**7. Patient selection and peri-operative management**

We consider the BMI is one of the main factors in patients' selection and the choice of surgery to achieve safest and best results. We adhere to a BMI of 30 kg/ m2 or less for liposuction and body contouring. For high definition body contouring and three-dimensional sculpting our choice of BMI is 26 kg/m<sup>2</sup> or less. The patients are ASA I-II (American Society of Anaesthetist classification); smoking must stop 4 weeks before surgery, and 3 weeks after. Non-steroidal anti-inflammatory drugs must stop usually 48–72 hours before surgery.

We ask patients to stop certain herbals, which increase bleeding 2-3 weeks prior to surgery. The combined contraceptive pill and HRT are stopped 4-5 weeks before surgery and not commenced for 3 weeks after. All patients undergoing abdominal contouring undergo pre-operative ultrasound investigation.

TED stocking are used to reduce risk of deep vein thrombosis in addition to intraoperative compression boot in all cases. In long procedures low molecular weight heparin is used until the patient is deemed fully mobile.

Seamless compression garments are used in all liposuction patients; however, when we perform three-dimensions high definition liposculpture we add appropriate soft padding to help maintain the contouring where it was created. The garments are worn for 4-6 weeks. The patients also undergo manual lymphatic drainage for the first 3 post-operative weeks.

Since COVID-19 pandemic the patient is asked to shield with the appropriate period, which differs between countries and a PCR antigen test carried out 2-3 days prior to surgery. Following the surgery we ask the patient to shield for a period of 10 days too.

If the patient has been vaccinated then we allow 10 days prior to surgery; however, if the patient has a positive COVID-19 test we defer the surgery for a minimum of 8-12 weeks and repeat the PCR test.

*Enhanced Liposuction - New Perspectives and Techniques*
