A Web-based Tool for Liposuction Endpoints and Postoperative Results: A Quantitative Prediction Model for Thigh Circumferential Liposuction

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Jiyang Li
Last updated:
Sun, 03/17/2024 - 21:48
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Background: The endpoint of liposuction surgery in a current clinical dilemma. The liposuction volume (LV) should be individualized according to each patient's objective and subjective needs.

Objectives: To create a mathematical model to quantitatively predict the change ratio of thigh circumference to LV.

Methods: In this retrospective cohort study, 122 patients who underwent circumferential liposuction of the thigh between July 2018 and June 2022 at a single center were included. Preoperative demographic variables and operative details were analyzed using linear regression to construct the prediction model.

Results: Body mass index (BMI), body fat rate (BFR), greatest thickness of subcutaneous adipose tissue (SAT) at the horizontal level at the innermost point via the groin (T-upper), and LV were independent predictors of the change ratio of the horizontal circumference at the innermost point via the groin (RC-upper). The linear regression model resulted in the following predictive equation: RC-upper = −1.0072 + 0.3225 × BMI − 0.1885 × BFR + 0.6721 × T-upper + 0.0015 × LV.

Conclusion: This personalized prediction model can be used in daily clinical practice to rationalize surgical expectations and to quantitatively assess surgeons' preoperative designs.


The preoperative demographic variables include age, BMI, BFR, basal metabolic rate (BMR), horizontal circumference at the innermost point via the groin (C-upper), circumference of superior patellar level (C-lower), the greatest thickness of subcutaneous adipose tissue (SAT) on the horizontal level at the innermost point via the groin (T-upper), the greatest thickness of SAT on the superior patellar level (T-lower), muscle contouring (none, slight, median, sharp), skin condition (none, slight, moderate, severe) evaluated from quality, elasticity, firmness, and overall appearance, workout routine (none, once a week, twice a week), genu valgum or genu varum, and reproductive history. This study's C-upper and C-lower values were the averages of the left and right legs. The operative details included the Liposuction volume (LV), volume of transplanted fat (TF), radiofrequency (RF) treatment, botulinum toxin type A (BtX-A) treatment, and operative time. The only postoperative complication in this cohort was seroma. The BFR and BMR were measured using an InBody 570 (InBody Co., Ltd. Korea).

The assessment of changes in thigh circumference has primarily relied on a standardized method of constant-tension tape measurement, which was highly reliable and repeatable. The SAT thickness in these cases was measured using calipers. The volume of fat was measured in the aspirate after settling. The C-upper and C-lower change ratio (RC-upper and RC-lower) was defined as the difference between the preoperative and postoperative data divided by the preoperative data.

Postoperative management and follow-up

Details of the surgical technique have been fully described in our previous report. Patients were advised to wear an elastic compression garment for 3–6 months; they generally achieve their final appearance over 3 months as edema subsides and skin contraction ensues. The postoperative thigh circumference was measured using a constant-tension tape at least 6 months postoperatively. Daily activities resumed 1 week after surgery, and a return to physical activities occurred 1.5 months after surgery. The follow-up period ranged from 12 to 24 months (mean, 15 months). Patient satisfaction with the postoperative appearance was assessed on a scale of 1 to 5 (1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent).