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Cosmetic Body Lift

de Runz, Antoine M.D.; Carloni, Raphael M.D.; Bekara, Farid M.D.; Boccara, David M.D.; Chaput, Benoit M.D.; Bertheuil, Nicolas M.D.

Author Information
Plastic and Reconstructive Surgery: November 2016 - Volume 138 - Issue 5 - p 945e-946e
doi: 10.1097/PRS.0000000000002725
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Sir:

We read with great interest the article by Hamra and Small entitled “Cosmetic Body Lift.”1 We would like to congratulate the authors for their refinements with a view to achieving optimal truncal contouring and their technique of 270-degree extended lipoabdominoplasty with adjunctive circumferential thigh intervention. This study confirms the low rate of postoperative complications associated with the use of abdominoplasty combined with liposuction (hematoma, 0 percent; seroma, 2.8 percent). Indeed, we have recently shown that liposuction in addition to preserving connective tissues, which contain nerves and lymphatic and blood vessels, preserves a significant part of the microvascular network. The low rate of complications could possibly be explained as a consequence of better preservation of the physiology of the remaining tissue (i.e., fluid, gas, nutrient, and waste exchanges).2 We would like to report our opinion, which is based on massive weight loss patients, and discuss some points that have not been addressed by the authors in the Discussion section.

First, based on our experience,3–5 we do not agree that the lower body lift is a more aggressive technique than a cosmetic body lift as stated by the authors. We have recently reviewed 42 articles and 1748 patients who underwent circumferential contouring of the lower trunk, and we note that the rate of complications has decreased among published reports, with a mean of 36.55 percent (range, 26.63 to 45.65 percent). This rate is comparable to that for abdominoplasty. We are convinced that the determining factor in reducing the rate of complications is the lipoabdominoplasty technique, rather than the length of the scar. Moreover, the authors do not report more complications than previously reported by Saldanha.

Second, the authors mention that patients have senile lateral ptosis or may even have previous flank liposuction with residual flank ptosis. We believe that it is often associated with a gluteal ptosis. For us, the lower body lift, unlike extended lipoabdominoplasty, allows one to correct not only thigh ptosis but also gluteal ptosis. Furthermore, we believe that the end of the scar of the 270-degree abdominoplasty, above the middle of the buttock, disrupts the gluteal aesthetic unit, contrary to a continuous scar. In our opinion, if the discontinuous scar is not perfectly symmetrical, so that there is a difference in level between the two ends of the scar, the result may be less aesthetically satisfactory than a circumferential scar, which has no ends.

Finally we offer our congratulations to Hamra and Small for their alternative reliable technique of cosmetic body lift for non–massive weight loss patients to address trunk and lateral thigh soft-tissue laxity and ptosis. We are of the view that a patient who is willing to accept the scar of a 270-degree abdominoplasty will accept the scar of a circumferential lower body lift. We consider this technique for the few patients who are unwilling to accept the circumferential scar, and for patients having minimal flank lipodystrophy, which could not be corrected by abdominoplasty without residual dog-ears.

DISCLOSURE

The authors have no financial interest to declare in relation to the content of this communication.

Antoine de Runz, M.D.
Department of Maxillofacial, Plastic, Reconstructive, and
Cosmetic Surgery
Nancy University Hospital
Nancy, France

Raphael Carloni, M.D.
Department of Plastic and Reconstructive Surgery
Hopital Sud
CHU Rennes
Rennes, France

Farid Bekara, M.D.
Department of Plastic and Reconstructive Surgery
Lapeyronie Hospital
CHU Montpellier
Montpellier, France

David Boccara, M.D.
Plastic, Reconstructive, and
Cosmetic and Burn Surgery Unit
Hôpital Saint Louis
Paris, France

Benoit Chaput, M.D.
Department of Plastic and Reconstructive Surgery
CHU Toulouse
Toulouse, France

Nicolas Bertheuil, M.D.
Department of Plastic and Reconstructive Surgery
Hopital Sud
CHU Rennes
Rennes, France

REFERENCES

1. Hamra ST, Small KH. Cosmetic body lift. Plast Reconstr Surg. 2016;137:453461.
2. Bertheuil N, Chaput B, Berger-Müller S, et al. Liposuction preserves the morphological integrity of the microvascular network: Flow cytometry and confocal microscopy evidence in a controlled study. Aesthet Surg J. 2016;36:609618.
3. de Runz A, Brix M, Gisquet H, et al. Satisfaction and complications after lower body lift with autologous gluteal augmentation by island fat flap: 55 case series over 3 years. J Plast Reconstr Aesthet Surg. 2015;68:410418.
4. Carloni R, Chaput B, Auquit-Auckbur I, Watier E, Bertheuil N. Dynamics of gluteal cleft morphology in lower body lift: Predictors of unfavorable outcomes. Plast Reconstr Surg. 2016;137:1053e1055e.
5. Bertheuil N, Carloni R, Herlin C, Chaput B, Watier E. Lower body lift after massive weight loss: Autoaugmentation versus no augmentation. Plast Reconstr Surg. 2016;137:476e477e.

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