Preserving Hip Projection in Lower Body Lift (Buttock Lift) Surgery: A Novel Adipofascial Flap Technique

Flattening of the hip with masculinization and lack of buttock projection are common consequences of buttock lift procedures in women. Rotational axial flaps provide central and lower buttock volume but often lack enough remaining tissue to provide hip and upper buttock projection.

We describe a buttock lift technique, utilizing a well-vascularized, broadly-based "sliding" adipofascial flap to preserve and enhance hip and upper buttock projection, while using autologous fat grafting for central and lower buttock volume.

A retrospective analysis was performed of all female patients who underwent buttock lift surgery with an autologous adipofascial flap by the senior surgeon between January 2015 and December 2020.

A total of 145 female patients underwent buttock lift surgery with a sliding adipofascial flap; 132 (91%) receiving concomitant fat grafting of the central and lower buttocks. Average follow-up was 9.7 months (2-48 months). Average patient age was 46 (23-68), and average BMI was 28.3 (17-39.6). The overall patient complication rate for all procedures performed was 17.2%, while the complication rate for the buttock lift procedure alone was 8.3%. No instance of adipofascial flap necrosis occurred.

The sliding adipofascial flap provides an alternative for volume enhancement in buttock lift surgery, prioritizing use of the valuable hip-flank adipose tissue for more proximal upper buttock and hip projection while relying on autologous fat grafting for the more distal central and lower buttock. This retrospective review demonstrates a strong safety profile with predictable aesthetic outcomes.