Oblique Flankplasty for Total Body Lift: A Safer, More Effective Approach to Waist Definition

Introduction

Oblique Flankplasty with Lipoabdominoplasty (OFLA) is emerging as a pivotal advancement in body contouring surgery, particularly for patients undergoing total body lift (TBL) after massive weight loss. The recent study published in Aesthetic Surgery Journal by Dr. Dennis J. Hurwitz and Dr. Armando A. Davila provides a comprehensive update on the technique, its efficacy, and its integration into modern plastic surgery.

Background

The evolution of body contouring for post-massive weight loss patients has been driven by the need for enhanced aesthetics and functional outcomes. Traditional techniques, such as the lower body lift (LBL) and fleur-de-lis abdominoplasty, have been criticized for suboptimal results, including persistent flank bulges and inadequate waist shaping. The oblique flankplasty technique addresses these concerns by providing a more tapered waistline, better posterior torso aesthetics, and improved long-term skin tightness.

Methodology

The study reviewed 151 consecutive cases performed between June 2010 and April 2023. The retrospective analysis examined patient demographics, associated procedures, complications, and overall outcomes. The authors also presented five diverse case studies to illustrate the broad applicability of the technique.

Efficacy and Aesthetic Outcomes

bodylift abdominoplasty weight loss plastic surgery delhi dehradun chandigarh — Compared to conventional abdominoplasty, the oblique cranioplasty technique actually excises the excess on the flanks up to the back. No dog ears and excess on the flanks as in conventional abdominoplasty.

The oblique flankplasty was found to effectively narrow the waist and improve skin tightness in the posterior torso.
The procedure was frequently combined with lipoabdominoplasty (70.9%) and thighplasty (13.9%).
Patients reported high satisfaction with the aesthetic results, particularly in terms of natural contours and improved waist definition.

Complication Rates

The overall complication rate was low, with only 3.3% experiencing significant wound healing issues.
Seromas were observed in 9.9% of cases, while infections occurred in 7.9%.
The procedure was deemed safer than traditional lower body lifts, particularly due to the avoidance of high-tension closures.

Clinical Implications

The study underscores the growing preference for oblique flankplasty as a standard component of body contouring surgeries. The technique offers advantages over conventional LBL by:

Providing a more sculpted and aesthetically appealing waistline.
Reducing the incidence of post-surgical flattening of the buttocks.
Minimizing complications associated with tension-heavy closures.
Avoiding the vertical midline scar associated with fleur-de-lis abdominoplasty.

Given these benefits, the procedure has the potential to become a key technique in post-weight loss body contouring, especially for patients seeking natural and long-lasting results.

Limitations

While the study offers valuable insights, it is limited by its retrospective nature and lack of a direct comparative analysis with other contouring techniques. Future research should include randomized controlled trials to further validate the superiority of oblique flankplasty over traditional methods.

Conclusion

Oblique flankplasty with lipoabdominoplasty represents a significant advancement in aesthetic body contouring. By addressing the limitations of traditional lower body lift procedures, it offers a refined approach for achieving natural, long-lasting results with minimal complications. Plastic surgeons seeking to optimize post-massive weight loss reconstructions should strongly consider incorporating this technique into their practice.

Key Highlights

Aspect	Findings
Procedure	Oblique Flankplasty with Lipoabdominoplasty (OFLA)
Study Scope	151 cases (2010-2023)
Key Benefits	Enhanced waist definition, improved posterior aesthetics, long-term skin tightness
Complications	Seromas (9.9%), infections (7.9%), significant wound issues (3.3%)
Surgical Integration	Often performed with J-torsoplasty and thighplasty
Patient Satisfaction	High, with natural contours and fewer revision requests
Comparison with LBL	Fewer complications, avoids buttock flattening, provides superior waist tapering

Hurwitz DJ, Davila AA. Update on Oblique Flankplasty: Easily Executed, Long-Lasting, Integral Component of Total Body Lift Surgery. Aesthetic Surgery Journal. 2024; 44(1): NP77–NP86. DOI: 10.1093/asj/sjad323.