title: Cosmetic Body Lift.
abstract: BACKGROUND
  High-tension lateral abdominoplasty provides ideal central contouring of the abdomen, but it inadequately addresses laxity and fullness in the flank and lateral thigh. The adjunct of liposuction improves abdomen contour, but excess flank soft tissue often persists. Small case series in the literature have suggested an extended abdominoplasty to address these deficits with variable outcomes. The senior author (S.T.H.) reports his successes in the largest series to date of a 270-degree extended lipoabdominoplasty (cosmetic body lift) for non-massive weight loss patients to optimally contour the abdomen, hips, and flanks while lifting the lateral thigh and reducing thigh circumference.
  
  
  METHODS
  A retrospective chart review was conducted on patients who had a cosmetic body lift between 2004 and 2014. On average, outcomes were reviewed 1 year postoperatively.
  
  
  RESULTS
  From 2004 to 2014, 72 consecutive patients (one male patient) with an average age of 53 years (range, 33 to 73 years) had a cosmetic body lift. All patients were nonsmokers and had insignificant preoperative comorbidities. Average total liposuction volume was 3067 cc. Complications included seroma in 2.8 percent (two of 72), infection in 4.2 percent (three of 72), delayed wound healing in 5.6 percent (four of 72), necrosis/ischemia in 4.2 percent (three of 72), revision in 18.1 percent (13 of 72), and deep vein thrombosis in 1.4 percent (one of 72), with zero hematomas.
  
  
  CONCLUSIONS
  This investigation is the largest series to date to evaluate the cosmetic body lift for the non-massive weight loss population. Consistent with reported complication rates of lipoabdominoplasty in the literature, the cosmetic body lift is a safe and effective operation for optimal waist contouring.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Sam T
authors.initials: ST
authors.lastname: Hamra
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Small
mesh_terms: D061645:Abdominoplasty / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013848:Thigh / Q000601:surgery
references.citation: Lockwood T. Lower body lift with superficial fascial system suspension. Plast Reconstr Surg. 1993;92:1112–1122
references.citation: Lockwood T. High-lateral-tension abdominoplasty with superficial fascial system suspension. Plast Reconstr Surg. 1995;96:603–615
references.citation: Lockwood TE. Superficial fascial system (SFS) of the trunk and extremities: A new concept. Plast Reconstr Surg. 1991;87:1009–1018
references.citation: Lockwood TE. Maximizing aesthetics in lateral-tension abdominoplasty and body lifts. Clin Plast Surg. 2004;31:523–537
references.citation: Lockwood TE. Lower-body lift. Aesthet Surg J. 2001;21:355–370
references.citation: Le Louarn C, Pascal JF. High superior tension abdominoplasty. Aesth Plast Surg. 2000;24:375–381
references.citation: Saldanha OR, Pinto EB, Matos WN, et al. Lipoabdominoplasty without undermining. Aesthet Surg J. 2001;21:518–526
references.citation: Pascal JF, Le Louarn C. Remodeling bodylift with high lateral tension. Aesthet Plast Surg. 2002;26:223–230
references.citation: Le Louarn C, Pascal JF. The high-superior-tension technique: Evolution of lipoabdominoplasty. Aesthet Plast Surg. 2010;34:773–781
references.citation: Stewart KJ, Stewart DA, Coghlan B, Harrison DH, Jones BM, Waterhouse N. Complications of 278 consecutive abdominoplasties. J Plast Reconstr Aesthet Surg. 2006;59:1152–1155
references.citation: Pollock H, Pollock T. Progressive tension sutures: A technique to reduce local complications in abdominoplasty. Plast Reconstr Surg. 2000;105:2583–2586
references.citation: Shestak KC. The extended abdominoplasty. Clin Plast Surg. 2014;41:705–713
references.citation: Mejia JA, Cárdenas Castellanos YA. Extended abdominoplasty: Applications and a new classification system for abdominoplasty. Aesthet Plast Surg. 2012;36:278–284
references.citation: Hamra S. Circumferential body lift. Aesthet Surg J. 1999;19:244–250
references.citation: Kenkel JM, Lipschitz AH, Luby M, et al. Hemodynamic physiology and thermoregulation in liposuction. Plast Reconstr Surg. 2004;114:503–513
references.citation: Wall S. SAFE circumferential liposuction with abdominoplasty. Clin Plast Surg. 2010;37:485–501
references.citation: Hein RE, Constantine RS, Cortez R, et al. An alternative outpatient care model: A review of safety in body contouring and postoperative guest suites based care. Aesthet Surg J. 2014;34:1225–1231
references.citation: Trussler AP, Kurkjian TJ, Hatef DA, Farkas JP, Rohrich RJ. Refinements in abdominoplasty: A critical outcomes analysis over a 20-year period. Plast Reconstr Surg. 2010;126:1063–1074
references.citation: Weiler J, Taggart P, Khoobehi K. A case for the safety and efficacy of lipoabdominoplasty: A single surgeon retrospective review of 173 consecutive cases. Aesthet Surg J. 2010;30:702–713
references.citation: Heller JB, Teng E, Knoll BI, Persing J. Outcome analysis of combined lipoabdominoplasty versus conventional abdominoplasty. Plast Reconstr Surg. 2008;121:1821–1829
references.citation: Roostaeian J, Harris R, Farkas JP, Barton FE, Kenkel JM. Comparison of limited-undermining lipoabdominoplasty and traditional abdominoplasty using laser fluorescence imaging. Aesthet Surg J. 2014;34:741–747
references.citation: Swanson E. Prospective outcome study of 360 patients treated with liposuction, lipoabdominoplasty, and abdominoplasty. Plast Reconstr Surg. 2012;129:965–978
references.citation: Castañares S, Goethel JA. Abdominal lipectomy: A modification in technique. Plast Reconstr Surg. 1967;40:378–383
references.citation: Moya AP, Sharma D. A modified technique combining vertical and high lateral incisions for abdominal-to-hip contouring following massive weight loss in persistently obese patients. J Plast Reconstr Aesthet Surg. 2009;62:56–64
references.citation: Friedman T, O’Brien Coon D, Michaels JV, et al. Fleur-de-lis abdominoplasty: A safe alternative to traditional abdominoplasty for the massive weight loss patient. Plast Reconstr Surg. 2010;125:1525–1535
references.citation: Hurvitz KA, Olaya WA, Nguyen A, Wells JH. Evidence-based medicine: Abdominoplasty. Plast Reconstr Surg. 2014;133:1214–1221
references.citation: Lissner L, Odell PM, D’Agostino RB, et al. Variability of body weight and health outcomes in the Framingham population. N Engl J Med. 1991;324:1839–1844
references.citation: Rebuffé-Scrive M, Eldh J, Hafström LO, Björntorp P. Metabolism of mammary, abdominal, and femoral adipocytes in women before and after menopause. Metabolism. 1986;35:792–797
references.citation: Colwell AS, Reish RG, Kuter DJ, Damjanovic B, Austen WG Jr, Fogerty AE. Abdominal contouring procedures increase activity of the coagulation cascade. Ann Plast Surg. 2012;69:129–133
references.citation: Iverson RE, Gomez JL. Deep venous thrombosis: Prevention and management. Clin Plast Surg. 2013;40:389–398
references.citation: Pannucci CJ, Barta RJ, Portschy PR, et al. Assessment of postoperative venous thromboembolism risk in plastic surgery patients using the 2005 and 2010 Caprini risk score. Plast Reconstr Surg. 2012;130:343–353
references.citation: Somogyi RB, Ahmad J, Shih JG, Lista F. Venous thromboembolism in abdominoplasty: A comprehensive approach to lower procedural risk. Aesthet Surg J. 2012;32:322–329
references.citation: Levesque AY, Daniels MA, Polynice A. Outpatient lipoabdominoplasty: Review of the literature and practical considerations for safe practice. Aesthet Surg J. 2013;33:1021–1029
references.citation: Cortez RE, Lazcano T, Miller RE, et al. Barbed sutures and wound complications in plastic surgery: An analysis of outcomes. Aesthet Surg J. 2015;35:178–188
references.citation: Andenaes K, Amland PF, Lingaas E, Abyholm F, Samdal F, Giercksky KE. A prospective, randomized surveillance study of postoperative wound infections after plastic surgery: A study of incidence and surveillance methods. Plast Reconstr Surg. 1995;96:948–956
references.citation: Hardy K, Davis KE, Constantine RS, et al. The impact of operative time on complications after plastic surgery: A multivariate regression analysis of 1753 cases. Aesthet Surg J. 2014;34:614–622