**4.1 Circumferential trunk liposuction**

Patient positioning for circumferential trunk liposuction can be performed in the supine, prone and lateral positions. Our preferred technique for circumferential trunk liposuction positions the patient prone and then supine. We do not routinely utilize lateral positioning. When the patient arrives in the operating room, they are initially placed supine on a stretcher and tumescent fluid is infiltrated anteriorly. The patient is then placed prone on the operating room table and the posterior trunk is similarly infiltrated. The patient is then prepped and draped in the usual sterile fashion and suctioning begins in the prone position. The patient is transferred back to the stretcher in the supine fashion and placed on the operating room table in the supine position. The patient is again prepped and draped and suctioning is performed to the anterior abdomen.

### **4.2 Abdominoplasty with liposuction**

A majority of our patients undergoing full abdominoplasty also receive abdominal liposuction to improve postoperative abdominal contour. Liposuction is performed prior to resection of the abdominal skin flaps. Access incisions are created within the area of planned resection and at the superior umbilicus.

A 4 mm Mercedes tip cannula is used with the Microaire PAL system to perform liposuction to the entire abdominal flap. The use of basket cannulas and fat equalization is minimized to prevent trauma to the vessels supplying the abdominoplasty skin flap. After the abdominal skin and fat is resected, the subscarpal fat is further trimmed to improve the contour and match the thickness of the mons.
