9311-1112 Lockwood
Lockwood T.
Lower body lift with superficial fascial system suspension.
Plast Reconstr Surg. 1993 Nov;92(6):1112-22; discussion 1123-5. PMID: 8234509
Comment in:
Plast Reconstr Surg. 1999 Sep;104(4):1212.
Multiple body contour deformities of the trunk and thighs are commonly treated
in separate stages to limit postoperative complications and disability. Recent
advances in the surgical design of the medial thigh lift and the lateral
thigh/buttock lift along with an understanding of the functional anatomy of the
superficial fascial system have significantly improved results and decreased
complications of trunk/thigh lifts. The enhanced safety of current trunk/thigh
lifts has allowed new combinations to treat multiple body contour deformities in
a single stage. Laxity of the entire lower trunk and thigh regions can be
treated in one stage in selected patients. The lower body lift combines the
transverse flank/thigh/buttock lift and the fascial anchoring medial thigh lift
in one operation. In addition to the expected tightening of the flank, buttocks,
and total thighs, this procedure results in a surprising degree of epigastric
and hypogastric tightening of mild to moderate abdominal laxity without direct
surgical undermining or umbilical transposition. Ten patients having the lower
body lift alone or in combination with liposuction and other body contouring
procedures were followed for 6 to 24 months. The primary indication for surgery
is moderate to severe soft-tissue laxity of the lower trunk and thighs with
minimal or mild residual fat deposits. Skin contour irregularities due to skin
laxity (cellulite of laxity) or to postliposuction adhesions are frequently
present and may be severe. Patients with significant fat deposits may be treated
initially with liposuction 3 to 4 months earlier to become candidates for this
procedure. Key technical elements of this procedure include (1) both supine and
lateral decubitus positioning with the hip flexed and abducted to allow
overcorrection, (2) appropriate direct surgical undermining through superficial
fascial system zones of adherence in the superior thigh while avoiding the
lymphatics of the femoral triangle, (3) more distal undermining of the thighs
with an atraumatic undermining cannula, (4) resection of redundant lower trunk
and thigh tissues with incisional closure within high-cut bikini lines, and (5)
complete superficial fascial system and dermal suspension throughout the repair.
The lower body lift requires 5 to 6 hours of operating time, 2 units of
autologous blood, 2 nights of nursing care, and 3 weeks off work. Although no
major complications occurred, minor complications were significantly higher than
with the component procedures alone and occurred in 50 percent of patients.
Technical changes and improved patient selection have significantly improved the
rate of complications in subsequent patients. Results have been consistent, and
patient satisfaction has remained high.
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