Anatomofunctional Zone-Based Marking of the Lower Limbs (Angioderma Leg Mapping): A Proposed Standardized Methodology...

The aesthetic-functional planning of the lower limbs is frequently conducted empirically, using idiosyncratic markings and limited standardization among specialists who work in this field. The absence of a common topographic language restricts clinical communication, technical reproducibility, documentation of results, and the integration between the aesthetic approach and the vascular/lymphatic assessment of the segment. This is a descriptive study of methodological development. Based on a review of the anatomic and surgical literature and prospective clinical application during body-contour consultations, six topographic zones of the lower limbs were defined: gluteal, trochanteric (saddlebag), thigh (anterior, medial, and posterior subunits), knee, crural (calf), and talocrural (ankle), each delimited by reproducible surface bony and muscular landmarks. Onto this map, the cartography of the zones of adherence, superficial and deep adipose planes separated by the superficial fascia, saphenous venous axes, and main lymphatic collector pathways was overlaid. A four-stage marking protocol was defined (orthostatism, marking of bony landmarks, zone delimitation, and coding of plane and intensity), with standardized photographic documentation. For each zone, the following are presented: anatomic boundaries, muscular and adipose content, vascular and lymphatic correlates, zones of adherence to be preserved, recommended working plane (deep, intermediate, or superficial), specific risks, and expected aesthetic outcomes. The map provides a common nomenclature among surgeons and enables technology to be prescribed by anatomic zone rather than by generic "region". This anatomofunctional zone-based marking provides a simple, low-cost, and reproducible instrument to structure the therapeutic planning of the lower limbs, aligning the aesthetic objective with the anatomic, vascular, and lymphatic constraints of the segment. Interobserver reliability studies and comparative clinical outcome studies are the necessary next step toward validation.