In the case shown here we find to important difficulties. First, the patient had a very extensive fat collection in the saddlebag area which distorted her shape. Second the situation was complicated by the fact that her skin has suffered a lot of stress after massive weight loss. The remaining skin was very loose and it was expected that fat extraction would likely aggravate this further.
Such situations are very difficult to manage. The patient had been advised to have a skin excision procedure elsewhere , which would have involved very visible scarring.
Our management of such complex cases consists of three steps: 1. We remove the fat accumulation with water jetstream liposuction. 2. The extracted fat was used to graft the midbuttock deficiency and 3. The remaining skin at the site of skin retraction was treated with laser liposuction for skin retraction.
This combination was able to achieve a very good result without resorting to more scarring.
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