Application of the Vertical Axillary Line for High-Definition Liposuction and Body Contouring

Background: We present a novel vertical axillary line protocol that offers several benefits to high-definition (HD) liposuction and body contouring procedures. High-definition liposuction and body contouring are predicated on addressing the body circumferentially in a 360-degree manner. The vertical axillary line protocol utilizes a vertical line drawn from the armpit or axilla down to the mid-lateral thigh. The benefits of this vertical axillary line to HD body contouring are derived from its ability to delineate the junction between the front and back halves of the body. Objective: The vertical axillary line provides safety measures and superior outcomes for HD body contouring cases. By gauging the halfway point when performing liposuction around the waist, the vertical axillary line avoids theoretical point burns from the tip of the ultrasound probe, promotes preservation of perforators during abdominoplasty, and even avoids inadvertent injury to breast implants. In addition, it helps clarify gender-specific contouring guidelines. Finally, it provides anatomical landmarks to guide preoperative surgical markings in excisional body lifting procedures, thereby ensuring symmetry of incision lines. Method: The HD vertical axillary lines are defined by the axillary folds located along the anterior and posterior aspects of the armpit. The apex of the axilla is used to set the mid-HD vertical axillary line. The anterior and posterior axillary folds define the anterior HD vertical axillary line and posterior HD vertical axillary line, respectively. These 3 points (anterior, mid, posterior) define the start point of the HD vertical axillary lines, which are then extended down through the mid-point of the lateral thigh. Results: We present 8 cases to demonstrate how the HD vertical axillary line protocol may improve safety measures and aesthetic outcomes. Conclusion: In summary, we present a novel HD vertical axillary line protocol that may help improve both safety and aesthetic outcomes in HD liposuction and body contouring surgeries. Level of Evidence: Level V, clinical experience