The male flanks, also known as love-handles, are located just above the crest of the hip bone. In the female the identical anatomic area is called the waist. The male flanks are a localized accumulation of fat that bulges over the belt-line in a most unflattering fashion and is accentuated by a pair of pants with a tight belt. When viewed from behind, the bulging male flanks appear bigger because the largest bulk of the male flank tends to be located toward the back.
The Female Flanks
In the female, the area of the below the bra strap, the back below the shoulder-blades is commonly designated as the female flank. This area in the female is a common target for liposuction in women who are at least somewhat over weight. The same area on a male figure is rarely targeted for liposuction.
The Male Belt-line
The location of the “belt line” is one of the most characteristic features that distinguish the silhouettes of the male and female torsos. In men the belt line is below the rim of the hip bone, whereas in women the belt line is above the hips and the rim of the hip bone and just below the lower margin of the ribs.
Liposuction of the male flanks with the patient lying on his back does not allow sufficient access to the fat on the posterior flank, and the area is often insufficiently treated. This situation arises most often when general anesthesia is used. Under general anesthesia, with a breathing-tube inserted into the trachea or wind-pipe, it is safest to have the patient positioned lying on the back. Rolling a liposuction patient onto his side can be done but it is risky because changing position might dislodge the breathing-tube and impair oxygen delivery. When doing liposuction totally by local anesthesia the problem of changing the patient’s position does not exist. One merely asks the patient to roll over on his side.
Post-liposuction Open Drainage
This is a technique of not closing liposuction incision sites with sutures. With open-drainage, the incisions are left open which allows maximum drainage of blood-tinged solution of local anesthetic fluid, which in turn reduces post-operative swelling, and bruising. After liposuction of the male flanks, patients wear absorptive pads to accommodate the open drainage. With open drainage there is no need to wear an elastic compression garment for a prolonged time.
Post-liposuction compression of the male flanks is usually accomplished with the use of elastic binders. Elastic torso binders may be either 15 cm (6 inch) or a 22.5 cm (9 inch) wide. Using paper tape absorptive pads are held in place over the multiple small incision or adits and then the elastic binders are applied. Usually the use of two binders, one on top of the other, provides optimal compression and comfort.
The fibrous tissue content in the fat of males is greater and is more difficult to remove by liposuction compared to fat of females. Liposuction of fibrous fat is much easier with the use of microcannulas (outside diameter less than 2.8 mm) than with larger cannula. In the past some surgeons have advocated the use of ultrasonic cannulas to do liposuction in fibrous fat, but ultrasonic liposuction has been largely abandoned because of its high rate of complications.