Lower Body Lift after Massive Weight Loss

Summary: A recently introduced novel fragmentation technique has made it possible to convert fat tissue from apronectomy into large-scale viable lipograft, providing a glimpse of an alternative to traditional liposuction and its harvesting limitations. The purpose of this study was to assess the initial clinical evidence on fragmented fat transfer to restore volume and enhance deflated gluteal contours in a sample of massive weight loss patients. The authors retrospectively reviewed medical records of 20 women who received autologous buttock fat grafts that were harvested and fragmented following belt lipectomies and/or fleur-de-lis abdominoplasties. The average total volume subcutaneously grafted into the buttocks was 720 ml (bilateral), ranging from 500 ml to 960 ml. No local gluteal complications, such as seroma, infection, fat necrosis, or subcutaneous nodulations, were reported. Photographic observation of postoperative results over a 6- to 14-month follow-up period showed clear enhancement of body contouring in all patients, especially in those in whom fat transfer was combined with circumferential lifts. Fat fragmentation has proved useful and effective in providing great amounts of viable fat graft in a safe, simple, and reproducible technique without noticeable complications. The method eliminates the organic response to the insult of liposuction while using the entirety of formerly discarded apronectomy tissue to provide fine, transferable, autologous fat without increasing operative time. Although preliminary, the authors’ clinical findings with this new technique support further studies of fragmented fat as an alternative to liposuction in gluteal fat grafting. Additional potential applications, including in wound healing and regenerative medicine, are worth exploring. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Section: Discussionmentioning

confidence: 99%

“…Especially in extremely deflated patients, whose buttocks really need both lifting and augmentation, liposuction alone is not likely to provide the required amount of lipograft. 16–20…”

Section: Discussionmentioning

confidence: 99%

Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring

Mendes

Viterbo

2022

“…The dorsal skin is gently pulled downward to draw the upper incision line and upward to draw the inferior line. If necessary, 10,11 a Pascal-LeLouarn flap is designed between the interspinal line and gluteal border line. The gluteal pocket is drawn up to 4 cm above the gluteal fold to preserve gluteal sensitivity.…”

Section: Methodsmentioning

confidence: 99%

Vrtical body lift: surgical technique and comparison with the inferior body lift technique

Musmarra

Aguilar

Struk

et al. 2023

Background: Patients with massive weight loss have excessive skin laxity along both vertical and transverse axes. Vertical body lift (VBL) is a body-contouring technique addressing both excesses, promoting not only body lifting but also a tightening effect. The aim of this study was to describe the authors' VBL surgical technique and its potential clinical applications. In addition, they present their experience among postbariatric surgery patients to compare surgical aspects and outcomes of VBL and the classic inferior body lift (IBL) technique. Methods: The authors reviewed data on 140 consecutive postbariatric surgery patients who underwent a body lift procedure between January of 2018 and March of 2020. The patients were divided into two groups: the VBL group and the IBL group. Patient demographics, operative details, and postoperative outcomes were compared between groups. Results: Of the 140 patients included in the study, 92 underwent IBL and 48 underwent VBL. There were no statistically significant differences between groups for surgical duration (IBL, 192 minutes; VBL, 193 minutes), hemoglobin decrease (IBL, 2.32 g/dL; VBL, 2.11 g/dL), hospital length of stay (IBL, 5.4 days; VBL, 5.7 days), or complication rate (IBL, 32%; VBL, 31%). Conclusions:The authors' study shows comparable operative details and postsurgical outcomes between the VBL and classic IBL techniques. In their experience, VBL is a reliable and reproducible technique that can improve aesthetic and functional outcomes in a subpopulation of approximately one-third of patients with massive weight loss.

“…The goal for the posterior resection is a snug closure; however, maximal tension on the closure is avoided in anticipation of the flexed abdominal position. If gluteal autoaugmentation is planned, the markings are adjusted more conservatively to account for the bulk of retained tissue to avoid increased tension and subsequent wound-healing problems 8,9 (Fig. 2).…”

Section: Methodsmentioning

confidence: 99%

Contemporary Lower Body Lift

Colwell

2022

Summary: Circumferential body contouring addresses abdominal, mons, lateral thigh, and buttock laxity. The goals of contouring are to optimize abdominal aesthetics while also addressing lateral thigh and buttock skin excess with an easily concealed scar. Key concepts in contemporary lower lift include a low anterior scar that gently slopes superior to help with waist accentuation and addressing lateral thigh contour. The posterior scar lies at the top of the gluteal crease to preserve the buttocks aesthetic unit, allow for autoaugmentation, and minimize wound-healing complications. Patient safety considerations include thromboembolism prevention, minimizing blood loss, and keeping the patient warm. With proper planning, the lower body lift effectively and aesthetically removes circumferential skin laxity.