Overstretched skin, due to the accumulation of fat during obesity, followed by deflation caused by weight loss, results in multiple functional and aesthetic irregularities in many areas of the body.
The flanks, outer thighs, lower back and buttocks are among the most affected areas, especially after extreme weight loss; in this instance, a real collapse of the trunk tissues occurs, with extreme sagging due to loss of elasticity and lack of support. Moreover, there may be persistent fat deposits. Of course, the natural ageing process, with or without weight loss, contributes to a progressive loss of skin elasticity in these areas.
Flankplasty, outer thigh lift and gluteoplasty cover multiple surgical techniques, which are planned and performed depending on the specific defects. These procedures usually consist of two phases:
Liposuction allows removal of fat deposits and contouring of fat tissue in neighbouring areas (liposculpture). It also seeks to minimise intra-operative bleeding and save lymphatic and blood vessels intact; these structures would be damaged if incorporated in a full-thickness excision. Liposuction allows fat removal and skin-only excision.
The skin excision results in a scar which runs along the flanks and, in the most severe cases, continues with the contralateral one, across the lower back. Usually, this is performed after an abdominoplasty, so the flankplasty scar is a circumferential continuation of the abdominoplasty scar. It runs low and is easily hidden by underwear or bathing wear.
Prior to careful application of a skin suture, it is essential to lift, tighten and secure the underlying connective fibrous tissues, which join skin and muscle, with a deep sturdy suture. The resulting firm framework will allow the final result to be more stable in functional and aesthetic terms. Only deep, dissolvable sutures are used.
The skin tension on the scar will be minor, which is essential to achieve better scar development.
Flankplasty, outer thigh lift and gluteoplasty are performed under general anaesthesia (the patient is asleep) with a two-night hospital stay after the surgery.
Careful administration of pain-killers during and after the surgery ensures that post-operative pain and discomfort are kept to a minimum.
The Dr. Simone is medical director at the Campus Bio-Medico University Polyclinic of Rome, where, in addition to carrying out surgical activities, he dedicates himself to teaching and scientific research, in an international academic context.