Revision of Body Contouring Complications

Universally, the fat under the skin is divided into two depths, the superficial and deep planes.

The superficial fat is located just beneath the skin and held in a fibrous network made up of structural supportive pillars called retaining ligament; this layer is not amenable to reduction using traditional liposuction techniques because the retaining ligaments do not allow for the entry and free movement of the fat removing cannulas. In contrast, the deep fat is located just above the muscles and under the superficial fat above and is held in a loose "areolar" plane that is void of any structural fibrous network; this layer only is amenable to fat removal using traditional liposuction techniques as it allows for the entry and free movement of the fat removing cannulas.

There are several known reasons for observed complications involving contour irregularity. The first is caused by the novice liposuction practitioner who is not able to completely eliminate the deep fat layer. This usually results in a wavy or asymmetric appearance in body contour caused by removing more of the deep fat from one side than the other. The second is caused by the cavalier surgeon, who tries to push the threshold of traditional liposuction by attempting to remove superficial fat. Unfortunately, the solid cannulas cannot uniformly penetrate this layer due to the retaining ligament pillars as discussed above, resulting in divots. This botched result often occurs over the abdomen and has been termed the "checkerboard" abdomen that is riddled with extensive divots.