[Surgical treatment of lipodystrophies]

Esthetic body contouring has become the most common esthetic surgical procedure since the advent of liposuction. The interest in this surgery led us to focus on the physiology of adipose tissue that behaves differently according to its localisation. Besides, a better knowledge of the anatomy of the subcutaneous tissue has helped us to treat the deep and superficial adipose deposits more effectively. Many technical refinements have been proposed in order to improve the results and decrease the risks. Local infiltration allows us to remove large amounts of fat with a minimal blood loss. Syringe aspiration is less traumatic and avoids the purchase of an expensive suction pump. However, although the technique of suction lipectomy looks simple, this procedure can induce important local complications (contour deformities, skin waves, ...) and general complications (pulmonary embolism, fat embolism, cardio-pulmonary decompensation). A rigorous technique, performed by a well trained surgeon in an adequate medical environment is essential to obtain the best results with suction lipectomy. In order to correct excesses of skin on the abdomen or the thighs after an important weight loss, skin excisions will be necessary. In there cases, the scars are often wide and sometimes difficult to hide.