Brazilian Buttock Lift for the Weight-Loss Patient

Introduction: Performing optimal gluteal augmentation using traditional methods in moderate to severe weight-loss patients poses a surgical challenge as such patients typically present with (1) significant skin redundancy, (2) soft tissues containing higher density of connective tissues, and (3) buttock ptosis. Materials and Methods: Excess skin redundancy and buttock check ptosis require consideration of supplemental excisional tucking to achieve optimal results. In addition, subcutaneous tissues that maintain more connective tissue pose difficulty with fat removal using traditional liposuction techniques. As such, we present a novel surgical technique to optimally augment and shape the buttock in patients who have undergone weight-loss. Results: This procedure uses a modified lateral thigh and buttock tuck excision not only to lift the buttock cheek complex but also to create a dermal fat flap that is transposed into the upper buttock pole to achieve upper buttock fullness. The remainder of the excised tissue undergoes novel ex-vivo liposuction, which allows for simultaneous repair of the created excision line while fat is being harvested. Discussion: We present a new Brazilian buttock lift (BBL) procedure for weight-loss patients using a novel modified lateral thigh and buttock tuck with a dermal fat flap as well as ex-vivo liposuction and fat transfer. The described ex-vivo liposuction technique provides several advantages that include (1) limiting operative time, (2) allowing for maximal fat removal while avoiding unnecessary trauma to the patient, and (3) providing improved quality of fat that is less blood tinged. The lateral thigh and buttock tuck with dermal fat flap is used to eliminate buttock ptosis and augment the upper buttock. The ex-vivo harvested fat to the middle and lower buttock to complete buttock augmentation for the Brazilian buttock lift in a seamless fashion. Conclusions: In summary, we present a novel Brazilian buttock lift technique to augment the buttock in weight-loss patients that maximizes both patient safety and efficacy.