Drainless Lower Body Lift With Large-Volume Liposuction and Adjunctive Procedures: A Single-Surgeon Retrospective Review of 137 Consecutive Patients and Outcomes

Abstract Background Lower body lift (LBL) is a powerful 360° contouring procedure, most commonly performed after massive weight loss. Objectives In this study, the author reviews outcomes of a large series of drainless LBL procedures performed by a single surgeon combined with high-volume liposuction and adjunctive body procedures. The surgeon’s technique is described. Methods A retrospective review was conducted on 137 consecutive patients who underwent drainless LBL between 2023 and 2025 by a single surgeon. Data collected included demographics, adjunctive procedures, liposuction volumes, fat grafting, hemoglobin levels, estimated blood loss (EBL), complications, and reoperations. All patients received preoperative optimization, including iron supplementation, and a multimodal perioperative protocol was employed. No drains were used for the procedures. Results The mean age was 44.5 years, and the mean BMI was 26.8 kg/m2. Average liposuction volume was 2518 cc, with 1976 cc of pure fat removed. Mean fat transfer volumes were 1075 cc (buttocks) and 628 cc (breasts). Average EBL was 572 cc. Adjunctive procedures included Brazilian butt lift (99.3%), 360 liposuction (96.4%), fleur-de-lis tummy tuck (41.6%), mastopexy (29.2%), and others. The complication rate was 6.6%, with 0.7% requiring reoperation. Complications included hematoma (n = 1), deep vein thrombosis (n = 1), transfusions (n = 2), and delayed healing (n = 5). No seromas or revisions were reported. Conclusions Drainless LBL with progressive tension sutures, scarpal flap preservation, and limited undermining is a safe and effective approach and can be combined with high-volume liposuction and multiple adjunctive procedures. This technique resulted in lower complication and revision rates compared with previously published series. Level of Evidence: 4 (Therapeutic)