Treating Saddlebag Deformity after Massive Weight Loss: Vertical versus Lower Body Lift

Summary: The saddlebag deformity remains a persistent and difficult-to-treat problem following body contouring surgery (BCS). A new way to handle the saddlebag deformity is with the vertical lower body lift (VLBL) as described by Pascal [1]. This retrospective cohort study evaluated the overall reconstruction outcome of the VLBL in 16 patients, respectively 32 saddlebags, and compared it to standard LBL. The BODY-Q as well as the Pittsburgh Rating Scale (PRS)-saddlebag scale were used in the evaluation process. The authors showed that surgical outcomes regarding the saddlebag deformity are in favor of the VLBL technique in patients with marked saddlebag deformity. A decrease of 1.16 in mean PRS-saddlebag score and relative change of 61.67% is observed for the VLBL group, while the LBL group shows only a mean decrease of 0.29 and relative change of 21.6%. BODY-Q endpoint and change in scores did not differ between the VLBL and LBL group at 3 months follow-up and were at one year follow-up in favor of the VLBL group in the body appraisal domain. Patients are greatly satisfied with the contour and appearance of their lateral thigh despite the extra scarring that had to be made by using this novel technique. Therefore, the authors advise clinicians to consider performing a VLBL instead of the standard LBL in massive weight loss patients with a notable saddlebag.