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  • Lipedema is a chronic and potentially progressive fat distribution disorder. Disease-related symptoms, such as pain and discomfort, can require surgical intervention when conservative therapies are exhausted. These megaliposuctions are functional in nature and need to be distinguished from esthetic liposuctions. This new surgical approach, the hybrid technique combining power-assisted liposuction (PAL) with manual extraction (ME), has been developed to more effectively treat fibrotic nodules, particularly in the lower legs, where conventional liposuction techniques often fall short.

  • Infragluteal deformities are a challenging complication following liposuction, particularly when injury occurs to the fibrous osteocutaneous bands of the gluteal crease. Various surgical solutions have been proposed, including autologous fat grafting, skin-lifting procedures, and flap reconstructions, yet a consistent, scar-free, and minimally invasive technique remains elusive. In this report, we present a new modified net suture technique, inspired by the hemostatic net used in aesthetic facial surgery, as a promising treatment for post-liposuction infragluteal deformities. After aggressive power-assisted liposuction to detach mispositioned adhesions within the gluteal crease, we apply a transcutaneous continuous-running suture using non-absorbable nylon, fixed along the newly established crease. The suture is laid loosely to preserve skin perfusion, cushioned by an ointment dressing, and supported with external compression. The technique is completed in approximately 15 minutes, with suture removal on postoperative day 4. In our experience, this approach leads to aesthetically satisfactory outcomes, restores gluteal symmetry, and avoids the formation of additional scars. Our technique is simple, cost-effective, and preserves lymphatic and vascular integrity. This manuscript describes our methodology, rationale, and early clinical observations supporting this low-risk intervention.

Last update from database: 5/20/26, 7:23 AM (UTC)

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