Treating Saddlebag Deformity after Massive Weight Loss: Vertical versus Lower Body Lift

Abstract

Summary: The saddlebag deformity remains a persistent and difficult-to-treat problem after body-contouring surgery. A new way to handle the saddlebag deformity is with the vertical lower body lift (VLBL). This retrospective cohort study evaluated the overall reconstruction outcome of the VLBL in 16 patients (32 saddlebags) and compared it to standard lower body lift (LBL). The BODY-Q and the Pittsburgh Rating Scale (PRS)–Saddlebag Scale were used in the evaluation process. Surgical outcomes regarding the saddlebag deformity were in favor of the VLBL technique in patients with marked saddlebag deformity. A 1.16 decrease in mean PRS saddlebag score (relative change of 61.7%) was observed for the VLBL group versus a mean decrease of 0.29 (relative change of 21.6%) in the LBL group. BODY-Q end point and change in scores did not differ between the VLBL and LBL groups at 3-month follow-up, but at 1-year follow-up, they were in favor of the VLBL group in the body appraisal domain. Patients were highly satisfied with the contour and appearance of their lateral thigh, despite the extra scarring caused by this novel technique. Therefore, the authors advise clinicians to consider performing a VLBL instead of the standard LBL in patients with notable saddlebag deformities after massive weight loss. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.