“Lower Body Lift in the Massive Weight Loss Patient: A New Classification and Algorithm for Gluteal Augmentation”

Background: An often neglected part of the lower body lift procedure is the gluteal region. The objective of this study is to classify the massive weight loss (MWL) patients undergoing a body lift procedure and provide a safe, standardized approach for gluteal augmentation. Methods: A retrospective review of all body lift procedures performed between January 2012 and January 2017 was conducted. Patients undergoing a lower body lift with or without gluteal augmentation were included for analysis. Patients were classified as follow: type I, minimal lower and upper back fat and deflated buttock; type II, substantial lower back fat, minimal upper back fat and deflated buttock; type III, substantial lower and upper back fat and deflated buttock; type IV, good buttock projection. Type I patients had gluteal implants, type II patients had autologous flap augmentation, type III patients had gluteal lipofilling and type IV patients did not have any gluteal augmentation. Results: 280 patients were included for analysis. 238 underwent concomitant gluteal augmentation (85%): 213 had autologous flaps (76%), 13 had gluteal implants (5%) and 12 had large volume lipofilling (4%). Forty-two patients underwent a body lift with no gluteal augmentation (15%). Gluteal augmentation did not increase the rate of complication. In both groups no skin necrosis, venous thrombosis or pulmonary embolism were reported. Patients who had a sleeve gastrectomy had significantly lower odd of complications when compared to gastric bypass (OR= 0.45, p=0.017). Conclusion: A standardized algorithmic approach for gluteal augmentation may optimize the result without increasing the complication rate. Financial Disclosure Statement: All the authors have nothing to disclose. No funding was received for the article. Corresponding author: Samer Jabbour, MD, 191 Rue Saint Charles, Paris, France. samermed@gmail.com ©2017American Society of Plastic Surgeons