Aboueldahab Abdelmohsen Khalaf
Assistant Professor of Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Alexandria University, Egypt.
J Cutan Aesthet Surg. 2013 Oct;6(4):217-25. doi: 10.4103/0974-2077.123410.
The abdomen, thighs and buttocks are often the areas of greatest concern to patients following massive weight loss due to bariatric surgery. The typical appearance of the patient who has lost a massive amount of weight derives from a combination of factors, including gender-dependent body morphology and a change in body mass index, which lead to skin and soft-tissue excess and poor skin tone. Thigh laxity and redundancy represents a great challenge to both patients and surgeons. Not only because of the difficulty to satisfy the patients, but also due to the higher incidence of complications especially, with those obese patients who have not undergone bariatric surgery before. The problems with such patients are due to the heavy thighs that require both debulking and tight anchorage to prevent scar migration or labial distortion.
The aim of the present study is to improve the aesthetic outcome and avoid the complications of medial thigh lifting with simultaneous liposuction in obese and non-obese.
A total of 25 female patients presented during the period from January 2007 to July 2011 complaining of moderate to severe thigh laxity with or without lipodystrophy. In 20 patients medial transverse thigh lift was performed, to treat medial thigh friction and laxity particularly in the upper half. Whereas, in the other five patients were suffering from upper and lower medial thigh bulkiness, vertical thigh lift was performed.
All patients recovered well in 2 weeks and showed improvement of thigh contour. Scar downward displacement in one patient. No skin necrosis or seroma. No labial distortion or separation encountered.
Simultaneous liposuction and thigh lift gave good results provided proper patients selection, appropriate technique to each patient, meticulous, cautious liposuction and handling of the tissues and most importantly is the deep tight anchorage sutures to guard against the effect of heavy skin flaps.
腹部、大腿和臀部通常是接受减肥手术后体重大幅减轻的患者最为关注的部位。大量减重患者的典型外观源于多种因素的综合作用,包括性别相关的身体形态以及体重指数的变化,这些因素导致皮肤和软组织多余且肤色不佳。大腿松弛和赘肉对患者和外科医生来说都是巨大的挑战。这不仅是因为难以满足患者的需求,还由于并发症的发生率较高,尤其是对于那些之前未接受过减肥手术的肥胖患者。这类患者的问题在于大腿沉重,既需要进行减容又需要牢固的固定,以防止瘢痕移位或阴唇变形。
本研究的目的是改善美学效果,并避免在肥胖和非肥胖患者中同时进行吸脂术和大腿内侧提升术的并发症。
2007年1月至2011年7月期间,共有25名女性患者前来就诊,她们抱怨存在中度至重度大腿松弛,伴有或不伴有脂肪营养不良。其中20名患者接受了大腿内侧横向提升术,以治疗大腿内侧尤其是上半部分的摩擦和松弛。而另外5名患者患有大腿内侧上下部臃肿,接受了大腿垂直提升术。
所有患者在2周内恢复良好,大腿轮廓得到改善。1名患者出现瘢痕向下移位。未发生皮肤坏死或血清肿。未遇到阴唇变形或分离的情况。
只要进行适当的患者选择,针对每个患者采用合适的技术,进行细致、谨慎的吸脂和组织处理,最重要的是进行深部牢固的锚定缝合以防止沉重皮瓣的影响,同时进行吸脂术和大腿提升术就能取得良好效果。