摘要

Objectives: The objective of this presentation is to describe and analyze a comprehensive 3D High-Definition torsoplasty approach for the restoration of trunk contour in patients with skin laxity and volume depletion following massive weight loss or aging. The aims are: • to illustrate the surgical planning principles of circumferential torsoplasty combined with buttock lifting and autologous fat grafting, ° to detail intraoperative strategies for Threedimensional sculpting • to evaluate the role of macrofat and microfat grafting in restorin Introduction: Flaccidity of the abdomen and buttocks is a common concern in both men and women, often arising after significant weight loss due to dietary restrictions, bariatric surgery, or as a natural consequence of aging. The loss of adipose tissue leads to structural imbalances, including skin redundancy, abdominal muscle diastasis, and volume depletion in the gluteal region. Materials / method: For optimal and lasting results, surgical intervention is ideally performed once the patient has reached a stable weight plateau, typically around one year post-bariatric surgery. Among the most effective body contouring procedures for reshaping the mid and lower trunk is circumferential torsoplasty combined with buttock lifting, a comprehensive approach that respects the three-dimensional nature of the human form. Results: The gluteal region is meticulously sculpted to restore its natural roundness, projection, and definition through a combination of buttock lifting and autologous fat grafting, using self-prosthesis techniques. The lower third of the buttocks is enhanced with Macrofat and Microfat grafting, strategically performed via lipofilling to optimize both volume and contour. To further refine body lines, liposculpture of adjacent areas—such as the trochanters and hips—is performed, ensuring a harmonious and balanced silhouette. Conclusion: This presentation will detail the surgical planning, intraoperative strategies, and technical refinements essential for achieving both aesthetic and functional restoration of the trunk. Additionally, the author will share insights drawn from a 12-year experience in body contouring surgery, encompassing 1,885 abdominoplasties, of which 263 were circumferential, with a comprehensive analysis of outcomes and long-term stability.