High-Definition Liposculpture 18-Year Evolution: Patient Safety and Aesthetic Outcomes

Background: High-definition liposculpture (HDL) emerged as an innovative surgical technique that allowed plastic surgeons to achieve improved aesthetic results with a natural and athletic appearance using minimal incisions and with imperceptible scarring. Its targets are high aesthetic standards and patient safety. Purpose: This article summarizes the evolution of HDL by explaining upgrades to the original technique and comparing the complication rates among them. Methods: The authors retrospectively reviewed records from four private medical centers (Evolution Medical Center, Santa Barbara Medical Center, and Dhara Clinic in Bogota and FOSCAL in Bucaramanga, Colombia) of patients who underwent HDL performed by the senior author (A.E.H) over an 18-year period (2002 through 2019). Patients were classified into three groups: suction-assisted lipoplasty (period 1), vibration amplification of sound energy at resonance–assisted HDL (period 2), and dynamic definition liposculpture (period 3). Results: The authors established a cohort of 5052 patients (4300 women and 752 men): 923 in period 1, 1272 in period 2, and 2857 in period 3. The most common complications included seroma, bruising, hematoma, acute anemia, hyperchromia, wrinkled skin, wound dehiscence, and local infections. Conclusions: HDL and dynamic-definition liposculpture procedures are safe and reproducible techniques to achieve an athletic and natural body contour. Complication rates, especially those related to bleeding, decreased as the technique evolved. These procedures are aimed toward patient safety to provide higher aesthetic outcomes using extensive medical, anatomic, artistic, and technological knowledge. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.