Circumferential Lower Body Lift With Superficial Fascial System Preservation in Patients With BMI Below 30: A Standardized Technique and Retrospective Analysis of 110 Patients

Abstract Background Circumferential lower body lift is an effective procedure for treating truncal deformities following weight loss; however, it is associated with significant complication rates, particularly seroma formation. Objectives To describe a standardized seven-point (A–G) marking system and surgical approach for circumferential lower body lift with reduced undermining and preservation of the superficial fascial system (SFS), and to evaluate clinical outcomes and complication rates. Methods A retrospective observational study was conducted including 110 consecutive patients undergoing circumferential lower body lift between 2014 and 2026. Patients were stratified into bariatric versus non-bariatric and primary versus secondary procedures. Variables analyzed included age, body mass index (BMI), liposuction volume, gluteal fat grafting, drain duration, and postoperative complications classified according to the Clavien-Dindo system. Statistical analysis was performed using the Mann–Whitney test for continuous variables and Fisher’s exact test for categorical variables, with significance set at p < 0.05. Results The mean BMI was 25.6 ± 2.2 kg/m2. The overall complication rate was 7.3%, with most complications classified as low-grade according to the Clavien-Dindo system. Three seromas (2.7%) requiring outpatient aspiration were observed. Other complications included hematoma (0.9%), infection (0.9%), wound dehiscence (2.7%), and one case of deep vein thrombosis (0.9%). No statistically significant differences were found between bariatric and non-bariatric patients or between primary and secondary procedures (p > 0.05). Conclusions Circumferential lower body lift with reduced undermining and preservation of the superficial fascial system may be a safe and effective technique in patients presenting with BMI below 30 kg/m2. The use of a standardized Seven-Point (A–G) Marking System may facilitate surgical planning in this selected patient population.