Ricardo Proto, MD; Alfredo E. Hoyos, MD ; Mauricio E. Perez Pachon, MD ;
Carlos Oñate-Valdivieso, MD; Daniel Oñate-Valdivieso, MD;
Paulo Duarte, MD; Hugo Aguilar-Villa, MD; Raul Manzaneda-Cipriani, MD;
Icaro Samuel, MD; and Mariana Borras Osorio, MD
Background: High-definition liposculpture (HDL) has undergone significant evolution since its initial description, with the goal of achieving more
natural outcomes and a muscular-defined appearance. The introduction of intramuscular fat grafting has enhanced contouring capabilities, with its
applications extending to various muscle groups. Subperiosteal fat grafting efficacy and safety are well-established in facial surgery.
Objectives: Describe the technique of combining ultrasound (US)-guided subperiosteal lipoinjection of the anterior superior iliac spine (bikini
bridge) plus intramuscular fat grafting of the internal oblique muscles with HDL.
Methods: A retrospective cohort study was conducted across different specialized plastic surgery centers. Adult patients who underwent bikini
bridge and dynamic definition liposculpture were included. All patients were informed of the innovative use of the technique and consented to
participate. Descriptive statistical analysis was performed to summarize the variables.
Results: A total of 105 consecutive patients were included for analysis. Patients were mostly females (86.7%) plus 14 male patients (13.3%) who
were in the gender reassignment process. Mean age was 34.3 years (standard deviation [SD] 8.7 years) and the median BMI was 22.9 kg/m2 (SD
2.74 kg/m2). All patients underwent fat grafting the iliac spines + the oblique muscles as an additional procedure to HDL. Median volume of fat
injected was 15 cc (interquartile range 12 cc) for the iliac spines and 40 cc for the internal obliques. No major complications were reported.
Conclusions: The US-guided intramuscular and subperiosteal fat grafting of the abdomen is a safe and reproducible procedure, resulting in a
harmonious and athletic appearance with natural-looking outcomes, high satisfaction, and a very low rate of complications.
FONT: https://academic.oup.com/asjopenforum/article/doi/10.1093/asjof/ojae103/7908749
