Accentuation of saddle bags after body lift is not uncommon. This can either be due to significant removal of excess skin and fat from the abdomen, hip, and buttock region leading to heighten visual awareness of the saddle bag region. In addition, due to tension ones and the hips relaxing after a body lift, the saddle bags may accumulate after a body lift settles and falls postoperatively.
Your questions are a little difficult to answer without pictures; however, I will suggest a saddle bag reduction instead of a repeat body lift. Typically, the body lift will address the abdomen, lateral hips, and buttock region. If the saddle bags are your primary concern, I will then consider a saddle bag reduction.
Typically, this is done from an incision that is underneath the buttock that comes laterally over the hips and comes to join the body lift scar in the front. This directly removes the saddle bags on the side. Blood issue in this area has never been a problem for me after body lifts. I have done a significant number of direct saddle bag reductions after body lifts without blood flow issues.
J. Timothy Katzen, MD, FACS