Lower Body Lift Research Articles

The Three-Hour Lower Body Lift: Evolution of a Technique and Personal Experience after 155 Consecutive Cases.

Body-contouring is a surgical field in growing demand, as the number of massive weight loss patients following bariatric surgery is increasing. The purpose of this study was to provide a straightforward and time-efficient circumferential body lift technique to achieve optimal lower truncal contouring. A total of 155 massive weight loss patients (133 women and 22 men) underwent lower body lift surgery between 2006 and 2018. The mean preoperative weight reduction and body mass indices were 56.5 ± 16.6 kg and 26.7 ± 4.7 kg/m2, respectively. The preoperative markings focused on the back and gluteal region, and the modified surgical technique are described. Additionally, improvements of intra-operative repositioning of the patient and how to deal with sterilization and dressings are elucidated. The average intra-operative time was 178 ± 54.6 minutes. The mean follow-up of all patients was 8.2 ± 2.4 years. The most common complications were related to wound dehiscence (n = 38) and seroma (n = 18). The mean weight of the resected tissue was 3 056 ± 1 816.5 g. The lower body lift represents an effective and safe body contouring procedure to treat massive weight loss patients with multiple regions of concern. The current study describes a modified surgical technique that reduces operating time and complications, notably. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Body Contouring in Massive Weight Loss Patients Receiving Venous Thromboembolism Chemoprophylaxis: A Systematic Review.

Background:Venous thromboembolism (VTE) events are the leading cause of morbidity and mortality in plastic surgery. Currently, there is no consensus regarding the use of VTE chemoprophylaxis in the context of the risk for bleeding following specific body contouring procedures. Furthermore, there is increasing popularity of these procedures in the massive weight loss (MWL) patient population, who may be at higher risk due to multiple risk factors. The purpose of this study was to stratify the incidence of VTE and bleeding events among individual, specific body contouring procedures in MWL patients receiving chemoprophylaxis.Methods:A systematic review was designed according to PRISMA guidelines. We screened all articles published between 1988 and 2018 reporting chemoprophylaxis status, VTE, and bleeding events in MWL patients undergoing body contouring procedures.Results:Thirty-one publications were reviewed. The VTE incidence for any procedure was too low to reach significance. Overall, hematoma incidence in single-procedure patients (8.7%) was significantly higher than concomitant-procedure patients (4.2%, P < 0.01). However, when stratified into operative and nonoperative hematomas, no significant difference between single- and concomitant-procedure groups overall was demonstrated for either category. Individually, only thighplasty patients had a higher rate of operative hematomas when undergoing thighplasty alone (5.3%) compared with thighplasty with concomitant procedures (0.6%, P < 0.05).Conclusions:Overall, MWL patients undergoing single body contouring procedures (among abdominoplasty, belt lipectomy, thighplasty) were found to have a higher risk of hematoma compared with those undergoing combined contouring procedures. However, stratified hematoma data revealed no differences in overall risk between single- and multiple-procedure operations.

Body Contouring of the Trunk

Body contouring is a term that encompasses both surgical and non-surgical (minimally invasive) procedures for improving the form of the body. There are a variety of reasons patients may seek out truncal body contouring, including massive weight loss and changes associated with childbirth and aging. Knowledge of the available treatment options and technologies is paramount to the ability to counsel patients accurately about suitability for surgery, expected outcomes, and recognition of complications. This review covers pre-operative patient assessment, techniques, and complications of surgical and non-surgical treatments for body contouring of the trunk (excluding abdominoplasty, which is covered in a separate chapter). This review contains 4 figures, 2 tables, and 27 references. Keywords: body contouring, trunk, liposuction, lower body lift, upper body lift, skin tightening, skin laxity, cryolipolysis, panniculectomy, focused ultrasound, radiofrequency.

Expanding the Progressive Tension Suture Concept: A Study of Its Utility in Body Contouring Procedures.

Seroma is one of the most common complications following body contouring. Progressive tension sutures (PTSs) have been shown to decrease the seroma rate following abdominoplasty, component separation, and facelifts and following latissimus flap and deep inferior epigastric artery perforator flap harvest. The aim of this study was to investigate the effects of PTS techniques and their impact on the seroma rate in body contouring flap procedures. A retrospective review was performed of all patients undergoing a flap procedure (defined as any procedure that produces a dead space and subsequent susceptibility to seroma) by a single surgeon at a single institution over 3 years. All patients/procedures utilized PTS techniques, as is routine in the surgeon's practice. No drains were used. Patient demographics and complications, including seroma, were tracked. A total of 441 flap procedures were performed in 351 patients over the 3-year study period. These procedures comprised 305 abdominoplasties, 68 lower body lifts, 17 medial thigh lifts, 36 brachioplasties, and 15 torsoplasties. PTSs were used in all procedures. No drains were utilized. Complications occurred in 72 procedures (16.3%), with the most common complication being minor wound dehiscence without infection. There were no cases of seroma. PTSs represent an effective technique for reducing the seroma rate, eliminating the potential space and promoting tissue adherence in flap procedures for body contouring. This is the first study of its kind demonstrating the use and role of this technique in body contouring procedures beyond the scope of abdominoplasty.

The Effect of Obesity, Bariatric Surgery, and Operative Time on Abdominal Body Contouring Outcomes.

Abdominal body contouring procedures are associated with the highest rates of complications among all aesthetic procedures. Patient selection and optimization of surgical variables are crucial in reducing morbidity and complications. The purpose of this single-institution study was to assess complication rates, and to evaluate BMI, operative time, and history of bariatric surgery as individual risk factors in abdominal body contouring surgery. A retrospective chart review was performed of all patients who underwent abdominoplasty, circumferential lower body lift, fleur-de-lis panniculectomy (FDL), and circumferential FDL between August 2014 and February 2020. Endpoints were the incidence of venous thromboembolism, bleeding events, seroma, infection, wound complications, and reoperations. Univariate statistical analysis and multivariate logistic regressions were performed. Covariates in the multivariate logistic regression were BMI, procedure time, and history of bariatric surgery. A total of 632 patients were included in the study. Univariate analysis revealed that longer procedure time was associated with infection (P = 0.0008), seroma (P = 0.002), necrosis/dehiscence (P = 0.01), and reoperation (P = 0.002). These associations persisted following multivariate analyses. There was a trend toward history of bariatric surgery being associated with minor reoperation (P = 0.054). No significant increase in the incidence of major reoperation was found in association with overweight or obese patient habitus, history of bariatric surgery, or prolonged procedure time. BMI was not found to be an individual risk factor for morbidity in this patient population. In abdominal body contouring surgery, surgery lasting longer than 6 hours is associated with higher incidence of seroma and infectious complications, as well as higher rates of minor reoperation.

The Department of General Surgery, Faculty of Medicine, Cairo University

Background: Post-bariatric patients suffer from laxity ofskin and redundancy in different parts of the body, withresultant unaesthetic appearance. Concerning the lower body,different surgeons have introduced lower body lift and buttockaugmentation and have discussed different approaches andtechniques. In this study, we compare between buttock autoaugmentationwith fat injection and buttock auto-augmentationwith gluteal implant application as regards the maximumaesthetic outcome in post-bariatric patients.Patients and Methods: 26 post-bariatric patients withredundancy of the skin of the abdomen and buttocks. Allpatients had belt lipectomy/abdominoplasty and buttockaugmentation (auto-augmentation) in addition to fat injection(Group A, 15 cases), or application of intramuscular glutealimplants (Group B, 11 cases).Results: All patients had follow-up for one year with nomajor complications. The p-value was calculated for bothgroups and was found that there is a highly significant statisticaldifference in the post-operative measurements in Group A(fat injection).Conclusion: Dual autoaugmentation for post bariatricptotic buttocks give more appealing results for patients, eitherobjectively by measurements or subjectively by high satisfactionscores with a higher preference for fat injection.

Evaluation of the Effect of Erector Spinae Plane Block in Patients Undergoing Belt Lipectomy Surgery.

The interest in and demand for post-bariatric surgery have increased along with the increase in obesity surgery. Belt lipectomy, during which a circular correction is made in the center of the trunk, is the most commonly performed among these surgical techniques. Postoperative pain is an important problem due to the size of the surgical site and stretched closure. In this study, it was aimed to evaluate the intraoperative and postoperative narcotic analgesic consumption, postoperative analgesic requirement, postoperative visual analog scale (VAS) scores, postoperative nausea and vomiting (PONV), and the first mobilization time in patients with and without erector spinae plane block (ESPB). The files of patients who had undergone belt lipectomy between 2016 and 2019 in our hospital were retrospectively reviewed. Patients who received ESPB were called group 1, and those who did not undergo ESPB were called group 2. Their demographic characteristics, intraoperative and postoperative narcotic and non-narcotic analgesic consumption, VAS scores, PONV, and the first mobilization times were recorded. The files of a total of 51 patients, including 23 patients in group 1 and 28 patients in group 2, were reviewed. It was determined that intraoperative and postoperative narcotic analgesic consumption (p < 0.005), PONV (p < 0.005), and the first mobilization time (p < 0.005) were significantly lower in group 1 compared with group 2. The use of the ESP block in belt lipectomy surgeries significantly reduces intraoperative and postoperative narcotic analgesic consumption and pain scores. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Body contouring : Full lower circumferential Torsoplasty

After a rapid and massive weight loss, there is a sudden change in BMI which leads to skin and soft tissue becoming redundant with a poor tone. These patents are always seeking an aesthetic outcome to improve their body image and self esteem. The first body contouring surgery is usually the lower body lift including abdominoplasty. Modifications of those surgeries occurred during the 20th century with a variety of incision designs and techniques to reach the best the esthetic outcome. Because belt lipectomy procedures are still not widely accepted, still considered time consuming and difficult to perform and well known for their high complication rate we present the full lower circumferential torsoplasty as a good alternative for those procedures.

Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures.

Background:Lower body lift surgery has increased in popularity. A circumferential body lift or belt lipectomy is often recommended to treat skin redundancy. A drawback for this procedure is the midline scar bridging the lower back causing elongation of the gluteal cleft. Autoaugmentation methods have not been shown to provide a net increase in buttock volume.Methods:A retrospective study was undertaken among 40 consecutive women and men undergoing near-circumferential outer thigh and buttock lifts, including 21 lower body lifts (with abdominoplasty). All procedures were performed by the author as outpatients, under total intravenous anesthesia, without muscle relaxation and without prone positioning. Most patients (80%) had liposuction. Fourteen patients had simultaneous inner thigh lifts. Buttock fat transfer was used in 13 patients. Most patients had simultaneous cosmetic procedures of the face or breasts.Results:Fourteen patients (35%) experienced complications. One patient developed a deep venous thrombosis, detected by routine ultrasound screening on the day after surgery. Local complications included 3 patients with seromas (8%), 2 wound dehiscences (5%), and 1 infection (3%). Three patients (8%) returned for secondary outer thigh lifts. There were no complications related to fat injections.Conclusions:The near-circumferential lower body lift may be performed in healthy outpatients with attention to safe anesthesia, normothermia, limited blood loss, and operating times <6 hours. A scar across the posterior midline may be avoided. Fat injection safely restores gluteal volume. Secondary surgery may be recommended to treat persistent skin laxity.

The Benefits and Limitations of Predicting One Repetition Maximum Using the Load-Velocity Relationship

ABSTRACT This review aims to provide an overview of the current load-velocity (L-V) approaches and their ability to estimate one-repetition maximum (1RM). The bench press exercise appears to be the most valid and reliable when applying this approach. The ability for L-V relationship to predict 1RM for lower-body lifts remains questionable. Individualized regression equations should be used alongside mean velocity when utilizing this method during the bench press. The 2-point method (2 distinguishable loads, as opposed to multiple loads) and normative velocity data (minimal velocity thresholds at 1RM) may provide a novel and practical way to assess athletes' 1RM.

Lower Body Lift After Bariatric Surgery: 323 Consecutive Cases Over 10-Year Experience.

Lower body lift is a widespread procedure for massive weight loss patients aimed to improve the contour of the lower trunk, gluteal region and proximal lower extremity. The data about complications are confusing, and there is a lack of uniform studies for massive weight loss patients. A simple formula to carry out a reliable procedure in a short time with a low complication rate should be advocated. This retrospective study analyzed data of 323 patients undergoing lower body lift after bariatric surgery over a 10-year period. Selection criteria, careful preoperative marking, reliable intra- and postoperative care and a few surgical tips are discussed. All the complications (both major and minor) and the aesthetic satisfaction were evaluated. Risk factors assessed were patient age, tobacco consumption, current BMI, operative time and combined surgery. The overall complication rate was 42%. We recorded a lower rate of major complications and skin dehiscence; no infection and no skin necrosis were observed. The most frequent complication was seroma (35%). A complication development was straight related to age (p = 0.0177) and tobacco use (p = 0.0336). Patients' satisfaction about overall aesthetic was high. We present our case load and describe an easy recipe to perform a safe surgery without undermining and liposuction in short operative times. The reasonable overall complication rate and the surprisingly lower rate of dehiscence and skin necrosis combined with a pleasant aesthetic result make the lower body lift an easy and safe procedure, when applied to the appropriate patient population. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Impact of Lipo-Body Lift Compared to Classical Lower Body Lift on Postoperative Outcome and Patient's Satisfaction: A Retrospective Study.

Lately, the growing number of bariatric procedures performed each year led to an increasing demand for lower trunk reconstruction. Our team previously described the lipo-body lift (LBL) technique into lower duration of drainage and therefore seromas and other complications. In this study, we compared the classical body lift (CBL) technique to the LBL procedure. All patients who underwent a LBL or CBL after massive weight loss between November 2012 and October 2017 were included. Surgery outcome parameters were collected as well as patient satisfaction through a satisfaction score realized at least after 1year postoperative. Comparisons between CBL and LBL were conducted to assess the surgery's safety and the patient's satisfaction. A total of 130 patients were included, 61 patients who had a LBL were compared to 69 patients who had a CBL. The mean patient age was 39.64 ± 9.97 (21-66) years old, the mean body mass index before plastic surgery was 26.83 ± 3.08kg/m2 (19.83-32.69), and the average weight loss was 53.40 ± 17.37kg. The two groups had comparable preoperative data. Duration of drainage and hospital stay was significantly lower in the LBL group than in the CBL (p < 0.0001 and p < 0.0001, respectively). Surgical outcomes were comparable between groups as well as patient satisfaction scores. Lipo-body lift allows early discharge of the patient by reducing the duration of drainage without increasing the risk for complications. In our opinion, this technique should be used for type 1 and 2 patients with no contraindication for abdominal liposuction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Early Experience With Body Contouring Procedures in Patients With End-Stage Renal Disease Awaiting Renal Transplant.

Patients with (end-stage renal disease) ESRD often have many medical comorbidities, posing a higher risk for any surgical procedure. Obese patients are asked to lose weight to become more acceptable renal transplant candidates. Unfortunately, this often results in a panniculus and excess ptotic skin with accompanying functional and aesthetic concerns. We report our early experience in body contouring procedures in patients with ESRD who underwent massive weight loss. Three patients with ESRD on the renal transplant waitlist at UC Davis Medical Center opted for elective body contouring procedures before their transplant surgery. All 3 patients were determined by the transplant team to have a high-risk panniculus and were referred to plastic surgery for panniculectomy before renal transplant. Two of the patients had concurrent lower body lift with panniculectomy, and the third patient underwent modified upper body lift with gynecomastia surgery 7 months after the initial panniculectomy. The mean age of the group was 49 (range = 40-62) years, including 1 male and 2 female patients. The average body mass index of the group was 25.6 (range = 22.8-31.8), and all 3 patients had massive weight loss, with a mean BMI drop of 28.1 (range = 24.2-34.9). Postoperatively, only 1 patient experienced minor wound healing delay, which resolved 3 months after surgery with debridement in clinic and local wound care. In our early experience, we have seen that body contouring surgery in patients with ESRD awaiting renal transplant has an acceptable and manageable risk profile. By making minor modifications to preoperative, intraoperative, and postoperative routines, body contouring procedures can be safely performed in this patient population and can significantly decrease the functional and aesthetic problems caused by excess skin, resulting in improved body image and quality of life.

Lymphostasis and Hemostasis in Body-Contouring Surgery Using a Polysaccharide Based Hemostat (4DryField PH).

Background:Following liposuction, abdominoplasty is the most frequent body-contouring intervention in the world. The transection of small blood vessels in large areas and subsequent bleeding is a viable risk during this procedure. The resulting microvascular bleedings should be stopped thoroughly to reduce the probability of related complications. In this prospective, monocentric, randomized study, the efficacy of the polysaccharide-based hemostat 4DryField PH (4DF) (PlanTec Medical, Lueneburg, Germany) is examined in classic abdominoplasty and lower body lift after Lockwood.Methods:For this prospective, monocentric, randomized study, 40 patients underwent surgery for both interventions. Twenty patients received an abdominoplasty, and 20 patients underwent a body lift. In each group, 10 patients have been treated with 4DF, whereas 10 have been served as the untreated control group.Results:4DF had neither a beneficial nor a negative effect on necessity of drainages, drainage volume and duration, length of hospital stay or frequency of postoperative seromas, wound healing disturbances, and infections, independent of surgical intervention. Patients in the 4DF group, however, had more individual risk factors, and required extended surgical interventions that might mask primary outcome results.Conclusions:This is the first prospective, monocentric, randomized study on 4DF in body-contouring surgery. The use of 4DF did not lead to a better postoperative outcome regarding hemostasis and lymphostasis. Potential benefits need further evaluation in high-volume studies.

Analysis and Interpretation of Google Trends Data on Public Interest in Cosmetic Body Procedures.

Several online resources such as Google Trends (GT) enable plastic surgeons to track search volume trends for cosmetic procedures. Understanding these data may allow surgeons to better anticipate patients' interests and meet their needs. The authors sought to evaluate the correlation between GT search volumes and annual surgery volumes. Search terms were generated using the "related queries" feature of GT. Data were obtained for the terms breast augmentation, buttock augmentation, buttock implants, buttock lift, calf augmentation, liposuction, lower body lift, thighplasty, abdominoplasty, and brachioplasty from January 2004 to November 2017. Annual volumes for respective procedures were obtained from statistics reports of the American Society of Plastic Surgeons (ASPS) from 2006 to 2017 and American Society of Aesthetic Plastic Surgery (ASAPS) from 2004 to 2017. Correlations were evaluated applying univariate linear regression of GT data to both ASPS and ASAPS data. Geographical and temporal variations in search volume were detected during the study. Search volume trends that correlated significantly with both ASPS and ASAPS surgery volume trends were: "butt implants surgery" (ASPS: R2 = 0.366, P = 0.049; ASAPS: R2 = 0.380, P = 0.019); "liposuction" (ASPS: R2 = 0.690, P = 0.002; ASAPS: R2 = 0.578, P = 0.002); and "liposuction surgery" (ASPS: R2 = 0.672, P = 0.002; ASAPS: R2 = 0.476, P = 0.006). Several search terms demonstrated no significant relationships, negative correlations, or were significant with only one database. This study characterizes GT as a convenient and informative data set for plastic surgeons to analyze patient interest in cosmetic body-sculpting procedures. GT represents a useful instrument for tailoring marketing strategies and addressing the needs of our patient population.

The Lipo-Body Lift: Operative Technique.

Summary:Bariatric surgery induces massive weight loss, which results in global and complex skin deformities. Lower body lift procedure has become the gold standard for lower trunk reconstruction. The authors describe in this video the lipo-body lift technique in detail. The video is divided into 4 parts: part 1, indications and preoperative markings; part 2, posterior contouring; part 3, anterior contouring; and part 4, preoperative and postoperative results. Patient selection and technical key points of the technique are discussed. The lipo-body lift method is an important component of reconstructive strategies and should be widely offered to patients who experienced massive weight loss.

Post Massive Weight Loss Lower Bodylift a Comparative Study between Belt Lipectomy and Lockwood Technique

Post Massive Weight Loss Lower Bodylift a Comparative Study between Belt Lipectomy and Lockwood Technique

Refined running suture lower body lift in massive weight loss patients

The circumferential lower body lift is a recognized procedure for body contouring of massive weight loss (MWL) patients. We present a modified suture technique and setup, which significantly reduce the operative time and increase the efficiency of the procedure. We included 59 MWL patients undergoing lower body lift with fleur-de-lis. We registered demographics, weight loss method, co-morbidity, perioperative measurements and postoperative complications. The number of surgeons, suture technique and time for surgery were registered. The mean operative time for one surgeon using interrupted sutures was 195±28 minutes compared to 131±36 minutes for one surgeon using running sutures (P=0.0001). The mean operative time for two surgeons using running sutures was 88±13 minutes (P=0.0001). The use of running sutures as well as the number of surgeons significantly reduced the time for surgery. The lower body lift including a fleur-de-lis abdominoplasty can be performed in 1.5 hours with an optimal setup and surgical technique.

Seasonal Impact on Surgical-Site Infections in Body Contouring Surgery: A Retrospective Cohort Study of 602 Patients over a Period of 6 Years.

Postoperative surgical-site infections are severe complications following body contouring surgery. Here, the authors evaluate whether surgical-site infection rates are influenced by higher temperatures during the summer season. We enrolled 602 patients who underwent body contouring surgery between 2009 and 2015 in a retrospective cohort study. Data collected included demographics, surgical data, and postoperative outcome. Body contouring surgery procedures included lower and upper body lift, abdominoplasty, breast reduction, mastopexy, brachioplasty, and thigh lift. Infection rates were calculated on a seasonal basis and compared using Fisher's exact test and logistic regression analysis. There were 136 patients (125 women and 11 men) in the warm season [June to August; with an average temperature of 67.622°F (19.79°C)] and 466 patients (438 women and 28 men) in the cold seasons group [September to May, with an average temperature of 45.45 °F (7.47°C)]. The composition of the study cohorts was comparable. The average age was 40 years and the average body mass index was 27 kg/m. From a total of 602 patients, the authors observed 33 surgical-site infections, representing a rate of 5.48 percent. A statistically significant increase of postoperative surgical-site infections could be detected during summer (10.29 percent versus 4.08 percent; p = 0.0071), representing an increase of 150 percent. In addition, a logistic regression analysis determined "season" as the strongest predictor for surgical-site infections, with a risk increase of 2.693 times in the warm season. Body contouring operations are elective procedures, making careful risk consideration an absolute prerequisite. The authors demonstrate a significantly increased infection risk during summer and establish a causal link between the warm season and surgical-site infection accumulation. Consequently, preoperative patient information and operative planning should be adjusted accordingly. Risk, II.

Video showing the refined running suture lower body lift in massive weight loss patients

Video showing the refined running suture lower body lift in massive weight loss patients