High-Definition Liposuction (HD) Techniques: Anatomical Foundations and Risks

Abstract

Introduction: High-definition (HD) liposuction represents an evolution in body contouring techniques, combining selective fat removal with the enhancement of muscular anatomical landmarks. Despite its growing popularity, the technique presents increased complexity and a specific risk profile that requires critical analysis. Objective: To review the anatomical foundations, technical principles, and main risks associated with high-definition liposuction, focusing on safety and predictability of aesthetic outcomes. Methods: This is a narrative literature review with an integrative and critical approach. The search was conducted in PubMed, Scopus, and Web of Science databases using descriptors related to HD liposuction, anatomy, body contouring, and complications. Original studies, case series, and relevant technical articles were included, without initial time restriction. Results: HD liposuction is based on the selective manipulation of superficial and deep adipose compartments, highlighting anatomical landmarks such as the linea alba and semilunar line. Techniques involving superficial planes provide enhanced aesthetic definition but are associated with higher rates of local complications, including contour irregularities, fibrosis, and skin necrosis. Systemic complications, such as thromboembolism and fat embolism, although less frequent, present high severity. Significant heterogeneity among techniques and lack of standardized outcome assessment were also observed. Conclusion: High-definition liposuction is an effective technique for advanced body contouring; however, it requires in-depth anatomical knowledge, precise technical execution, and careful patient selection. Safety must be prioritized over aesthetic enhancement, and further standardization and higher-level evidence studies are needed.