There are five danger zones in the body where we have modified techniques to avoid potential liposuction complications. These include:

1. Lateral chest region where trauma to the brachial plexus and axillary vein is possible.
2. The upper and upper mid-abdomen where trauma to the diaphragm and lungs is possible.
3. The lower back and posterior flanks where trauma to the kidneys is possible.
4. The anterior flanks where trauma to the large intestine is possible.
5. Chest region where trauma to the lungs is possible.

Lateral Chest

Pictured Above: Male and Female lateral chest danger zones

The lateral chest may require debulking in both males and females. For male patients, debulking will provide a stronger contrast between the armor plate lateral chest prominence and the cored-out lateral chest wall. Additionally, the female lateral chest debulking rounds out the breasts and provide more breast mound projection. However, this has traditionally required a port placed in the lateral inframammary crease. Unfortunately, this port site allows for inadvertent injury to the brachial plexus and/or axillary vein as one directs the liposuction cannula superiorly. Furthermore, modification of port placement over the anterior axillary region allows the provider to direct the liposuction inferiorly and away from these vital structures to avoid liposuction complications.

Upper and Upper Mid Abdomen

Pictured Above: Male and Female upper and upper mid-abdomen danger zones

The upper and upper mid-abdomen are prone to inadvertent injury to the diaphragm when using pubic and umbilical port sites. This is because we direct the cannulas superiorly. In patients with generous rib cage protrusion, one could inadvertently guide the cannula tip under the rib cage. Therefore, to eliminate potential complications and risks to the diaphragm or lungs, inframammary crease incisions are recommended for the contouring of the upper and upper ½ of the mid-abdomen. In this manner, one directs the cannulas inferiorly and away from the rib cage. The umbilical and pubic port sites are specifically reserved for contouring the lower and lower ½ of the mid-abdomen.

Lower Back and Posterior Flanks

Pictured Above: Male and Female lower back and posterior flanks danger zones

Liposuction of the lower back and posterior flanks can create potential dangers to inadvertent injury of the kidneys and thus create liposuction complications. This occurs when using the sacral and posterior superior iliac port sites in patients with an acute lordosis because it is difficult to guide the liposuction cannula around the lower back curvature. Subsequently, in patients with lordosis, one should position the posterior superior iliac port sites slightly higher on the lower back. This allows cannulas to make it around the curve without risking injury to the retroperitoneal structures.

Anterior Flanks

Pictured Above: Male and Female anterior flanks danger zones

Experts typically liposuction the anterior flanks from the pubic port sites. However, one must be able to maneuver the liposuction cannulas around and over the lateral hip bones. When patients present with prominent lateral hip bones inadvertent entry into the intra-abdominal cavity can be possible if the cannula is directed under the lateral hip bone instead of over the lateral hip bone crest. In patients with prominent lateral hip bones, it is prudent to place the pubic port sites more laterally so that one avoids potential injury to the large bowel and present liposuction complications.

Chest

Pictured Above: Avoiding chest danger zone

The chest region is often contoured in male patients to remove unwanted soft tissue fullness that feminizes the breast, called gynecomastia. This region is vulnerable to injury to the underlying lungs if one guides the liposuction cannula between any two ribs. As such, experts should position liposuction ports so that liposuction cannula vectors are perpendicular rather than parallel to the individual ribs. Furthermore, Using an infra-areolar or inframammary crease port and an anterior axillary port site achieves this and avoid any liposuction complications.