Dr. Pane evaluates the case of a patient who is considering a lower body lift after substantial weight loss.
The Question
Cosmetic surgery is one of the fastest-growing and at the same time most stigmatized fields of medicine. An ongoing prejudice assumes that cosmetic surgery is unnatural, unnecessary and solely for vanity’s sake. However, there are real medical issues which can only be corrected through surgical means, and cosmetic surgery is no different. An example of this is the focus of Atlantic Coast Aesthetics’ Ask Dr. Pane segment this week. This patient asks, “Am I a good candidate for a lower body lift with rotational flaps into the buttocks?” She has lost a substantial amount of weight, resulting in significant loose skin around the abdomen, and would like to correct this as well as considering a tummy tuck at the same time.
The Case
Dr. Pane evaluated the photographs the patient included. They demonstrated a large amount of loose, hanging skin from rapid weight loss, and appear to show very little remaining subcutaneous fat.
The Answer
In this case, the patient would be an excellent candidate for a lower body lift and a tummy tuck. A lower body lift is essentially a posterior tummy tuck, in which incisions are placed on the buttocks and the buttock area is lifted up. It allows patients who have lost a significant amount of weight to use their own skin to tighten and raise the buttocks in patients where insufficient subcutaneous adipose tissue is present to make a Brazilian butt lift with fat transfer a practical alternative, and/or where the patient prefers to avoid artificial implants in the buttocks. This procedure is one of the more invasive cosmetic surgical procedures, and is only indicated for patients who have lost a great deal of weight and fatty tissue.
The lower body lift functions almost identically to abdominoplasty in terms of the basic procedure. Like a tummy tuck, the scarring from the lower body lift is targeted in such a way that it can be easily concealed under the bikini line. The primary difference when a rotational butt lift comes into play is that the buttocks are rotated 45 degrees and pulled upward, using the patient’s own skin to produce a more aesthetically pleasing posterior. Also, this procedure creates what is called a “gullwing” scar in the back, rather than a straight scar across the top of the pubis.
Dr. Pane prefers not to do this in conjunction with a tummy tuck. Generally, doing the tummy tuck first and then the posterior body lift is the preferred methodology. The reason for this is because both of these are highly invasive procedures and doing them concurrently greatly increases both the surgical time required and the odds of complications during and after the procedure. For safety reasons, it is vastly preferable for the patient to undergo the tummy tuck first and then use the lower body lift as a “cleanup” procedure after the tummy tuck has fuy resolved itself.
It is important to note that there is rarely one “right” answer that applies to any case, let alone EVERY case. Often, a clinical evaluation in the office coupled with the patient’s medical history and a clearer expression of what the patient’s stated goals and objectives are may suggest another procedure or complex of treatment options will garner results as good as, if not better than, the procedure initially under consideration. This is why we at ACA strongly recommend patients educate themselves about the possible options, but not get “married” to them. While a patient may appear to be an ideal candidate for this procedure or that treatment in photos and from a brief personal history statement, other factors may emerge later which change the situation and require other avenues and treatment options be pursued.
If you have a question about anything related to cosmetic or plastic surgery treatments, the staff of Atlantic Coast Aesthetics is always happy to address your interests, comments, questions and concerns. Simply call us at (561) 422-4116; email us at https://acplasticsurg.com; or follow us on Twitter, Facebook and Instagram. Your question might even end up being answered live in an upcoming Ask Dr. Pane segment by our very own founder and Chief Medical Officer, Dr. Thomas A. Pane. These segments help us address your questions while also educating others who may be afraid to ask but want or even need to know the answers. Remember, at ACA, we believe the only bad question is the one you don’t ask!