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Obesity can be defined as a chronic disease in which there is excess of body adiposity, leading to severe secondary health problems. This metabolic pathology shortens life-span and is a main cause of diabetes, atherosclerosis, systemic arterial hypertension, and reduction of pulmonary function, among others. The plastic surgeon is involved with the obese patient under two circumstances: either the patient is currently overweight and requests reduction of excess adipose tissue, or has suffered a great weight loss and desires correction of one, or more, contour deformities. In either case, planning demands a close preoperative analysis and careful preparation of the patient, execution of a meticulous surgical routine, and close postoperative follow-up. In this article, various body contour deformities will be addressed, showing the senior author's strategy in treating the obese patient that has achieved the loss of considerable weight.

This article presents the senior author's experience in fat grafting for the treatment of contour deformities of the buttocks and lower limbs. This method has been termed liposculpture and consists in removal of adipose tissue by cannula and syringe and cleaning of the aspirated material with saline. All external contact is thus carefully avoided, preventing contamination. Fat grafting is done in multiple tunnels in a deep plane. Total of 140 patients were treated over the last 5 years and results were considered uniformly satisfactory. Fat absorption was estimated by clinical evaluation to be less than 20% volume. A low rate of complications (less than 3%) supports the authors' opinion that this is an efficient and safe procedure to correct or enhance contour deformities of the lower limbs.