Reply: The Lipo–Body Lift
However, we do not agree with the authors with regard to restricting the indication for the technique to type II patients. Liposuction helps to avoid major complications such as bleeding and hematoma and reduce minor complications such as lymphedema and seroma, which were absent in our experience. In our original study1 of 25 patients, liposuction volume and smoking status were significantly associated with the development of complications. As mentioned in the Limitation section, it is a small cohort, and the lack of multivariate analysis does not make it possible to know whether they are two independent variables. Between January of 2015 and January of 2017, 46 patients underwent the lipo–body lift performed by the same surgeon (N.B.). With this wider series, the operative time and complication rate decrease (Table 1), probably because of the learning curve. It is interesting to note that liposuction volume (p = 0.139) no longer appears to be a risk factor, unlike smoking status (p = 0.002) (Table 2). Even if the remark of Dr. Dast is good on the wound dehiscence rate, which can be promoted by liposuction (swelling and liquid flow through the wound), currently there is nothing to prove it. In our opinion, smoking status is the main risk factor for wound dehiscence after the lipo–body lift.
In conclusion, we reserve the lipo–body lift for type I and II massive weight loss patients of our classification. This is a safe and less invasive operative strategy than traditional undermining, reducing the complication rate (all of our patients were grade I on the classification of surgical complications5) without decreasing the satisfaction of these complex patients.