The Lipo–Body Lift: A New Circumferential Body-Contouring Technique Useful after Bariatric Surgery

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We read with great interest the article entitled “The Lipo–Body Lift: A New Circumferential Body-Contouring Technique Useful after Bariatric Surgery” by Bertheuil et al.1 We would like to congratulate the authors for their work and their novel technique, which is less invasive than the traditional lower body-lift method that confirms our thoughts on buttock autoaugmentation. In our daily practice, we are not totally satisfied with the buttock augmentation by flaps or fat grafting. The authors demonstrate for the first time a technique increasing buttock projection by moving the buttock tissues centrally without invasive gestures and major complications. We would like to share our experience in the last 24 lower body lifts over the past year and discuss the problems of buttock projection.
First, we noticed in our practice that a small buttock projection occurs frequently in type I patients (body mass index <25 kg/m2) according to the authors’ classification after intervention. This point is important, and the surgeon must take into account the desire of these patients to regain a gluteal contour. In our opinion, this desire occurs frequently in young patients. To answer this question, we have attempted different techniques well described in the literature.
We first performed gluteal flaps on these patients initially reported by Pascal and Le Louarn.2 The aesthetic result is satisfactory without major complications. However, the patients have a subjective feeling of dysesthesia in front of the gluteal flap area. This sensation persists throughout the first year and provides significant discomfort to the patient. After the results of these patients, we realized that autologous fat grafting of the buttocks is useful to compensate for the lack of projection. The total volume injected was between 300 and 400 ml. The immediate postoperative aesthetic result was satisfactory. At 3 months, we found a disappointing aesthetic result, with a significant loss of gluteal volume despite deep injections in the gluteal muscle. It can be aggravated by the unavoidable sitting position compared with a well-established graft survival rate as high as 80 percent reported in the literature.3 Subsequently, we combined the two techniques: gluteal flap and fat grafting. The aesthetic result is more satisfactory than the flap alone for buttock projection; however, the operative time is considerably extended and the dysesthesia not resolved.
We do believe that the posterior step of the lipo–body lift4 is an attractive surgical technique that permits improvement of gluteal projection without any invasive gestures. The authors’ technique seems to be simple, quick, and safe. It would be interesting to report a long-term result for buttock projection maintenance and to compare it to results after buttock flap or fat grafting. In conclusion, we want to provide patients gluteal projection that satisfies their desire. This technique opens new doors for solving this problem.
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