Echo-guided Lower-back Sculpture and Volumization as a Complement to High-definition Liposuction (XPINE-FAT)

Abstract

Background: Knowledge about lower-back aesthetics is very limited, especially regarding surgical techniques that improve its appearance. Thus, this study aimed to describe a high-definition liposuction technique with intramuscular grafting of erector spinae muscles (longissimus). Methods: A total of 15 female patients 25-48 years of age were recruited between November 2021 and January 2022, who underwent body contouring surgery and subsequently underwent a low-back lipodefinition and echo-guided intramuscular erector spinae (longissimus) fat graft to complement the procedure. As part of the study, measurements were performed before surgery and in the immediate postoperative period. The data were stored in a database and analyzed with the SPSS Version 25 statistical software. Results: The patients' ages ranged from 25 to 48 years (mean: 37 years), with a body mass index of 18.6-29.3 (mean: 25.5). The surgical times ranged between 1 and 8 hours (mean: 3.73 hours); hospitalization times were 0.7-1 days (mean: 0.940 days). Lipograft was performed on the erector spinae muscles (longissimus), the right one with a range of 20-60 cm 3 (mean: 43.33 cm 3 ) and percentage increase of 65.3% (P < 0.0001). Regarding the left erector, similar volumes between 20 and 60 cm 3 (mean: 44.67 cm 3 ) were grafted with a percentage increase of 66.4% (P < 0.0001). Conclusions: XPINE-FAT is a safe technique that allows an increase in the immediate intramuscular thickness of the erector spinae muscles (longissimus). We observed no adverse events during the study.

Intramuscular Posterior Thigh Volumization: An Aesthetic and Harmonious Transition to the Gluteal Region (Hv-FAT)

“…Our approach to the Hv-FAT procedure involves regarding the gluteal region as a box and the lower back as the upper frame. For these regions, several types of treatments are currently available, including the XPINE-FAT technique of fat grafting on erector spinae muscles, PRS Global Open • 2023 6 using intraoperative ultrasound, 12 thereby improving the transition from the lower back to the gluteal region. For the profile view, which is determined by the hips, liposuction or fat transfer can be used based on the requirements of each patient.…”

“…Fat grafting is being increasingly used to volumize muscle groups, especially as a complement to body contouring surgery, styling, and highlighting with liposuction results and few adverse events. [8][9][10][11][12][13][18][19][20][21] The results showed that the increase of the thickness in the immediate postoperative period is evident and 1-month follow-up ultrasound measurements highlighted a decrease in the muscle thickness in relation to the immediate postoperative period in all fat-grafted muscle groups (long head of the biceps femoris and semitendinosus muscles), bilaterally. Nevertheless, despite these results, the patients maintained a good distribution of muscle thickness 1 month after surgery, and this decrease is minimal when compared with the thickness initially obtained after fat grafting, which suggest that the results are possibly sustainable over time (Table 4).…”

“…Fat grafting is being increasingly used to volumize muscle groups, especially as a complement to body contouring surgery, styling, and highlighting with liposuction results and few adverse events. 8–13,18–21…”

“…5,6 Various procedures have been developed for the volumization of muscle groups to meet patient requirements, such as fat grafting techniques for pectoral and deltoid muscles, biceps and triceps, rectus abdominis, trapezius, erector spinae, and vastus muscles. [7][8][9][10][11][12][13] Research on the thigh remains limited, and studies that have been conducted in the anterior thigh are favored because they emphasize the current trends in projecting an athletic image. 14 However, studies on the posterior thigh…”

Ultrasonography as a Tool to Improve Preoperative Marking in Body Contour Surgery

“…The use of US deepens basic understanding of anatomy and helps to reveal individual differences and further tailor techniques. [14][15] US enables us to further personalize the areas to highlight while respecting each patients' individual characteristics. [16][17][18] US is an easy way to improve the marking technique for liposuction of the rectus abdominis or other surgical interventions on the anterior wall of the abdomen in clinical practice.…”