The "Hip Flap". a New Flap to Maintain and or Augment the Hip Area Following Lower Body Lift Procedures

Background:  The number of Lower Body Lift surgeries following massive weight loss has increased considerably over the last ten to fifteen years. Although techniques have improved, the problem of masculinization in females, with an unnatural cinched waist and maximum projection at the greater trochanteric point, persists in a high proportion of patients. Numerous techniques for autologous augmentation of the buttocks have been described(1 2 3), but none specifically for the hips.

Methods:  A first of its kind technique to correct the unnatural full trochanteric, absent hip and cinched waist appearance is described here. A random pattern dermal/fat flap based on the lateral tissue usually discarded in lower body lift procedures, is completely released from the surrounding tissue and secured to the desired position. This is usually performed in conjunction with an autologous buttock flap.

Results:  53 consecutive patients were operated on between July 2009 and September 2014. All had hip flaps performed. There were no seroms, hematomas or fat necroses noted. The dehiscence rate was not increased adding this technique to the lower body lift procedure. In one patient there was unintended superior migration of the flap on one side. This occurred when I was using an external bolster suture technique early on, which I then stopped using. Pre and post- operative photos show consistent improvement in hip contour compared to those patients who did not have this procedure.

Summery:  A random pattern dermal/fat flap has been designed for suitable patients, usually after massive weight loss, to maintain or even accentuate their hip width, resulting in an appropriate contour. The addition of this flap has markedly improved the aesthetic outcomes when used in these patients. The author feels that this flap will increase the armamentarium of procedures available to Plastic Surgeons specializing in this field.