What is high definition liposuction?

Superficial fat does not sit in an open space. It is held by retaining ligaments, fibrous cables that run from the skin to the muscle. Those cables keep the skin attached, which is how the skin keeps its integrity. The same cables stop a liposuction cannula from crossing the superficial layer freely, so suction alone cannot clear that layer.

The chest follows the same two layers. Fat over the pectoralis has a deep portion and a superficial portion held by retaining ligaments, the same arrangement that holds the abdominal skin. Clearing only the deep chest fat debulks the chest. It does not leave a border that can be drawn on the pectoralis. The axilla sits beside that chest and is treated in the same pass, so the side of the chest and the front of the chest stay one contour. The photograph above is that combination: abdomen, back, chest, and axilla, seen from the front.

Ultrasound is used first, to melt the fat in the superficial layer. VASER is the ultrasound used for that melt. The cannula then travels through the deep layer and removes the deep fat. Once the deep layer is empty, compression coupling pushes the melted superficial fat down into the deep layer, where the cannula can take it. That sequence is what makes muscle sculpting possible. The order is fixed. Melt the superficial fat while the retaining ligaments still hold the skin to the muscle. Empty the deep layer with the cannula. Only then use compression so the melted fat moves into the space the deep fat left. Suctioning before the melt means the cannula is working against those fibrous cables, which is why a deep-layer-only technique stops at a debulk.

The American Society of Plastic Surgeons describes liposuction as removal of fat with a cannula to change contour. The added step here is the ultrasound that melts superficial fat before that cannula works, which is what VASER liposuction adds to the suction. The deep-layer pass is still suction. The superficial fat has been freed so it can be moved into the path of the cannula.

Clearing both fat layers lets the surgeon unveil muscle highlights. That unveiling is called 3-dimensional contouring. On the abdomen it is a six-pack in men and a four-pack in women. Abdominal etching is the drawing of those packs. The lines follow the muscle that is already there. A six-pack and a four-pack are different muscle maps, not two doses of one drawing. The male abdomen is lined to show six segments. The female abdomen is lined to show four. Both maps are drawn only after the superficial fat has been melted and moved. A line drawn while that fat is still in the way stays a groove in the fat.

A further step watches how muscles change shape when they move and when they meet neighboring muscles. That step has been called 4-dimensional contouring. It has to be planned from the position the muscle actually holds. The pectoralis is the example used here. It is sculpted with the arms at 45 degrees. It is not sculpted with the arms out at 90 degrees, and it is not sculpted with the arms down at the side. Those other positions change the outline of the muscle, so a line drawn in the wrong position will not match the chest in ordinary posture.

High definition liposuction is the setting in which that muscle outline is made. The same attention has to go all the way around the torso. A front that has been etched and a back that has only been debulked do not meet cleanly. The procedure overview and the abdominal etching page go further into the lines themselves.

Circumferential sculpting treats the body as a form that is seen from every angle. That pass is 360 liposuction, and it is part of high definition liposuction rather than a separate operation bolted on at the end. A result that looks right only from the front, or only from the back, has not been contoured circumferentially.

The sides matter more than the front or the back alone. The flanks, the love handles, and the axilla, or armpit, sit where the front meets the back. Leave them thick and the front and the back never join. Thin them without a plan and the junction looks cut in. Gender differences in contour show most on these sides. Love handles are the flank fullness at the waist. The axilla is the fullness beside the chest, under the arm. A chest sculpted at 45 degrees still has to meet the axilla next to it, because the chest and the armpit are read as one border. The flank has to meet the lower back the same way.

When the arms, the flanks, and the waist are included, the chest and abdomen photographs stop looking like isolated panels. The frontal view of the chest, abdomen, back, and axilla is one pass of that idea: the axilla is on the side, and it has to agree with the chest in front of it and the back behind it.