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  • The aesthetic-functional planning of the lower limbs is frequently conducted empirically, using idiosyncratic markings and limited standardization among specialists who work in this field. The absence of a common topographic language restricts clinical communication, technical reproducibility, documentation of results, and the integration between the aesthetic approach and the vascular/lymphatic assessment of the segment. This is a descriptive study of methodological development. Based on a review of the anatomic and surgical literature and prospective clinical application during body-contour consultations, six topographic zones of the lower limbs were defined: gluteal, trochanteric (saddlebag), thigh (anterior, medial, and posterior subunits), knee, crural (calf), and talocrural (ankle), each delimited by reproducible surface bony and muscular landmarks. Onto this map, the cartography of the zones of adherence, superficial and deep adipose planes separated by the superficial fascia, saphenous venous axes, and main lymphatic collector pathways was overlaid. A four-stage marking protocol was defined (orthostatism, marking of bony landmarks, zone delimitation, and coding of plane and intensity), with standardized photographic documentation. For each zone, the following are presented: anatomic boundaries, muscular and adipose content, vascular and lymphatic correlates, zones of adherence to be preserved, recommended working plane (deep, intermediate, or superficial), specific risks, and expected aesthetic outcomes. The map provides a common nomenclature among surgeons and enables technology to be prescribed by anatomic zone rather than by generic "region". This anatomofunctional zone-based marking provides a simple, low-cost, and reproducible instrument to structure the therapeutic planning of the lower limbs, aligning the aesthetic objective with the anatomic, vascular, and lymphatic constraints of the segment. Interobserver reliability studies and comparative clinical outcome studies are the necessary next step toward validation.

  • Objectives This double-blind, randomized clinical trial sought to demonstrate the effectiveness of Pycnogenol® in the symptomatic control and body composition management of patients with lipedema. Methods This was a double-blind, randomized clinical trial with 60 days of follow-up involving one hundred patients. The study utilized a quality-of-life questionnaire (QuASiL), bioimpedance analysis, and clinical monitoring. Results Of the one hundred patients initially included, seven were lost to follow-up; however, monotonic multiple imputation was applied for data analysis. The two groups were similar in all aspects except for initial weight. The placebo group showed an increase in mean QuASiL scores after 30 and 60 days from the first assessment, representing a worsening of symptoms over time. In contrast, the intervention group demonstrated a progressive and significant reduction in scores, with means of 69.5 ± 28 at 30 days and 63.2 ± 27 at 60 days (p < 0.001). This group also showed a statistically significant reduction in weight, BMI, and body fat percentage. Conclusions Pycnogenol® appears to be a promising therapeutic option to support the clinical management of lipedema, a condition that exerts numerous negative physical and emotional impacts throughout the lives of affected patients.

Last update from database: 11/2/26, 8:21 AM (UTC)

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