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Upper Body Lift in the Massive Weight Loss Patient
Joseph Michaels 5th, MD1,Angela S. Landfair MD MPH, Devin Coon, MD2, Chad Purnell, BA2, Tali Friedman, MD2, J. Peter Rubin, MD2
University of Pittsburgh
2010-04-05
Presenter: Angela S. Landfair MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Aesthetics
A common deformity in the massive weight loss population is dropout of the lateral inframammary crease with continuation into redundant skin and subcutaneous tissue rolls of the upper back. The upper body lift (UBL) is a useful technique to achieve a more aesthetic contour.
Methods: The patient's intended scar location, usually the bra line, is marked. A superior anchor line is then drawn based on placing the skin under tension. A pinch test is then used to determine the estimated lower line of resection. Overall, much more tissue will be resected laterally then medially. Intraoperatively, the anchor line is incised and tissue is undermined to the level of the estimated inferior line of resection. Resection is then completed in a segmental fashion.
Results: Using the above procedure, 10 MWL patients (9F, 1M) were treated. Average weight loss in this cohort was 202 lbs, and average pre-operative BMI was 30.4. All patients had additional procedures , most often a vertical medial thigh lift (70%) and/or mastopexy (60%). The UBL was combined with liposuction in 50% of cases. Complication rate was very low.
Conclusions: Redundant skin and subcutaneous tissue in the upper back and lateral inframammary crease provide a challenge in body contouring surgery of the massive weight loss patient. The upper body lift is an effective procedure to provide a more pleasing contour in this area, with few complications. When performed with respect to the zones of adherence of the superficial fascial system, the scar location can be effectively controlled.
