Spiral lift: medial and lateral thigh lift with buttock lift and augmentation

Patients with a pear- or guitar-shaped body contour deformity are not frequently encountered, but represent a surgical challenge. Traditionally, these patients have been treated with belt lipectomies, lower body lifts, medial thigh lifts, and liposculpture because liposuction alone often is insufficient. This article describes an alternative method for performing a medial, anterior, and lateral thigh lift with a buttock lift and autoprosthesis augmentation through a single spiral incision easily concealed by underwear.

A retrospective study of patients treated for body contour deformities from January 2004 to June 2006 was conducted. The inclusion criteria for spiral lift were lipodystrophy and excess skin and subcutaneous tissue of the thighs, flanks, and buttocks without contour deformities of the abdomen. The incision extends from the inferior crease of the buttocks along the inguinal crease and continues just inferior to the anterior iliac spine, spiraling above the buttocks and meeting the contralateral incision at the sacrum. A dermal fat flap is rotated to function as an autologous buttock implant. Pre- and postoperative views, patient satisfaction, complications, and operative details are analyzed and described.

Of the 253 consecutive patients treated for body contour deformities, 5 met the inclusion criteria for the spiral lift. All the patients were women ranging in age from 30 to 43 years. Comparison of pre- and postoperative views demonstrated improved contour and firmness of the thighs and gluteal region with easily concealed scars. The inferior gluteal sulcus became less evident, and the buttock mass was elevated and augmented with maximum projection at midlevel. Patient and surgeon satisfaction was high. One patient experienced delayed wound healing. Stability in the body contour repair was demonstrated at the 1-year follow-up assessment.

A reliable, versatile, and effective technique is described. Applicability and experience with the procedure are limited due to infrequent presentation of patients seeking correction for such a body contour deformity.