High-Definition Liposuction Body Scale: Expanding Indications for High-Definition Liposuction

Introduction: Performing optimal gluteal augmentation using traditional methods in moderate to severe weight-loss patients poses a surgical challenge as such patients typically present with (1) severe skin redundancy, (2) soft tissues containing high-density connective tissues than fat content, and (3) ptotic buttock cheeks. Materials and Methods: This procedure uses a modified lateral thigh and buttock tuck excision not only to lift the buttock cheek complex but also to create a dermal fat flap that is transposed into the upper buttock pole to achieve upper buttock fullness. The remainder of the excised tissue undergoes novel ex vivo liposuction while remaining sterile, which allows for simultaneous repair of the created excision line. Results: This novel ex vivo liposuction technique provides several advantages that include (1) limiting operative time, (2) allowing for maximal fat removal while avoiding unnecessary trauma to the patient, and (3) providing improved quality with less blood and fat volumes. This ex vivo fat is then transferred to the mid- and lower buttock to complete buttock augmentation for the Brazilian buttock lift. Discussion: Excess skin redundancy and buttock check ptosis require consideration of supplemental excisional tucking to achieve optimal results. In addition, subcutaneous tissues that maintain more connective tissue pose difficulty with fat removal using traditional liposuction techniques. As such, we present a novel surgical technique to optimally augment and shape the buttock in patients who have undergone weight loss. Conclusion: In summary, we present a novel Brazilian buttock lift technique to augment the buttock in weight-loss patients that maximizes both patient safety and efficacy.