Background: Traditionally, liposuction is performed on the deeper layer of fat. However, in 1983, Illouz described a liposuction technique targeting the superficial layer of fat. High-definition liposuction (HDL) is an advanced technique of liposuction that generates a desirable profile of anatomical area while promoting skin retraction. Although the safety profile of basic or traditional liposuction has been extensively studied, data relevant to HDL are limited. A systematic review to determine the effectiveness and complications was conducted. Methods: Across the 21 articles included in the synthesis, a total of 6964 patients underwent HDL procedures. Of the cases where gender was reported, 44% were female patients (n = 1241) and 56% were male patients (n = 1556). The average age of patients was 38 years (range, 15 to 76 years) and body mass index was 25 kg/m2 (range, 18 to 38 kg/m2). Results: An overall complication rate of 14.4% (n = 994) was calculated, with only 0.2% (n = 13) of complications classified as major. Transient hyperpigmentation was the most frequently reported complication, affecting 260 patients (3.8%), followed by seroma in 231 (3.3%) and transient soft-tissue fibrosis in 185 (2.7%). Despite an absence of uniform reporting, satisfaction rates of 92.6% (n = 1497) were reported. Conclusions: There is a high demand for HDL surgery globally, and this systematic review illustrates the safety and efficacy of HDL. Major complication rates across the entirety of the literature reviewed were 0.2%, with minor complications seen in 14.2% across the 6964 cases reported. High patient satisfaction of 92.6% from HDL procedures was achieved, indicating the efficacy of this procedure.

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Background Tuberous breast is a complex congenital breast anomaly which can be challenging to correct surgically. Objectives The authors conducted a systematic review with pooled analysis of data with an aim to determine the effectiveness and complications related to operative management of the deformity. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used in performing this systematic review. A simplified classification system for tuberous breast deformity was developed to accurately compare data and guide analysis. Results The review identified 38 studies reporting a total of 897 patients undergoing tuberous breast surgery. The mean age of patients was 24 years (range 13-53 years). Mean follow up was 39 months. A combination of tissue rearrangement and implant augmentation was the most used technique (73% of patients) followed by fat transfer alone (9%). Breast implants were used in 83% of patients. The mean implanted volume per breast was 263 cc. Fat grafting was performed in 13% of patients and mean volume of fat grafted per breast was 185 cc. An overall complication rate of 20% was reported. Subjective assessment of patient satisfaction was 99% and the mean score using BREAST-Q for satisfaction with clinical outcome was 86.7. Future studies should focus on robust study designs including randomised and cohort studies, use of patient-reported outcome measures and long term follow up. Conclusions The surgical techniques to correct tuberous breast deformity are safe, effective and have a high satisfaction rate. Fat transfer has the capacity to provide promising results in tuberous breast deformity.