Lower Body Lift After Massive Weight Loss: Autoaugmentation Vs. No Augmentation

Purpose:  Lower body lift procedures have increased in popularity to treat massive weight loss patients with redundant tissues of the buttocks^1-3.  Assessments of maintenance of contour, projection, and satisfaction of autoaugmentation have not been assessed. Our aim is to elucidate any differences among patients who underwent autoaugmentation vs. no augmentation during lower body lift surgery with regard to complication rate and patient satisfaction.

Methods: A retrospective review from 2003-2011 was performed to record age, BMI indices, length of hospital stay, and complication rate. Additionally, a 20-question phone survey was performed to assess patient satisfaction on a scale of 1-5 (1=unsatisfied and 5=very satisfied).

Results: Of a total 97 patients, 42 underwent autoaugmentation and 55 did not. Mean Age in the augmented group was 46.1±9.9 years vs. 47.3±9.3 years in the nonaugmented group (p = 0.55); mean MaxBMI was 52.1±7.2 kg/m² vs. 50.6±10.1 kg/m² (p = 0.42); mean Current BMI was 29.1±2.7 kg/m² vs. 27.7±4.3 kg/m² (p = 0.10); mean DeltaBMI was 23.1 kg/m² vs±6.0 vs. 22.7±7.7 kg/m²(p = 0.81). 18 (42.3%) augmented patients had complications post-operatively compared to 11 (20%) nonaugmented patients (p = 0.018). Within the augmented and non-augmented groups, there were no significant differences between the subgroups who experienced complications and those who did not with regard to length of stay (p = 0.60), number of concurrent procedures (p = 0.40), Max BMI (p = 0.30), Current BMI (p = 0.35), Delta BMI (p = 0.08), or Age (p = 0.26). Augmented patients rated their pre-operative appearance as 1.38±0.7 vs. 2.3±1.7 for the nonaugmented patients (p = 0.23) while post-operative appearance was rated as 3.8±1.0 vs. 3.4±1.8 (p = 0.68). 30% of nonaugmented patients desired more projection, while no augmented patients felt this way (p = 0.31). All patients, augmented or not, would undergo the same procedure again and recommend it to a friend.

Conclusion: Patient satisfaction following lower body lift is high amongst augmented and nonaugmented patients. While the complication rate is significantly higher in augmented patients, this does not seem to affect patient satisfaction, likely because the complications were universally minor in nature. Thus, we recommend proceeding with autoaugmentation as indicated, as patient satisfaction is similar between the two groups, as well as continue to investigate ways to decrease complications.