CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(03): 289-295
DOI: 10.1055/s-0042-1748640
Cosmetic
Original Article

Gluteal Region Reshaping of Massive Weight Loss Patients—A Decision-Making Strategy

1   Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
,
1   Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
,
Ahmed Mohamed Bahaa El-Din
1   Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
,
1   Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
,
2   Clinic of Plastic and Reconstructive Surgery, Department of Neurosciences, Padova University, Padova, Italy
,
2   Clinic of Plastic and Reconstructive Surgery, Department of Neurosciences, Padova University, Padova, Italy
› Author Affiliations

Abstract

Background Massive weight loss (MWL) is a very common presentation that you may face as a plastic surgeon. Each patient has his own individual criteria, so, you should work according to a well-organized plan, especially when such cases have concerns about their gluteal area contour that were neglected before by many surgeons. A decision-making strategy was used to give a personalized treatment for targeting gluteal region reshaping of MWL patients.

Methods This study considered all patients with MWL subjected to buttock reshaping. There was no randomization in treatment; there was a case-by-case assessment. We analyzed the features of the buttocks, the type of surgery performed, the outcomes, and the complications.

Results Fifty two patients were included (41 females and 11 males), ages ranged between 21 and 66 years. Demographic data, preoperative body mass index (BMI), duration of surgery, type of surgery, and postoperative complications were collected. Statistically significant improvements were observed in gluteal ptosis and patient satisfaction grades.

Conclusion Aesthetic improvement of the buttocks involves either augmentation or contouring that may be obtained by liposculpture, surgical lifting, or combination. Patients with MWL have high expectations and are often treated with multiple procedures. Thus, an easy strategic approach personalized on each patient to treat multiple adjacent areas in one operation is necessary. Adipose tissue distribution, gluteal skin status, and BMI were the main factors that can forcefully affect our plan to guarantee reduction of unpleasant results and complications and improve patient satisfaction.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethics Committee (MFM-IRB), code number: MD/18.12.109.


Patient Consent

Written informed consent was obtained from all the patients.


Author Contributions

Conceptualization, data curation, formal analysis, methodology, visualization: M.A.M., A.M.Z., A.M.B.E.-D., A.H.E.-S., F.B., and V.V. Project administration: M.A.M., A.H.E.-S., F.B., V.V. Writing-original draft: M.A.M. and A.M.Z. Writing-review and editing: M.A.M., A.M.Z., A.M.B.E.-D., A.H.E.-S., and F.B., V.V.




Publication History

Article published online:
27 May 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Hurwitz D. Enhancing masculine features after massive weight loss. Aesthetic Plast Surg 2020; 44 (04) 1241-1251
  • 2 Swanson E. Near-circumferential lower body lift: a review of 40 outpatient procedures. Plast Reconstr Surg Glob Open 2019; 7 (12) e2548
  • 3 Yıldız Altun A, Demirel İ, Bolat E. et al. Evaluation of the effect of erector spinae plane block in patients undergoing belt lipectomy surgery. Aesthetic Plast Surg 2020; 44 (06) 2137-2142
  • 4 Oranges CM, Tremp M, di Summa PG. et al. Gluteal augmentation techniques: a comprehensive literature review. Aesthet Surg J 2017; 37 (05) 560-569
  • 5 Mendieta CG, Sood A. Classification system for gluteal evaluation: revisited. Clin Plast Surg 2018; 45 (02) 159-177
  • 6 El Melegy NG, Hegazy AM. The role of liposuclpture of the posterior trunk and thighs in combination with fat transfer to buttocks to improve the aesthetic results in different ethnic groups. Egypt J Plast Reconstr Surg 2020; 44: 31-46
  • 7 Kanapathy M, Pacifico M, Yassin AM, Bollen E, Mosahebi A. Safety of large-volume liposuction in aesthetic surgery: A systematic review and meta-analysis. Aesthet Surg J 2021; 41 (09) 1040-1053
  • 8 Losco L, Roxo AC, Roxo CW. et al. Lower body lift after bariatric surgery: 323 consecutive cases over 10-year experience. Aesthetic Plast Surg 2020; 44 (02) 421-432
  • 9 Rammos CK, Hunstad JP, Kortesis BG. The hybrid approach in modern gluteoplasty and a proposed decision-making algorithm. Eur J Plast Surg 2017; 40: 143-148
  • 10 Regnault P, Baroudi R, de Silveira Carvalho CG. Correction of lower limb lipodystrophy. Aesthetic Plast Surg 1979; 3 (01) 233-249
  • 11 González-Ulloa M. Gluteoplasty: a ten-year report. Aesthetic Plast Surg 1991; 15 (01) 85-91
  • 12 Levan P, Bassilios Habre S. Gluteal implants versus autologous flaps in patients with postbariatric surgery weight loss: a prospective comparative study of 3-dimensional gluteal projection after lower body lift. Aesthet Surg J 2017; 37 (09) 1012-1021
  • 13 Au K, Hazard III SW, Dyer AM, Boustred AM, Mackay DR, Miraliakbari R. Correlation of complications of body contouring surgery with increasing body mass index. Aesthet Surg J 2008; 28 (04) 425-429
  • 14 Small KH, Constantine R, Eaves III FF, Kenkel JM. Lessons learned after 15 years of circumferential bodylift surgery. Aesthet Surg J 2016; 36 (06) 681-692
  • 15 Marchica P, Bassetto F, Pavan C. et al. Retrospective analysis of the predictive factors associated with good surgical outcome in brachioplasty in massive weight loss patients. J Plast Surg Hand Surg 2020; 9: 1-9
  • 16 Pajula S, Jyränki J, Tukiainen E, Koljonen V. Complications after lower body contouring surgery due to massive weight loss unaffected by weight loss method. J Plast Reconstr Aesthet Surg 2019; 72 (04) 649-655
  • 17 Richter DF, Stoff A. Circumferential body contouring: the lower body lift. Clin Plast Surg 2014; 41 (04) 775-888
  • 18 Aly A, Mueller M. Circumferential truncal contouring: the belt lipectomy. Clin Plast Surg 2014; 41 (04) 765-774