INTRODUCTION: With continuously rising body mass indexes in our society and the growing access to bariatric surgery, body lift procedures are becoming more and more common. These contouring surgeries are invasive surgical interventions, and indications have to be well thought through. One of the main problems in lower body lift surgeries is the resulting “flat buttock syndrome.” We want to present a new simple staging concept for the surgical contouring of the lower body and describe our method of auto-augmenting the gluteal region in a circumferential body lift. The aim of this research project was also to establish portable 3-dimensional (3D) scanning as an objective research method to evaluate body contouring surgeries.
MATERIALS AND METHODS: So far, 45 patients underwent a circumferential lower body lift procedure since 2017. Twenty-five patients underwent the procedures without auto-augmentation of the gluteal region, and 20 patients were operated including an auto-augmentation of the buttock area. To augment the buttock area, a modified perforator flap technique was applied (modified SGAP rotation flap). Results of both groups were compared regarding operating time, complication rates, and buttock projection result. Surface scans were performed with a portable Artec Eva high-resolution 3D scanner. Patients were scanned pre-surgery, directly post-surgery, and additionally, 12 months post-surgery.
RESULTS: Portable 3D scanning in an operative setting is practical and straightforward to perform. No harm or risk is added to the surgical procedure or patient. In the 20 patients who underwent the body lift procedure with SGAP buttock augmentation, a significant improvement of buttock contouring was detected immediately after surgery. Esthetic results can be individualized to patient’s wishes/expectations: by flap design (shape, width, length, thickness), by pocket dissection (shape, width, depth), and by flap fixation (sutures, infragluteal fold reconstruction). The pronounced projection improvements measured directly after the surgery were only detected to a smaller extend after 12 months, nevertheless, still improved in regard to volume distribution and projection when compared to the nonaugmented group. Complication rates were not significantly higher in the augmentation group when compared to the conventional body lift group.
CONCLUSIONS: The auto-augmentation of the gluteal region in a body lift procedure via “SGA perforator rotation flap” is safe, reliable, and an effective technique to overcome the undesired flat buttock problem accompanied with conventional lower body lift procedures. Three-dimensional scanning is an objective method to compare and evaluate techniques in body contouring surgery. More patients and longer follow-up intervals will show whether the improved buttock projection results achieved with SGAP auto-augmentation surgeries prevail over time.