Nicolas Bertheuil1,2,3, Damien Bergeat4,5, Yanis Berkane6, Raphael Carloni7, Silvia Gandolfi8, Jérôme Duisit9. 1. Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 16 Boulevard de Bulgarie, 35200, Rennes, France. nbertheuil@gmail.com. 2. INSERM U1236, University of Rennes 1, Rennes, France. nbertheuil@gmail.com. 3. SITI Laboratory, Rennes University Hospital, Rennes, France. nbertheuil@gmail.com. 4. Department of HPB and Digestive Surgery, Pontchaillou Hospital, CHU Rennes, Rennes, France. 5. Institut NuMeCan (Nutrition Metabolism and Cancers), INSERM 1241, F-35000, Rennes, France. 6. Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 16 Boulevard de Bulgarie, 35200, Rennes, France. 7. Department of Plastic, Reconstructive and Aesthetic Surgery, Hopital Privé de l'estuaire, Le Havre, France. 8. Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rouen, Rouen, France. 9. Department of Plastic, Reconstructive and Aesthetic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Abstract
BACKGROUND: We report our experience using the Lipo-Bodylift technique for circumferential lower trunk reconstruction following massive weight loss. METHODS: The procedure combines extensive circular liposuction with circular skin resection immediately under the dermis. We classify lower trunk deformities using three parameters: (1) excess skin (in the horizontal direction, or both horizontally and vertically); (2) the body mass index (BMI); and, (3) skin quality (hyperlaxity or a normal tone). All patients can be divided into four groups, of whom groups I and II are the best candidates for the Lipo-Bodylift procedure. We also describe our perioperative management and patient outcomes, with a focus on postoperative complications. RESULTS: Between January 2015 and January 2020, 100 patients underwent Lipo-Bodylift treatment. The median patient age was 41 years. The median preoperative BMI was 26.3 kg/m2. The median drainage duration and hospital stay were both 3 days. Of all patients, 30% experienced at least one complication, 2% of which were major. Of the minor complications, 27 patients evidenced wound dehiscence. Only (positive) smoking status was significantly associated with postoperative complications (p < 0.001). CONCLUSION: We developed the Lipo-Bodylift technique after analyzing changes in the skin and subcutaneous fat after massive weight loss. The technique completes the arsenal of body contouring techniques, appears to be less invasive than the undermining that is usually performed during circumferential reconstruction of the lower trunk, and is associated with a lower rate of major complications. LEVEL OF EVIDENCE IV: 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 Table of Contents or the online Instructions to Authors www.springer.com/00266.
BACKGROUND: We report our experience using the Lipo-Bodylift technique for circumferential lower trunk reconstruction following massive weight loss. METHODS: The procedure combines extensive circular liposuction with circular skin resection immediately under the dermis. We classify lower trunk deformities using three parameters: (1) excess skin (in the horizontal direction, or both horizontally and vertically); (2) the body mass index (BMI); and, (3) skin quality (hyperlaxity or a normal tone). All patients can be divided into four groups, of whom groups I and II are the best candidates for the Lipo-Bodylift procedure. We also describe our perioperative management and patient outcomes, with a focus on postoperative complications. RESULTS: Between January 2015 and January 2020, 100 patients underwent Lipo-Bodylift treatment. The median patient age was 41 years. The median preoperative BMI was 26.3 kg/m2. The median drainage duration and hospital stay were both 3 days. Of all patients, 30% experienced at least one complication, 2% of which were major. Of the minor complications, 27 patients evidenced wound dehiscence. Only (positive) smoking status was significantly associated with postoperative complications (p < 0.001). CONCLUSION: We developed the Lipo-Bodylift technique after analyzing changes in the skin and subcutaneous fat after massive weight loss. The technique completes the arsenal of body contouring techniques, appears to be less invasive than the undermining that is usually performed during circumferential reconstruction of the lower trunk, and is associated with a lower rate of major complications. LEVEL OF EVIDENCE IV: 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 Table of Contents or the online Instructions to Authors www.springer.com/00266.