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 cm³ (mean: 43.33 cm³) and percentage increase of 65.3% (P < 0.0001). Regarding the left erector, similar volumes between 20 and 60 cm³ (mean: 44.67 cm³) 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.

Fig. 1.

Presurgical design. Yellow dots: standardized area of ultrasound measurement. Red dot: lower incision. Blue dots: upper incisions. Purple points: points where the dimples of Venus will be defined. Green lines: lateral edges of ESMs to be defined. Orange line: midline of both ESMs to be defined. Red lines: regions lateral to the erector spinae where liposuction will be performed.

Fig. 2.

Immediately before (A) and after (B) in the operating room.

Fig. 3.

Figure before (A) and 1 month after (B) the procedure wherein the female patient is seen in a standing position without muscle contraction.

Fig. 4.

Figure before (A) and 1 month after (B) the procedure wherein the female patient is seen in a standing position without muscle contraction.

Fig. 5.

Figure before (A) and 1 month after (B) the procedure wherein the female patient is seen in a standing position without muscle contraction.

Fig. 6.

Figure before (A) and 1 month after (B) the procedure wherein the female patient is seen in a standing position without muscle contraction.