Liposuction technique and lymphatic lesions in lower legs: anatomic study to reduce risks

Area of Science:

• Plastic Surgery
• Lymphatic System Anatomy
• Surgical Techniques

Background:

• Liposuction, particularly of the lower extremities, is a common plastic surgery procedure.
• The impact of liposuction on superficial lymphatic vessels (epifascial lymph collectors) remains unclear.
• Understanding potential lymph vessel injury is crucial for patient safety.

Purpose of the Study:

• To investigate the effect of liposuction cannula orientation on epifascial lymph vessel integrity.
• To compare lymph vessel injury from longitudinal versus transversal liposuction in lower extremities.
• To provide evidence-based recommendations for safer liposuction techniques.

Main Methods:

• Postmortem examination of 10 human lower extremities using conventional liposuction with a 4-mm blunt cannula and dry technique.
• Liposuction performed longitudinally (parallel to extremity axis) and transversally (90-degree angle to axis).
• Macroscopic assessment of lymph vessel injury using a standardized scoring system based on patent blue dye extravasation.

Main Results:

• Lymph flow was confirmed in all specimens via patent blue staining.
• Significantly greater lymph vessel injury occurred with transversal liposuction compared to longitudinal liposuction (p < 0.01).
• Adipose tissue removed and region volumes were comparable between both techniques.

Conclusions:

• Longitudinal liposuction of lower extremities poses a lower risk of significant epifascial lymph vessel damage.
• Performing liposuction parallel to the extremity axis is recommended to minimize lymph vessel injury.
• This finding supports a preferred technique for safer lower extremity liposuction.