Danilla Stefan, Abou-Kheir Nohelia, Gonzalez Raul, Richer Dirk
Clínica AUREA, Juan XXIII 6130, Vitacura, Santiago, Chile.
Clíncia Dr. Raul Gonzalez, Ribeirao Preto, Brazil.
Aesthetic Plast Surg. 2025 Jun;49(11):3121-3131. doi: 10.1007/s00266-025-04877-x. Epub 2025 Apr 21.
OBJECTIVE: The purpose of this study is to describe the outcomes and complications in patients with moderate to severe skin laxity who underwent a comprehensive lower body lift (LBL) using multilayer liposculpture, abdominal wall volumization, skin retraction technologies and buttocks augmentation with implants or flaps. METHODS: This retrospective case series included ASA 1 or 2 patients with abdominal dermatochalasis, gluteal ptosis, and variable lipodystrophy. Patients were selected with a maximum BMI of 28 kg/m. Surgical techniques combined multilayered liposculpture assisted by ultrasound (UAL), power-assisted liposculpture (PAL), and helium-based radiofrequency-assisted liposculpture (HeRFAL), along with circumferential abdominoplasty, pubic lift, and gluteal lift with implants using the YXZ technique or turnover flaps. Deltoid, rectus abdominis and external oblique were amplified with fat grafting. RESULTS: From 2021 to 2024, 32 female patients with an age range from 31 to 57 and an average BMI of 24.7 ± 2.7 Kg/m were treated. Surgery times ranged from 2 to 6 hours (mean 5.1 ± 1 h). The most frequent minor complications were seromas in 11 (37.9%) patients and minor dehiscences in 7 (25%) patients. Patient satisfaction was very high, and no patient requested excisional surgery for energy-treated areas. DISCUSSION: The study shows the feasibility and effectiveness of combining advanced techniques and technologies in LBL for patients with moderate to severe skin laxity. The integration of UAL, PAL, and HeRFAL technologies allowed for effective fat removal and tissue tightening, while RAFT and SPARTAN techniques enhanced abdominal wall. The YXZ technique provided tailored gluteal augmentation. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
目的:本研究旨在描述中重度皮肤松弛患者接受综合下半身提升术(LBL)的结果和并发症,该手术采用多层脂肪雕塑、腹壁容积增加、皮肤回缩技术以及植入物或皮瓣隆臀术。 方法:本回顾性病例系列纳入了美国麻醉医师协会(ASA)1或2级、有腹部皮肤松弛、臀下垂和不同程度脂肪营养不良的患者。入选患者的最大体重指数(BMI)为28kg/m²。手术技术结合了超声辅助多层脂肪雕塑(UAL)、动力辅助脂肪雕塑(PAL)和氦基射频辅助脂肪雕塑(HeRFAL),以及环形腹壁成形术、耻骨提升术和采用YXZ技术或翻转皮瓣的植入物隆臀术。通过脂肪移植增大三角肌、腹直肌和腹外斜肌。 结果:2021年至2024年,共治疗了32例年龄在31至57岁之间、平均BMI为24.7±2.7kg/m²的女性患者。手术时间为2至6小时(平均5.1±1小时)。最常见的轻微并发症是11例(37.9%)患者出现血清肿,7例(25%)患者出现轻微切口裂开。患者满意度非常高,没有患者要求对接受能量治疗的区域进行切除手术。 讨论:该研究表明,对于中重度皮肤松弛的患者,在LBL中结合先进技术具有可行性和有效性。UAL、PAL和HeRFAL技术的整合实现了有效的脂肪去除和组织紧致,而RAFT和SPARTAN技术增强了腹壁。YXZ技术提供了个性化的隆臀效果。 证据等级IV:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266 。
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