been reported to provide
up to 90+ % viability of fat cells [6, 7]. This is because single
fat cells in a liquid state are gently sweeped into suction cannulas thus avoiding mechanical injury.
13.6 High-Denition Liposuction Gallery
(Figs.13.9, 13.10, 13.11, 13.12, 13.13,
13.14, 13.15, 13.16, 13.17, and13.18)
Fig. 13.9 A 38-year-old patient following HDL 360 along with abdominal skin resection and BBL
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G. Hamlet and A. Mowlavi
Fig. 13.10 A 25-year-old female following HDL 360, with mid def sculpting of the abdomen combined with fat grafting to the buttock and hips
as well as a breast lift and implant augmentation
Fig. 13.11 A 23-year-old female following HDL 360 to achieve abdominal etching, waistline narrowing, back contouring, and buttock shaping
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Fig. 13.12 A 29-year-old patient following HDL 360 and full body Renuvion J plasma to provide for simultaneous skin tightening as well as fat
transfer to the buttock and hips
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Fig. 13.13 A 23-year-old female demonstrating abdominal muscle highlights following abdominal etching
G. Hamlet and A. Mowlavi
Fig. 13.14 A 27-year-old male with rectus muscle denition following abdominal etching using ultrasonic-assisted liposuction
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Fig. 13.15 A 31-year-old male with rectus muscle denition following abdominal etching using ultrasonic-assisted liposuction
Fig. 13.16 A 38-year-old male following simultaneous abdominal etching and surgical lower abdomen skin excision with the transformative
results
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Fig. 13.17 A 38-year-old
female following HDL
revision of contour
irregularities following prior
botched liposuction surgery
Fig. 13.18 A 28-year-old
female following Brazilian
Buttock lift (BBL) revision of
primary BBL that was
suboptimal and squared in
appearance. Using ultrasoundassisted liposuction and
Renuvion J plasma skin
tightening, difcult and
brous zone of the lower back
and ank prominence
eliminated while avoiding
skin redundancy
G. Hamlet and A. Mowlavi
13.7 High-Denition Liposuction
Conclusion
High-denition liposuction is currently considered the gold
standard in liposuction technique. HDL has raised the bar for
what was previously unattainable with creation of stunning
body contouring results. Creation of transformative results is
the mainstay for HDL that requires intimate knowledge of
muscle anatomy but also an artistic eye for gender-specic
aesthetic ideals. Finally, high-denition liposuction requires
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proper patient selection, a sound surgical plan, accurate preoperative markings, and mastery in ultrasound-assisted liposuction. Mastery in ultrasound-assisted liposuction remains
the largest hurdle in achieving HDL results and requires the
surgeon to evolve into an artisan.
References
1. Mowlavi A.High denition liposuction. Lulu Productions; 2020.
2. Hoyos A, Prendergast P.High denition body sculpting. Springer;
2014.
3. Mowlavi A, Talle A, Berri M, Rashid W.Successful back contouring
with elimination of back rolls using ultrasound-assisted liposuction
and helium-activated radiofrequency. Aesthet Surg J Open Forum.
2020;2(4):ojaa036.
4. Mowlavi A, Rashid W, Berry M, Talle A. Masculinized male
chest contouring: creating the armor plate. Aesthet Surg J.
2020;2(1):ojz023.
5. Mowlavi A, Farrell J, Talle A, Berri M, Hamlet G. Ultrasoundassisted liposuction and helium-activated radiofrequency skin
tightening for treatment of paradoxical adipose hyperplasia after
cryolipolysis. J Am J Cosmetic Surg; 2020.
6. Dominik D, Zeshaan N, Anna L, Matthias M.Ultrasound assisted
liposuction provides a source for functional adipose derived stromal
cells. Cytotherapy. 2017;19(12):1491–500.
7. Strong AL, Cederna PS, Rubin P, Coleman SR, Levi B.The current
state of fat grafting: a review of harvesting, processing, and injection techniques. Plast Reconstr Surg. 2015;36(4):897.
Hi-Def Liposuction- My Way
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AldoPerez
14
This is a high-level body sculpting technique for the corporal
muscles that can give an appropriately selected patient brilliant result, specically an exceptionally sculpted, athletic
body shape. This technique was described by Alfredo Hoyos
[1], Plastic Surgeon from Colombia, in a collaboration with
VASER, with excellent results.
To carve and sculpture an aesthetically and shapely body,
rst, we need to know its anatomy [2]. Therefore, as surgeons, we must know exactly the muscles, tendons, insertions, bones, and natural body concavities and convexities.
14.1 History
Charles H.Willi (1926) was one of the rst surgeons to inject
a small quantity of fat for aesthetic purposes.
Giorgio Fischer (1975) was the rst to describe the fat
removal using a cannula through small incisions, of about
5mm, with small holes to cut fat, it was called the “planotome” and it was attached to a suction machine. Other techniques of liposuction have evolved since.
Bircoll (1982) was the rst to describe the use of autologous fat removed in liposuction and using it to contour the
body and lling defects.
From supercial to deep:
1. Skin.
2. Supercial fascia (above the navel, it is a thin, single
layer of subcutaneous tissue). It is divided below the
umbilicus, a fatty supercial layer called Camper’s fascia, and a deeper one called Scarpa’s fascia (blood vessels
and nerves run between them).
3. Muscles.
4. Fascia.
5. Parietal peritoneum (Fig.14.1).
14.2.1 Structure andFunction
The main functions of the abdominal wall are:
• Protection of the internal abdominal organs.
• Trunk stability and rotation.
• Increased intra-abdominal pressure.
14.2.2 Blood Supply andLymphatics
The anterior abdominal wall is supplied by the following:
14.2 Anatomy oftheAbdominal Wall
The abdominal wall surrounds the anterolateral part of the
abdominal cavity, providing exible coverage and protection
for internal organs. This complex structure consists of
numerous layers of the abdomen.
Supplementary Information The online version contains supplementary
material available at [https://doi.org/10.1007/978- 981- 19- 4997- 5_14].
A. Perez (*)
Aesthetic Plastic surgery, Cuernavaca, Morelos, Mexico
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022
M. Thomas, J. D’silva (eds.), Manual of Cosmetic Surgery and Medicine, https://doi.org/10.1007/978-981-19-4997-5_14
• Superior epigastric artery.
• Inferior epigastric artery.
• Deep circumex iliac.
• Supercial epigastric vessels.
• Supercial circumex iliac.
Thoracoepigastric veins are running longitudinally, which
connect the lateral and supercial epigastric veins Varacallo
[2].
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