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Body
Contouring
Current Concepts and Best
Practices
JuarezMoraesAvelar
RicardoCavalcantiRibeiro
Editors
123
Body Contouring
Juarez Moraes Avelar • Ricardo CavalcantiRibeiro
Editors
Body Contouring
Current Concepts andBest Practices
Editors
Juarez Moraes Avelar
Brazilian Scientic Institute of Plastic
and Reconstructive Surgery
São Paulo, Brazil
Ricardo CavalcantiRibeiro
Plastic and Reconstructive Surgery
Federal University of the State of Rio
de Janeiro
Rio de Janeiro, Brazil
ISBN 978-3-031-42801-2 ISBN 978-3-031-42802-9 (eBook)
https://doi.org/10.1007/978-3-031-42802-9
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specic statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable.
Foreword
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This wonderful book opens a new era in the eld of body contouring surgery
edited by two renowned Brazilian plastic surgeons, Dr. Juarez Avelar and Dr.
Ricardo Ribeiro. Both have an unquestionable experience in presenting scientic
productions around the world, they have produced many papers of an outstanding
value and published in peer review journals a remarkable contribution. We can
distinguish four important papers published by Dr. Juarez: the “Mercedes” umbilicoplasty without external scar that appears in the rst issue of the APS Journal. A
second one about the histoanatomical research done in the subcutaneous abdominal ap that earned the rst price from the APS Journal in 1988. A third one in
1999 about abdominoplasty combining with assisted liposuction without undermining the abdomen wall that contributed to so many surgeons from our country
to start with similar procedures. And a fourth one about ear reconstruction that is
a “landmark” from him. He has edited 23 scientic books and many other chapters with emphasizes in body countering and facial surgeries. Besides these extensive scientic production, he served as National President of our Brazilian Society
of Plastic Surgery for two times (1986/87 and 1990/91).
Dr. Ricardo Ribeiro from Rio is the second Editor with a great experience on
research publishing many papers focusing on breast and body contouring surgeries.
He has on his career edited 9 books and 42 scientic chapters. He is Head of the
Division of Plastic and Reconstructive Surgery of Federal University of Rio de
Janeiro State (UNIRIO)and member of many plastic surgery societies around
the world.
Dr. Juarez and Dr. Ricardo have done a wonderful job to edit this book, around
500 pages like a compendium, distributed in 61 chapters. They have invited 82
renowned plastic surgeons from Brazil and abroad to bring the most important
advances of our specialty. Enriched with very nice pictures the subjects come
together with an extensive bibliographic reference to be prospected. This is a book
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Foreword
that certainly will enrich our knowledge and directly reach the young plastic surgeons and residents who are seeking for new ideas and horizons on their career. It is
something that certainly deserves to be in our libraries.
Division of Plastic Surgery CarlosOscarUebel
PUCRS University
Porto Alegre, Brazil
Foreword
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It is with great pleasure that I write the foreword of “body contouring,” one more
book edited by Juarez Avelar. He is not only a skilled plastic surgeon but also a
prolic writer whose energetic mind does not stop creating new scientic projects.
I have been fortunate to be part of Juarez’s creations since 1982, when I helped him
organize and edit the annals of our rst symposium for the Brazilian Society of
Plastic Surgery, and he has not stopped creating and innovating.
In this book, Juarez Avelar and Ricardo C. Ribeiro summarize everything the
modern plastic surgeon should know to be up to date with the newest techniques in
body contouring.
Starting with the surgical fundamentals for body contour surgery, a review of the
anatomy, and eight chapters about several abdominoplasty techniques. We cannot
forget that it was Avelar who, in 1999, established a new way of performing lipoabdominoplasty, preserving perforators and lymphatics, a technique copied and modied by many authors.
The modern vertical mammoplasty technique created in 1957 by George Arié
was soon modied by Ivo Pitanguy, transforming it into an inverted T, and became
known as the Arié-Pitanguy breast technique. Over the last six decades, many modications appeared and the nine chapters dedicated to breast surgery create a full
panorama on how to reduce and lift the female breast and gynecomastia.
Avelar was among the rst Brazilians to start performing liposuction in the early
1980s in São Paulo. Not only that, he was responsible for bringing Yves Gérard
Illouz and Pierre Fournier to perform surgical demonstrations in the congresses I
helped him organize in São Paulo in 1983 and 1984. Avelar and Illouz published the
rst Brazilian book on liposuction in 1986.
For this book, the editors have commissioned seven chapters from prominent
surgeons on liposuction and liposculpture and six on fat grafting, covering all
aspects of these landmark techniques with special attention to safety and correction
of irregularities.
Massive weight loss patients represent today another branch of plastic surgery,
the post-bariatric surgery techniques, for body lift, thigh lift, gluteoplasty, torsoplasty, ank and armplasty. The surgeons invited to contribute chapters are highly
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Foreword
experienced professionals who teach us the steps on how to perform these difcult
procedures with careful planning. We know there are many books on body contouring. The experienced surgeon, however, will nd here all the necessary steps towards
obtaining a good result. Both editors and all authors of the chapters are outstanding
Brazilian plastic surgeons teaching renements and updating techniques concerning
the subject of this book.
I wish you good reading and even better results.
LuizToledo
MMC Aesthetics
Plastic and Reconstructive Surgery Department
Dubai, UAE
Tribute to Prof. Ivo Pitanguy
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and Prof. Yves G.Illouz
We dedicate this book to the memories of Profs. Pitanguy and Illouz for their constant incentive for scientic development of plastic surgery through their talents and
creativities transmitted in their numerous publications. Besides, to teach their
knowledge both were always happy to stimulate scientic contributions conscious
of the progress and the future of our specialty. Although they are not among us anymore, since both passed away in 2016, we felt their presence during preparation of
this book. Denitely, if they were here both would be writing once more their
remarkable chapters concerning their superb scientic contributions to plastic surgery. We are so sad since they are not in our world, but we are very happy to dedicate this book to their memories with our gratitude for their permanent devotion to
stimulate plastic surgery to all specialists all around the world.
Homage toProf. Ivo Pitanguy
It is our privilege to pay homage to Prof. Ivo Pitanguy for his remarkable contribution to body contouring surgery since his publication in 1964 concerning surgical
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treatment of trochanteric lipodystrophy. He used to perform combined surgeries
resulting in outstanding improvement remodeling the silhouette and created the
expression—body contouring. In fact, to perform breast reduction combined with
abdominoplasty since 60 years, before liposuction technique, means reshaping the
body contour.
Prof. Pitanguy during all his professional activities devoted so much effort performing associated procedures, even writing useful scientic articles as well as giving lectures all around the world teaching to all plastic surgeons his personal
contributions.
Although he is not among us in our world, but wherever he is, he is still stimulating everyone to dedicate improving plastic surgery.
While we were preparing the manuscripts for this book, we felt the presence of
Prof. Pitanguy in our spirit to follow our hard work to offer scientic knowledge to
plastic surgeons from Brazil and from all other countries. He is not physically close
to us, but wherever he is, we are constantly asking him to bless us to follow his way,
sharing our knowledge.
With the essence of our heart, we homage to Prof. Ivo Pitanguy simultaneously
with our gratitude for his superb work developed during all his life giving up the
chance to learn his personal techniques as well as the Noble attitude to transmit
knowledge to the readers.
Sincerely,
Juarez Moraes Avelar, MD
Ricardo Cavalcanti Ribeiro, MD
Tribute to Prof. Ivo Pitanguy and Prof. Yves G.Illouz
Homage toProf. Yves G.Illouz
Publishing this book is the representation of the fulllment of our desire to transmit
knowledge to plastic surgeons wishing to improve their body contouring skills and
techniques. Regarding this subject, it is an honor for us to pay homage to Prof. Yves
G.Illouz for his memorable contribution to plastic surgery developing and publishing liposuction technique. We had the great privilege to learn from him one of the
most revolutionary procedures introduced to plastic surgery during the last decades
of twentieth century. Prof. Illouz was a brilliant French plastic surgeon, but he used
to come several times to Brazil teaching his remarkable method that he became
almost a Brazilian.
Since 1980 when Prof. Illouz came for the rst time to teach his fantastic technique during the Brazilian Congress held in Fortaleza, state of Ceará, we have
developed a special ambience to learn it. He was always happy to attend our invitations to come to our country to participate at our events to share his knowledge with
our colleagues.
Liposuction developed and worldwide popularized by Prof. Illouz changed the
concepts of plastic surgery. Instead of leaving long scars to remove the volume of
localized adiposities, his method leaves inconspicuous ones. Reshaping the
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