Keywords
lipectomy
upper extremity
How to Cite
Abstract
Introduction: Skin laxity represents one of the main challenges of isolated upper-arm liposuction. LIPO 360 (Circumferential Lipo-Slicing Technique) is a systematic circumferential approach based on mechanical release of the subcutaneous tissue and postoperative management of the skin envelope. This study aimed to describe its technical principles and characterize its clinical outcomes.
Materials and Methods: This retrospective observational study included 71 women who underwent circumferential upper-arm liposuction using LIPO 360 between 2023 and 2026. Clinical, anthropometric, intraoperative, and postoperative variables were collected. The main outcomes were postoperative complications and the need for secondary brachioplasty. Descriptive statistics and an exploratory comparative analysis using the Mann–Whitney U test were performed.
Results: The mean age was 42.7 ± 8.4 years, and the mean preoperative BMI was 30.2 ± 4.4 kg/m². The mean aspirated volume was 5,801.6 ± 1,480.2 mL, and the mean follow-up was 15.0 ± 10.0 months. During follow-up, 58 patients (81.7%) had no clinical indication for secondary brachioplasty. Patients who subsequently underwent brachioplasty were older (p=0.048), whereas preoperative BMI showed a numerical difference without statistical significance (p=0.055). One lymphocele (1.4%) was documented and resolved spontaneously. Clinical contour changes were observed without intraoperative energy-based technologies specifically intended to promote skin retraction.
Conclusions: LIPO 360 is a systematic mechanical approach to circumferential upper-arm liposuction. The combination of circumferential tissue release and directed postoperative management represents a strategy aimed at promoting skin-envelope accommodation after volumetric reduction. The findings support its clinical applicability and warrant prospective studies using objective measures of skin laxity and accommodation.
References
1. El Khatib, H. A. (2007). Classification of brachial ptosis: Strategy for treatment. Plastic and Reconstructive Surgery, 119(4), 1337–1342. https://doi.org/10.1097/01.prs.0000254796.40226.92
2. Teimourian, B., & Malekzadeh, S. (1998). Rejuvenation of the upper arm. Plastic and Reconstructive Surgery, 102(2), 545–551. https://doi.org/10.1097/00006534-199808000-00041
3. Duncan, D. I. (2012). Improving outcomes in upper arm liposuction: Adding radiofrequency-assisted liposuction to induce skin contraction. Aesthetic Surgery Journal, 32(1), 84–95. https://doi.org/10.1177/1090820X11429549
4. Hong, Y. G., Sim, H. B., Lee, M. Y., Seo, S. W., Chang, C. H., Yeo, K. K., & Kim, J.-K. (2012). Three-dimensional circumferential liposuction of the overweight or obese upper arm. Aesthetic Plastic Surgery, 36(3), 497–503. https://doi.org/10.1007/s00266-011-9856-z
5. Bossert, R. P., Dreifuss, S., Coon, D., Wollstein, A., Clavijo-Alvarez, J., Gusenoff, J. A., & Rubin, J. P. (2013). Liposuction of the arm concurrent with brachioplasty in the massive weight loss patient: Is it safe? Plastic and Reconstructive Surgery, 131(2), 357–365. https://doi.org/10.1097/PRS.0b013e3182789de9
6. Langer, K. (1861). Zur Anatomie und Physiologie der Haut. I. Über die Spaltbarkeit der Cutis. Sitzungsberichte der Kaiserlichen Akademie der Wissenschaften, Mathematisch-Naturwissenschaftliche Classe, 44, 19–46.
7. Ní Annaidh, A., Bruyère, K., Destrade, M., Gilchrist, M. D., & Otténio, M. (2012). Characterization of the anisotropic mechanical properties of excised human skin. Journal of the Mechanical Behavior of Biomedical Materials, 5(1), 139–148. https://doi.org/10.1016/j.jmbbm.2011.08.016
8. Laiacona, D., Cohen, J. M., Coulon, K., Lipsky, Z. W., Maiorana, C., Boltyanskiy, R., Dufresne, E. R., & German, G. K. (2019). Non-invasive in vivo quantification of human skin tension lines. Acta Biomaterialia, 88, 141–148. https://doi.org/10.1016/j.actbio.2019.02.003
9. Chia, C. T., Theodorou, S. J., Hoyos, A. E., & Pitman, G. H. (2015). Radiofrequency-assisted liposuction compared with aggressive superficial, subdermal liposuction of the arms: A bilateral quantitative comparison. Plastic and Reconstructive Surgery–Global Open, 3(7), e459. https://doi.org/10.1097/GOX.0000000000000429
10. Tettamanzi, M., Pili, N., Rodio, M., Serra, P. L., Trignano, C., Rubino, C., & Trignano, E. (2023). Use of radiofrequency-assisted liposuction (BodyTite) for upper arms lifting. Aesthetic Plastic Surgery, 47(6), 2495–2501. https://doi.org/10.1007/s00266-023-03452-6
11. Cala Uribe, L. C., Perez Pachon, M. E., Zannin Ferrero, A., Neri Morales, C., Silva Gutierrez, J., Manrique Cruz, A. D., Maza, M. F., Acero Mondragon, E. J., & Celis Regalado, L. G. (2023). Effects of bipolar radiofrequency on collagen synthesis from patients with brachial ptosis. Plastic and Reconstructive Surgery–Global Open, 11(4), e4924. https://doi.org/10.1097/GOX.0000000000004924
12. Van De Water, L., Varney, S., & Tomasek, J. J. (2013). Mechanoregulation of the myofibroblast in wound contraction, scarring, and fibrosis: Opportunities for new therapeutic intervention. Advances in Wound Care, 2(4), 122–141. https://doi.org/10.1089/wound.2012.0393
13. Tracy, L. E., Minasian, R. A., & Caterson, E. J. (2016). Extracellular matrix and dermal fibroblast function in the healing wound. Advances in Wound Care, 5(3), 119–136. https://doi.org/10.1089/wound.2014.0561
14. Vasilakis, V., Isakson, M. H., Yamin, F., Kortesis, B. G., Bharti, G., & Hunstad, J. P. (2020). Four-position four-entry site circumferential arm liposuction: Technique overview and experience. Aesthetic Plastic Surgery, 44(5), 1596–1603. https://doi.org/10.1007/s00266-020-01857-1
15. Gu, Y., Kang, N., Lv, Q., Qi, Y., Liu, Z., Chen, W., Sun, X., Chen, H., Ma, G.-E., & Qi, Z. (2021). Application of a proposed multi-positional circumferential arm liposuction method and quantification of its clinical efficacy evaluation. Aesthetic Plastic Surgery, 45(3), 1115–1124. https://doi.org/10.1007/s00266-020-02121-2
16. Boeni, R. (2019). Circumferential liposuction of the female arm. The American Journal of Cosmetic Surgery, 36(3), 125–129. https://doi.org/10.1177/0748806818807574
17. Herbst, K. L., Kahn, L. A., Iker, E., Ehrlich, C., Wright, T., McHutchison, L., Schwartz, J., Sleigh, M., Mc Donahue, P., Lisson, K. H., Faris, T., Miller, J., Lontok, E., Schwartz, M. S., Dean, S. M., Bartholomew, J. R., Armour, P., Correa-Perez, M., Pennings, N., Wallace, E. L., & Larson, E. (2021). Standard of care for lipedema in the United States. Phlebology, 36(10), 779–796. https://doi.org/10.1177/02683555211015887
18. Nash, L. G., Phillips, M. N., Nicholson, H., Barnett, R., & Zhang, M. (2004). Skin ligaments: Regional distribution and variation in morphology. Clinical Anatomy, 17(4), 287–293. https://doi.org/10.1002/ca.10203
19. El-Fahar, M. H., & El-Gharbawi, A. H. (2023). Ultrasound-assisted liposuction (UAL) arm contouring in non-post-bariatric patients: No rush for brachioplasty. Aesthetic Plastic Surgery, 47(1), 260–268. https://doi.org/10.1007/s00266-022-03070-8
20. Frick, A., Hoffmann, J. N., Baumeister, R. G. H., & Putz, R. (1999). Liposuction technique and lymphatic lesions in lower legs: Anatomic study to reduce risks. Plastic and Reconstructive Surgery, 103(7), 1868–1873. https://doi.org/10.1097/00006534-199906000-00009
21. Yagmur, C., Akaishi, S., Ogawa, R., & Guneren, E. (2010). Mechanical receptor-related mechanisms in scar management: A review and hypothesis. Plastic and Reconstructive Surgery, 126(2), 426–434. https://doi.org/10.1097/PRS.0b013e3181df715d
22. O’Reilly, S., Crofton, E., Brown, J., Strong, J., & Ziviani, J. (2021). Use of tape for the management of hypertrophic scar development: A comprehensive review. Scars, Burns & Healing, 7, 20595131211029206. https://doi.org/10.1177/20595131211029206
23. Sawant, M., Hinz, B., Schönborn, K., Zeinert, I., Eckes, B., Krieg, T., & Schuster, R. (2021). A story of fibers and stress: Matrix-embedded signals for fibroblast activation in the skin. Wound Repair and Regeneration, 29(4), 515–530. https://doi.org/10.1111/wrr.12950
24. Theodorou, S., & Chia, C. (2013). Radiofrequency-assisted liposuction for arm contouring: Technique under local anesthesia. Plastic and Reconstructive Surgery–Global Open, 1(5), e37. https://doi.org/10.1097/GOX.0b013e3182a58c80
25. Wu, D. C., Liolios, A., Mahoney, L., Guiha, I., & Goldman, M. P. (2016). Subdermal radiofrequency for skin tightening of the posterior upper arms. Dermatologic Surgery, 42(9), 1089–1093. https://doi.org/10.1097/DSS.0000000000000842
26. Paul, M., Blugerman, G., Kreindel, M., & Mulholland, R. S. (2011). Three-dimensional radiofrequency tissue tightening: A proposed mechanism and applications for body contouring. Aesthetic Plastic Surgery, 35(1), 87–95. https://doi.org/10.1007/s00266-010-9564-0
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.