A regional approach to patient selection and evaluation for liposuction.

Any area of the body where the deformity is due to regional excess fat and where there is overlying good skin tone is presumably amenable to body contouring by liposuction. It is an understandable temptation to attempt to remove large quantities of fat without major surgery and without noticeable scars. With experience, the surgeon will be able to estimate preoperatively the amount of fat that should be removed. However, liposuction is a procedure that requires conservatism because overzealous fat removal can generally leave unsightly permanent sequelae. Careful patient selection and proper identification of the correct indications of the technique are of paramount importance in achieving good aesthetic results and in avoiding complications. The ideal candidate is young, with good skin tone, moderate localized fatty deposits, and realistic expectations. There is certainly a wide range of patients who will benefit from the use of liposuction, and the average patient with less-than-ideal indications is more commonly encountered. The poor candidate is obese or has a significant deformity, poor skin tone, and, ironically, the most unrealistic expectations. Old age is not an absolute contraindication, although with increased age there is a concomitant decrease in elastic fibers, resulting in decreased capability to adapt a new contour. However, many patients "past their prime" will also have an acceptable cosmetic result and are particularly pleased with their changed, clothed silhouette. Appropriate patient selection, appreciation of the underlying anatomy, and judicious surgical technique are all essential for optimal results and patient satisfaction. Liposuction as described, either alone or as an adjunct to other procedures, allows for optimal aesthetic correction of figure faults due to adipose tissue.