We would like to suggest some recommendations for the popular 360 degree circumferential liposuction of the thighs, which we welcome our patients and colleagues to discuss together. Based on our experience, we prefer to perform “two-dimensional liposuction” on the thighs, including the outer thighs “saddlebag deformity” and the inner thighs and excess fat in the knees. Although fat on the anterior and posterior thighs is occasionally treated, these two areas have poor skin contraction and are prone to unevenness after surgery, and the fullness and roundness of the anterior thighs can be damaged, so careful consideration should be given. The lateral thigh fat accumulation is divided into 4 types: 1, true saddle capsule deformity, due to fat accumulation in the thigh rotor area, such patients are the most common, treatment from the side liposuction, the edge of the fat bulging parts as the liposuction boundary. 2. Superficial fat accumulation in the back of the thighs and hypertrophy of the buttocks. Treatment should deal with both saddle capsule deformity and posterior lateral fat of the buttocks. 3.Deep fat accumulation in the posterior thighs and saddle capsule deformity also need to be treated. 4, Well-defined saddle capsule deformity in the deep sunken gluteal sulcus. Superficial liposuction of the lower part of the buttocks is performed on patients with types 2 and 3, and we often find that sagging of the buttocks and skin necrosis are prone to occur when performing superficial aspiration in the lower part of the buttocks, so we mainly address the fat layer on both sides of the buttock sulcus when aspiration is performed, and only transitional aspiration is performed at the buttock sulcus, so that skin necrosis and sagging of the buttocks can be avoided so that the buttocks can also be lifted. At the same time, the fat accumulation on the lateral thighs is mainly addressed. Local anatomy and precautions for thigh aspiration The fat at the thigh is divided into two layers by the fascia, the muscle tissue of the buttocks and thigh is surrounded by the deep fascia, the deep fascia converges and thickens to form the outer iliotibial bundle of the thigh, the deep fat layer is located on the surface of the deep fascia, the deep fat tissue is connected to the fibrous tissue of the deep fascia and superficial fascia divided into several well-defined chambers. The superficial adipose tissue is mainly located under the skin, and liposuction of thighs is mainly carried out in the superficial and deep layers. In the superficial fat liposuction, attention should be paid to retaining 1cm thickness of fat tissue under the skin to avoid damaging the subdermal vascular network and the irregular appearance of the postoperative form, but at the same time, the liposuction should not be too deep, because too deep will damage the deep fascia layer and lead to muscle expansion and muscle adhesion, which will lead to pulling and depression deformity and pain when walking. Particular attention should be paid to protecting the deep fibrous compartment in the buttock sulcus, because the important sensory nerves and large blood vessels behind the femur are located under the deep fat layer, and some of the sensory nerves pass through the fat layer, which may be damaged during surgery and cause temporary sensory loss. Liposuction techniques All liposuction should be performed along the long axis of the lower extremity to prevent bending of the liposuction tube and to reduce damage to the lymphatic vessels of the lower extremity. Generally, a 3mm diameter blunt-tipped liposuction tube is chosen. The tube is inserted deep into the fat and moved along the long axis of the limb to open the fibrous septum, and when the amount of fat aspirated is sufficient and the patient’s discomfort or bleeding increases, the tube is replaced with a 2mm diameter tube and liposuction begins in the superficial fat layer. The small diameter porous liposuction tube can efficiently suction out the fat and preserve the subcutaneous fibrous compartment. Particular care should be taken when dealing with banana crepe of the buttocks, and the amount of liposuction should be reserved. The liposuction level should be limited to the superficial fat layer with a 2mm liposuction tube, and one should be vigilant not to damage the fibrous septum of the gluteal sulcus. The liposuction volume in this area should not exceed should not exceed 50ml, and this area is a transitional area, mainly concentrating on both sides of the gluteal fat suction to avoid causing skin necrosis and gluteal drop. For the inner thigh subcutaneous fat lacking fiber septum, liposuction in this area should use liposuction tube with diameter less than 2mm to avoid excessive fat suction, when suctioning the inner thigh fat, the liposuction range often extends to the outer thigh, at this time, we should choose the thinnest diameter liposuction tube, keep the position of liposuction tube in the deepest liposuction plane as far as possible, and do long distance vertical movement, which can reduce the postoperative unevenness of this area. This will reduce the incidence of unevenness in the area after surgery.