Is the Lower Back Consider the Flank Area?

Question

I had TT, BA, and lipo of the flanks. I was under the impression that my lower back was part of the flank area. When my PS drew the lines to where he was going to lipo, it went all the way toward my lower back. Its been 10 mos in and I still have the love handle effect on my lower back. I did asked my PS and he said that it is two different areas. Can someone please tell me where the flank area ends and the lower back begins.

Richard J. Bruneteau, MD · Answer

Unfortunately, terminology can sometimes represent an
obstacle to understanding.The term
“flank” is a nondescript term that is used differently by different
people.In most cases, it refers to the
posterior lateral lower back above the hips.This is a common area for fat accumulation in both men and women. It’s
not unusual for surgeons to mark patients pre-operatively to minimize
confusion.Apparently, this maneuver
didn’t work in this particular case.Under
these circumstances, it’s reasonable to sit down with your surgeon and
re-discuss the issue.Hopefully, a
solution can be obtained that will address your concerns.

S. Larry Schlesinger, MD, FACS · Answer

Liposuction of the flank area may mean different things to different plastic surgeons. Flank fat has no standardized meaning in the plastic surgery community. If you chose a board-certified plastic surgeon, then I'm sure he or she, in good faith, removed that area that they believed to be covered by the term "flank fat". I wrote an article in Aesthetic Surgery (Aesthetic Surgery Journal March 20, 1995 , 15: 1: 2, doi:10.1016/S1090-820X(05)80016-0). This article may explain why there is still fat in that area after liposuction. At any rate, there has been a miscommunication between you and your plastic surgeon. At this point, an open and honest discussion should lead to a satisfactory resolution for both of you. As I've often said, surgery doesn't end at surgery. It ends when both the surgeon and the patient are satisfied that the best possible results have been achieved.

Adam Tattelbaum, MD · Answer

Thank you for your question.  It's a challenging question because each plastic surgeon may have a slightly different definition.

	In my own practice I frequently perform flank liposuction with my tummy tucks as part of the procedure.  For appropriate candidates with good skin tone I think it just makes the tummy tuck look better.  I call this frontal flank liposuction and it basically involve suctioning of the sides of the abdomen as far back as I can with a patient asleep facing upright.

	 

	Some patients have additional flank fulness above the buttocks.  I really can't get to this area with the patient facing upright during tummy tuck.  For patients with fatty fulness in this area I offer them additional posterior flank liposuction, placing them face down before we even begin the tummy tuck and suctioning the lower  posterior flank. In the appropriate candidate I find that suctioning this area can give a much more aesthetic shape to the lower back in the upper buttocks.

	 

	Because this posterior  flank takes  longer and is more extensive than the standard frontal flank liposuction I consider this a second site of liposuction.

	 

	It sounds like your plastic surgeon may handle this similarly  I would recommend you speak with him or her. No bridges have been burned because you can always add this on as an additional side of liposuction at a later date.

	 

	Best wishes.

Moneer Jaibaji, MD · Answer

It is difficult without pictures or examination to tell exactly what you mean by lower back, is it lower back roll or excess skin a fat adjacent to midline. The flanks usually refer to waist area and stops before the back midline. Having the love handle on lower back may mean you required extended tummy tuck or lower body lift. You need to talk to your plastic surgeon about your concerns.

Tom J. Pousti, MD · Answer

Thank you for the question. Unfortunately, the definition of the “flank” area may differ from one surgeon to another.  I use the term flank to describe the area on a patient's side ( otherwise known as "love handle" or "muffin top”).  If you feel that there has been a miscommunication between yourself and your plastic surgeon, it would be best to address this in a calm and nonaccusatory fashion with him.

	Best wishes.

Douglas J. Raskin, MD (retired) · Answer

When we perform a mommy makeover, we use patient photographs at the consultation to show any 'flank' area needing liposuction. Since the patient lies on her back for the surgery, the posterior back fullness is not addressed at the time of her breast and tummy surgeries.

	We always mark the areas to be liposuctioned, with the patient standing and unmedicated, just before her surgery.  This is done to confirm that the patient sees the borders of her 'flank' fullness being treated at this surgery.

	With gentle patient rolling during surgery, some of the areas of the posterior flanks can be cared for with the liposuction, but not the low back.

	 

	Best Regards,

Is the Lower Back Consider the Flank Area?

Answers (6)