Is a butt flap augmentation without a lower body lift an option? (photos)

Question

I've lost 120 pounds and was planning my next surgery to be thighplasty (just completed debulking), but I'm now considering adding a lower body lift. It's on my mind, but not something that I'm particularly enthusiastic about. I'd like to consider various options to address the loose skin on my butt, but think a BBL may not fill it enough. Is getting ONLY butt flap auto aug w/out LBL an option? Anything else to consider? Should whichever procedure be done with the thighplasty or separately?

J. Timothy Katzen, MD, FACS · Answer

Hello Ela_mybody, 
Thank you for your question regarding is a butt flap augmentation without a lower body an option.  The quick answer is “no, a buttock flap augmentation is not an option without a lower body lift”. Let’s discuss what happens during a buttock flap augmentation. During buttock flap augmentation, tissue is harvested from the upper portion of the buttock. The upper dermis and outer layer of the dermis are removed. The deep dermis and underlying fat is then rotated as a particle or propeller into the buttock (that is why this is often called a propeller flap). Then, the incision is closed.  There is no way to create a buttock flap without making an incision. The incision is made either for a posterior buttock lift or a 360 circumferential lower body lift or a belt lipectomy. Therefore, you can see a incision is required to create a buttock flap. Since your buttock bothers you, I would suggest a posterior buttock lift. This would achieve the results that you are simulating in your second picture, where you are holding up your buttocks skin.  Approximately one to two months later, I would undergo the thigh lift, thigh reduction or thighplasty. During the thigh lift procedure, fat will be harvested from your inner thighs. This fat then can be transferred to the buttocks like a Brazilian butt lift or BBL. Approximately one to two
months later, I would undergo the thigh lift, thigh reduction or thighplasty. During the thigh lift procedure, thigh fat can be harvested from the inner thighs. This fat then can be transferred to the buttocks as a BBL. Since fat cannot be transferred to the buttock during a posterior buttock lift, that is why I would suggest the buttock lift be performed first and then, the thighplasty secondarily. 
You don’t necessarily need a lower body lift which would encompass the abdomen, hips and back. If you are OK with your abdomen, you do not need the front portion of the lower body lift. Therefore, you may only need the posterior buttock lift.  I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Salvador Medina, MD · Answer

Hello Ela_mybody.To have the best result you need a lower body lift, to reposition the skin of the butt and also add fat for volume and shape. With the lower body lift we lift the outer thighs, butt,, pubis and stretch the abdomen.I personaly do the inner thigh lift in a second procedure.
Thank you
Dr. Medina

Is a butt flap augmentation without a lower body lift an option? (photos)

Answers (2)

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