Subdermal Liposuction: Long-Term Experience

Novel usage of superficial liposuction in hidradenitis suppurativa

“…In 1989, Gasperoni [7] discovered a new path of liposuction when he presented superficial liposuction, which is the suction of superficial fat layer (subdermal). This technique permits treatment at the thin adipose layer so that better result can be achieved than traditional liposuction.…”

“…Back than liposuction was used exclusively in the deep layer of subcutaneous tissue and not to suck superficial fat layer to avoid skin irregularities [5,6]. With better anatomical understanding of superficial fascia system, Gasperoni [7] described superficial liposuction technique. He further described subcutaneous layer which is dived into 2 by superficial fascia: superficial fat-areolar and deep fat layerlamilla ( Figure 1).…”

Three-dimensional Superficial Liposculpture of the Hips, Flank, and Thighs

“…Large size cannulas were recommended to aspirate only deep fat deposits (1–2 cm below the dermis level) to preserve the integrity of the superficial fat and to prevent the occurrence of postoperative skin irregularities. 10 , 11 In addition, Klein’s 12 , 13 description of the tumescent technique, in which dilute buffered lidocaine and epinephrine were injected into the tissues to be suctioned to the point of turgidity, allowed liposuction to be performed with the patient under local or conscious sedation anesthesia with an excellent safety profile, principally minimizing blood loss and the risks of general anesthesia. In the 1990s, some histological and clinical investigations of the subcutaneous tissue distinguished a stiffer and more superficial areolar fat layer and a softer and deeper lamellar adipose tissue layer that were separated by the superficial fascial system.…”

“…In the 1990s, some histological and clinical investigations of the subcutaneous tissue distinguished a stiffer and more superficial areolar fat layer and a softer and deeper lamellar adipose tissue layer that were separated by the superficial fascial system. 10 , 11 The areolar layer thickness usually remains stable during massive weight increase or loss because it acts as a pad, serving as a protection and shock absorber, whereas the deeper lamellar layer volume greatly changes during fattening or thinning and it is considered the real energy storage place of the body and is evidently present in areas where the body fattens the most. 10 , 11 The focus of liposuction changed: the suction of the deep lamellar layer could provide a stable reduction of the thickness of the fat deposits and the changes made on the structural areolar layer allowed for a permanent change of the shape achieved with the suction.…”

“… 10 , 11 The areolar layer thickness usually remains stable during massive weight increase or loss because it acts as a pad, serving as a protection and shock absorber, whereas the deeper lamellar layer volume greatly changes during fattening or thinning and it is considered the real energy storage place of the body and is evidently present in areas where the body fattens the most. 10 , 11 The focus of liposuction changed: the suction of the deep lamellar layer could provide a stable reduction of the thickness of the fat deposits and the changes made on the structural areolar layer allowed for a permanent change of the shape achieved with the suction. The new anatomical knowledge combined with the introduction of fine cannulas allowed for the introduction of superficial liposuction that dramatically changed the indication for lipoplasty through which it was possible to reduce the volume of fat deposit while promoting the skin to contract and retract significantly.…”