Book Review
Aesthetic Surgery Journal
Alfredo E. Hoyos and Peter M. Prendergast. High Definition
Body Sculpting: Art and Advanced Lipoplasty Techniques.
New York, NY: Springer, 2014. ISBN-10: 3642548903,
ISBN-13: 978-3642548901, $159.00.
Reviewed by: Megan C. Jack, MD; and Jason N. Pozner,
MD, FACS
High Definition Body Sculpting, written by Drs Alfredo
Hoyos and Peter Prendergast, is a 238-page textbook that
integrates artistic and anatomic concepts to provide a well-
rounded, sophisticated approach to body contouring
surgery. Both authors have published their experience pre-
viously in print and aesthetic journals, and here provide ex-
panded detail on techniques developed by Dr Hoyos and
adopted by Dr Prendergast. The authors encourage readers
to take basic liposuction to the next level in skill by adding
technology and fat grafting techniques to provide patients
with a more “complete” transformation. This text is a well-
written and elegantly illustrated work that is useful for
plastic surgeons interested in improving their overall
patient satisfaction and outcomes in cosmetic body con-
touring surgery.
The book is broken up into four parts and progresses logi-
cally from an artistic and scientific background of human
muscle and fat, to step-by-step male and female intraoperative
techniques, to postoperative considerations and outcomes.
Part I discusses an artistic approach to considering the human
form, the evolution of what culture views as aesthetically
pleasing, and the basic concepts of their advanced liposculp-
ture technique. The authors then progress to a discussion of
muscular anatomy and its relationship to surface landmarks
for the most important regions of the body addressed during
liposculpture. They include side-by-side anatomic diagrams
with photographs to illustrate these relationships. Their
discussion of preoperative assessment and preparation is
2016, Vol 36(2) NP94–NP95
© 2015 The American Society for
Aesthetic Plastic Surgery, Inc.
Reprints and permission:
journals.permissions@oup.com
DOI: 10.1093/asj/sjv048
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thorough and inclusive of examination, patient selection, in-
formed consent, patient counseling, and selection of anesthet-
ic type. Finally, the authors discuss intraoperative techniques
and instrumentation used with their preferred approach, such
as ultrasound (VASER, Solta Medical, Hayward, CA) and/or
power-assisted liposuction combined with fat grafting.
Parts II and III discuss male and female anatomic differ-
ences, while also addressing surgical techniques to achieve
a more masculine or feminine form using high-definition
liposculpture. In both sections the authors discuss the im-
portance of surgical markings and selective removal of fat
from certain areas while leaving a layer of fat over muscle
groups to truly sculpt the body and provide critical muscle
definition. Each of these parts are broken down into chap-
ters based on one anatomic region of the body (eg, male
torso, arms, etc.), helping the reader to specifically refer-
ence anatomic areas and avoiding over-generalization of
technique application to all anatomic areas. In Part IV, the
final section of the book, postoperative care is specifically
discussed, including the use of compression garments and
lymphatic massage. The authors appropriately end the
book by describing the commonly known complications of
liposuction, including a discussion of ultrasonic energy–
specific complications such as skin burns, and identify
newer developments in the field, combining their tech-
nique with abdominoplasty and cellulite treatment.
Drs Jack and Pozner are Academic Adjunct Faculty in Plastic Surgery
at the Cleveland Clinic Florida, Weston, FL, and Affiliate Assistant
Professors in the Department of Surgery at Florida Atlantic University,
Boca Raton, FL.
Corresponding Author:
Dr Megan C. Jack, 4800 N. Federal Highway, C101, Boca Raton,
FL 33431, USA.
E-mail: drjack@sanctuarymedical.com
Jack and Pozner
STRENGTHS
This book is helpful for the aesthetic plastic surgeon with a
background knowledge of basic liposuction techniques and
allows the reader to consider liposuction from a new, more
artistic perspective, focusing on building and sculpting the
human form rather than just blindly debulking fat. The
density of the information provided is appropriate and the
illustrations and photographs help keep the reader engaged
and motived to enhance their liposuction results: they also
clearly show the potential of the authors’ techniques.
Although all trained plastic surgeons have a basic anatomic
knowledge base, it is helpful to provide a brief review of
the key muscle groups that help define the superficial land-
marks that are aesthetically pleasing to the eye. I also found
it critically important to discuss the difference between
male and female shape and anatomic landmarks. When
performing body contouring surgery it is important not to
generalize techniques to both sexes to avoid feminization
of the male form and vice versa. The detail provided in the
specific technique sections is adequately thorough, includ-
ing selection of specific instrumentation and ultrasonic
device power settings. Perhaps most helpful is the discus-
sion on detailed patient marking in each region, which cer-
tainly provides an approach that is not utilized by the
average cosmetic surgeon. Warning boxes are also inter-
jected in each section to alert readers to potential pitfalls
and complications.
WEAKNESSES
The main concern with the book is that the techniques de-
scribed are advanced and the reader should be cautioned to
consider hands-on training in these techniques prior to full
implementation into clinical practice. Plastic surgeons need
to familiarize themselves with any technology added to tra-
ditional liposuction techniques, including the proper set-
tings and use of the devices. Dr Hoyos prefers to utilize
VASER (Solta Medical, Hayward, CA) for added skin tight-
ening and lessened strain on the surgeon, among other
NP95
reasons. The power settings indicated in the text are poten-
tially too aggressive for some patients and particularly for
beginner VASER users. An additional section discussing al-
ternative advanced techniques when a VASER device is un-
available or too costly for the average cosmetic plastic
surgeon would have been helpful to readers. Finally, a
more thorough discussion of the more problematic compli-
cations of these techniques (eg, cutis marmorata and fat
embolism) and more specific methods to prevent these
complications would have been prudent.
SUMMARY
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Overall, High Definition Body Sculpting provides cosmetic
plastic surgeons with detail-oriented descriptions of ad-
vanced liposculpture techniques to help propel liposuction
results to a more sophisticated level. This text is probably
best served as an adjunct to hands-on experience with such
techniques. It helps the cosmetic plastic surgeon view lipo-
suction from a more structured yet artistic approach, but
careful patient counseling as to the additional risks of these
refined techniques is important. The authors’ outstanding
before-and-after examples show just how dramatic a trans-
formation can be when their techniques are responsibly
utilized.
RATING: 4 OF 5
To purchase, visit: http://www.springer.com/us/book/
9783642548901.
Disclosures
Dr Jack is a speaker for Solta Medical (Hayward, CA). Dr Pozner
is a consultant for Valeant Pharmaceuticals (Bridgewater, NJ).