Modern High-Definition Liposculpture: technologies, anatomic planning, fat grafting, and patient safety - a narrative review

Abstract

Introduction: Contemporary liposculpture combines selective fat removal, refinement of body contours, and, for selected patients, autologous fat grafting. Technical sophistication does not eliminate local or systemic complications. Objective: To review indications, liposuction modalities, high-definition strategies, fat grafting, and patient safety recommendations. Methods: Critical narrative review of clinical studies, systematic reviews, and professional society statements available through October 2026, without original patient data or meta-analysis. Discussion: Conventional suction-assisted, power-assisted, ultrasound-assisted, and energy-based modalities; patient selection; subcutaneous tissue planes; contour irregularity prevention; aspirate volume; fluid balance; venous thromboembolism; thermal injuries; and gluteal fat-grafting safety are examined. Synthesis: Liposuction improves contour, but results depend on anatomy, selection, and surgical expertise. Comparative evidence among technologies remains heterogeneous. For gluteal grafting, professional recommendations emphasize strictly subcutaneous fat placement and real-time ultrasound guidance. Conclusion: Safety is determined by patient selection, appropriately equipped facilities, atraumatic technique, monitoring, and timely complication management rather than technology alone. Interpretation must account for heterogeneity across studies, individual anatomy, local resources, and the limitations of available evidence. Clinical decisions therefore require context-sensitive judgment rather than unsupported generalizations about the comparative superiority of a single approach.