The “lower body” this is considered as from the umbilicus down to the ankles. It is recognized that there are several areas, particularly in the female that are genetically prone to becoming fat deposits, are resistant to dieting, or even after bariatric surgery may fail to reduce in proportion to the rest of the body.

Liposuction, translated from the Latin, this means “sucking out the fat,” which gives the unfortunate impression that anyone can do it. The procedure is better termed lipoplasty for a degree of remodelling is usually required; there is more to it than merely sucking out the fat, the skill comes in knowing which fat, and how much.

The upper, outer thighs are often the site of pads of excess fat in the subcutaneous tissue, known colloquially as “saddlebags.” They don’t disappear with either diet or exercise. The inner thighs also acquire bulky fat deposits, the thighs rub together and the skin may be chafed, quite apart from concern about the unsightly appearance. When fat needs to be removed from both medial and lateral aspects of thighs, it is inevitable that a degree of reshaping of the anterior aspect will also be required.

The region of the inner knee in some women is like the upper outer thigh, deposits of fat resist dieting and can be removed by liposuction.

The region of the ankles is on view even in full clothes and wearing pants. The skeleton is the same in both overweight and underweight persons, and so are the tendons, so any appearance of thickness of the ankle is due to excess fat. This can be delicately “sculpted” by lipoplasty, but extreme care based on substantial anatomic knowledge is required to avoid damage to the arteries and nerves in the region.