Comprehensive Body Contouring by Dennis Hurwitz

Author:Dennis Hurwitz
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

4.3.4 Case 4.8 Obese Lower Body and Thighs

Case 4.8 is most concerned over her large and sagging lower abdomen, medial thighs, and legs (Fig. 4.44). The enormity of the challenge limited the extent of surgery. She is 59 years old, 5′ 1″ and 158 lb (BMI 29.9) after losing150 lb from vertical gastroplasty. Later her bariatric surgeon performed an open ventral hernia repair with mesh and panniculectomy. She has treated hypothyroidism and depression. On exam her breasts are broad with grade III ptosis. She has upper, mid, and lower back rolls. There is a Mercedes style abdominal surgical scar with moderate excess mid-abdominal skin and broad waist. Severe ptosis of the mons pubis overhangs the upper medial thighs. The thighs are loose and bulging with fat, especially medially. There is minimal saddlebag, buttock, or posterior thigh deformity.

Fig. 4.44Case 4.8: Preoperative markings for a FDL that includes the prior scars and lateral extensions over contour depressions of the hips. The thigh markings demand extensive UAL and spiral thighplasty with a wide vertical extension. Her thighplasty combines FDL with a picture frame pubic monsplasty

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