Male High Definition Liposuction Preoperative Markings

Male High Definition Liposuction Preoperative Markings

Male High Definition Liposuction Preoperative Markings are far more extensive than typical liposuction. As you can see from the pictures at the bottom and the descriptions below, a detailed surgical plan is esssential for superior, natural looking results.

Abdominal markings

  • Linea alba (vertical line that separates two sides of ab muscles)
  • Slightly wider than females
  • Extends down to the belly button only
  • Wider as it gets lower
  • Sculpt after inscriptions done in order to avoid over defining

Inscriptions

  • 3 instead of 2 for females 3rd inscription near upper aspect of belly button
  • Inscriptions not necessarily straight and at different levels on two sides
  • Must mark preoperatively with patient pushing down on your shoulder/head
  • Must palpate with fingers the inscriptions; superficial Ultrasound and use of thumb to define
  • Sculpt lower inscription from belly button
  • Sculpt upper inscription from infrareolar crease
  • Sculpt middle inscription using perpendicular sculpting with Power X and curved cannula from infrareolar crease
  • Curved around laterally at the semilunaris line and up (curved up)

Packs

  • 6 pack versus 4 pack
  • Highest pack weakest and smallest may not even be present
  • Middle and lower pack the largest and most prominent
  • More linear and concaved up laterally (at the upper aspect)
  • More concaved up starting earlier (especially lower pack)
  • Must debulk fat (mark as blue)
  • Lipo: start with 4.6, then 3.7 as you get close to the end, then 4.6 to bring down the whole region.

Chest Proper (Pecs)

  • Must define the lateral aspect of the pec (linear – creates medial aspect of lateral chest diamond)
  • Must remove more fat over inferior aspect than upper aspect
  • Must debulk superficial fat (make as blue)
  • Must define muscle shape (gentle concave at bottom/may have linear component at mid mammary line; medially curves up the muscle attaches along the clavicle and laterally to the humerus.

Semilunaris line

  • Curved down from lateral aspect of areola and around down to the pubic symphysis.
  • Not necessarily a straight line especially at the inscriptions
  • May even not be contiguous (broken up by serratus anterior fingers)
  • Sculpt from top down using lateral infra-areolar port(1st) and then from pubic tubercle from bottom up (2nd)
  • Associated with negative triangles (2 to 3): triangles become wider as move down the abdomen.

External oblique

  • Must be debulked minimally and be more prominent than its adjacent neighbors (superiorly the serratus anterior), medially the semi-lunaris line, inferiorly the V to the P (the iliac crest) and posteriorly the back

Lateral chest (a diamond shape)

  • Medial upper border the lateral pectoralis
  • Medial lower border the subcostal border (extends from lateral infra-areola)
  • Lateral Posterior border the latisimuss
  • Superior border the armpit
  • Inferior border the external oblique muscle
  • Base: serratus anterior muscle and rib cage
  • Inferior base: demonstrates serratus fingers (lowest two fingers extend inferior oblique onto the upper and upper middle packs of the abdomen); extend just below the rib cage
  • Etch inferior diamond from belly button port and from posterior port
  • Etch superior diamond from anterior axillary port

Axilla

  • Anterior etching minimal make smooth with pec contour
  • Posterior etching more aggressive and can create a cavity

Inferior lateral abdomen

  • Referred to as a V to P
  • Area below the iliac crest
  • Negative space concavity just under the iliac crest/lip

Central lower abdomen

  • Avoid debulking in zone of adherence (may fat graft)
  • May have to fat graft to complete infra-areolar pack;

Arms:

  • Use anterior and posterior axillary ports (must provide access yet be hidden)
  • Etch deltoids from ports (use 3.0 cannulas)
  • May also create slight triceps and biceps accents
  • Leave more fat at mid triceps in males to give it more bulk
  • Posterior axilla may create more of a crater give triceps more definition.

Back

  • Lower back debulk completely (create a hole as Hamlet says -no transition zone)
  • Buttocks shelf desirable (in comparison to female)
  • Latisimuss definition inferiorly;
  • Central lower back(diamond in females) must be minimally debulked.
  • Buttocks shape more square
  • Define central vertical line (along the spine)
  • Define the lateral paravertebral muscle lines (extend from ports over the pit dimples)

Buttocks

  • Buttocks shelf desirable (no transition zone)
  • Upper aspect more square; mid buttocks more horizontal (not rounded)
  • Central inferior back upper buttocks minimally debulked and linear shaped
  • Buttocks proper more square
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