Bariatric Times - December 2008 - (Page 20)

20 Body Contouring Perspective Bariatric Times • December 2008 Body Contouring: Lower Body Lift by Kristen M. Rezak, MD; Michel C. Samson, MD, FRCS (C), FACS; and Martin I. Newman, MD, FACS All from the Department of Plastic Surgery, Cleveland Clinic Florida Weston, Florida. INTRODUCTION Body contouring procedures performed for the massive weight loss patient (MWL) have been shown to be safe and effective in treating the significant skin excess that results from the rapid and substantial weight loss following bariatric surgery. There are a host of procedures available today to manage the resultant skin redundancy, and aesthetic outcomes can be remarkable. Although techniques may differ among plastic surgeons, there seems to be a general agreement that the MWL patient benefits from a modification of the approach utilized for the traditional, non-MWL cosmetic surgery patient. Substantial progress has been made in treating the complex, multidimensional skin excess that occurs throughout the body in the MWL patient. One difference appreciated by many of those familiar with this patient population is that the skin redundancy on a MWL patient extends circumferentially in a majority of the cases. The traditional abdominoplasty was not originally designed treat this circumferential deformity sufficiently.1 In recent years, procedures were developed to manage the anterior and posterior skin excess concomitantly and effectively. There are many ways to describe these specialized techniques; however belt lipectomy and lower body lift are two of the more commonly used terms to date.2 The concept of circumferential skin removal was first described in 1940 by Somalo and modified into the belt lipectomy by Gonzalez-Ulloa in the 1960s.3 These techniques have been modified for application to the MWL patient. In practice, the terms lower body lift and belt lipectomy are used interchangeably. The lower body lift aims to treat the pannus, lateral thigh laxity, and buttock ptosis in one combined procedure. Pubic mons ptosis may also be corrected in the vertical dimension with this procedure, but the transverse skin excess of the pubis is often observed as well. Such a side-to-side deformity of the pubis may benefit from an additional procedure termed monsplasty.4 In essence, the lower body lift will lift the mons and remove the pannus with the frontal part of the procedure, raise the buttocks with the posterior portion of the procedure, and help restore an hourglass shape to the hip and flank regions.5-7 PREOPERATIVE CONSULTATION AND PATIENT SELECTION At initial consultation with a plastic surgeon, many MWL patients often focus on their undesired pannus

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Bariatric Times - December 2008 Table of Contents Patient Management Perspective Diabetes Perspective Interview: ASMBS’s Georgeann Mallory Editorial Message Editorial Board Body Contouring Perspective Meeting Perspective Journal Watch Advertiser Index News & Trends

Bariatric Times - December 2008

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