Product Description

This course reviews the 18-year evolution of high-definition liposculpture (HDL) and its most important technical upgrades, focusing on patient safety and complication trends as the technique matured from suction-assisted lipoplasty (2002–2005) to VASER-assisted HDL (2006–2010) and ultimately dynamic definition (4D) liposculpture (2011–2019). In a retrospective cohort of 5052 patients treated by the senior author across four private centers, the authors compare complication profiles across the three eras and describe the accompanying refinements in perioperative protocols (e.g., improved temperature management, VTE prophylaxis, and bleeding control strategies such as tranexamic acid). As the approach evolved, overall complication rates—particularly bleeding-related events—declined, while maintaining the central aesthetic goal of a natural, athletic contour achieved through detailed anatomic “sculpting” rather than simple fat removal, supporting HDL/4D liposculpture as safe, reproducible techniques when performed with appropriate patient selection and standardized safety measures.

Intended Audience

This educational activity is intended for all CME-related persons including plastic surgery practitioners, residents, and other healthcare professionals.

Learning Objectives

After viewing this course, the participant should be able to:

1. Describe the three evolutionary periods of high-definition liposculpture (SAL 2002–2005, VASER-assisted HDL 2006–2010, and dynamic definition/4D liposculpture 2011–2019) and identify the primary technological and conceptual upgrades introduced in each period. 
2. Compare complication rates across the three periods using the data from Table 5, specifically quantifying the progressive reduction in seroma, hematoma, acute anemia, skin necrosis, hyperchromia, and contour irregularities, and explain the clinical significance of this trend for patient safety.
3. Outline the current comprehensive safety protocol for dynamic definition liposculpture, including preoperative patient selection criteria and contraindications, intraoperative hypothermia and VTE prevention measures (Blanketrol, pneumatic compression, tranexamic acid), and postoperative care (compression garments, drains, enoxaparin, and follow-up schedule).
4. Explain the impact of key adjunctive measures (tranexamic acid + Blanketrol system, drains, and radiofrequency skin-tightening devices) on bleeding control, postoperative hemoglobin/hematocrit levels, and overall blood loss, citing the statistically significant findings from Tables 1 and 4.
5. Define and apply the core artistic and anatomic concepts of dynamic definition (4D) liposculpture, including differentiation of power versus definition muscles, transition zones, the “all-or-nothing” and 360-degree principles, variable sculpting by biotype, and the shift from “removing fat” to “revealing anatomy.”

Faculty:

Alfredo E. Hoyos, MD, Laura C. Cala, MD, Mauricio E. Perez, MD, Ivan R. Mogollon, MD, Rodrigo Dominguez-Millan, MD

Plastic and Reconstructive Surgery Global Open Editors

Editor-in-Chief: Kevin C. Chung, MD

Co-editor: Amy S. Colwell, MD

Cosmetic editor: Bernard L. Markowitz, MD

CME Faculty:

Josef Hadeed, MD, FACS

Accreditation

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation

The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA PRA Category 1 CreditTM: 1.0

Media: Journal Article

Release Date: 2/27/2026

Expiration Date: 2/27/2029*

Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Disclosure Policy

The American Society of Plastic Surgeons (ASPS) requires all instructors, planners, reviewers, managers and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. ASPS also requires faculty/authors to disclose when off-label/unapproved uses of product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

The following planners/faculty members/reviewers have the following disclosures:

Alfredo E. Hoyos, MD was an unpaid consultant and speaker for the product development team of the Sound Surgical Technologies system and Cannulas (now VASER 2018, Solta Medical, Bausch Health Companies, Inc.) up to May of 2013 and receives royalties for the liposuction kits named after him.

The following planners and faculty members have no relevant financial relationships or affiliations to disclose:

Laura C. Cala, MD, Mauricio E. Perez, MD, Ivan R. Mogollon, MD, Rodrigo Dominguez-Millan, MD

Editor-in-Chief: Kevin C. Chung, MD

Co-Editor: Amy S. Colwell, MD

CME Faculty: Josef Hadeed, MD, FACS

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

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