Much of the revision work I perform as a liposuction surgeon, occurs because the previous surgeon did not consider the cosmetic unit in its entirety. For example, when I began practicing liposuction over twenty years ago, I saw many patients that were unhappy with their results, especially in the area of the tricky calves and ankles. This was because their previous surgeon only treated bits and pieces of the calves and ankles. Their surgeon did not understand that to shape an entire area, like the lower legs, you must visualize it as a curved three-dimensional cosmetic unit, that begins at the knee and ends at the ankle.
In my decades of performing liposuction, I have come to realize the importance of looking at the whole body holistically, for balance and proportion. Instead of treating a single area with liposuction, which doesn’t necessarily provide the best outcome, I look at the body from the standpoint of respecting the cosmetic unit. To give you an idea of what a cosmetic unit is, the neck, torso, arms, thighs, and lower legs are all individual cosmetic units.
Building upon the idea of the cosmetic unit, is the circumferential approach. This is a key point in understanding the philosophy behind addressing disproportion and creating balance with liposuction. The cosmetic unit must be viewed as a curved three-dimensional object and be treated circumferentially. Many of the problems I see created by other surgeons, is that the blending of an area was not performed in a three-dimensional manner. The body is three dimensional with curves and roundness. When an area is treated without appropriate blending, it can create an unnatural looking flat appearance.
When the three-dimensional circumferential approach is successfully applied to each cosmetic unit, it leads to superior, more natural looking outcomes, without the need for subsequent revision surgeries.
