Oblique Flankplasty with Lipoabdominoplasty for Truncal Reshaping after Massive Weight Loss: A Prospective Case Series

Oblique Flankplasty with Lipoabdominoplasty for Truncal Reshaping after Massive Weight Loss: A Prospective Case Series | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Oblique Flankplasty with Lipoabdominoplasty for Truncal Reshaping after Massive Weight Loss: A Prospective Case Series Ahmed Awdallah, Tarek shoukr, Mohamed Arafa, Elsayed abdelrazik This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8463389/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Mar, 2026 Read the published version in European Journal of Plastic Surgery → Version 1 posted 9 You are reading this latest preprint version Abstract Background Massive weight loss often results in residual flank and abdominal redundancy not fully addressed by standard abdominoplasty or belt lipectomy. Recent studies show that oblique flankplasty with lipoabdominoplasty (OFLA) can effectively enhance lateral waist contour and posterior skin laxity with low complication rates.¹⁻³ This study aims to evaluate aesthetic and functional outcomes of OFLA in post–massive weight loss patients at a single center. Methods A prospective observational case series of 35 patients with Type II–III Pitanguy abdominal deformities and Grade 2–3 flank deformities (Pittsburgh classification) who underwent OFLA between June 2024 and June 2025 at Tanta University Hospitals. Data included demographics, BMI, complications, Vancouver Scar Scale (VSS) scores, waist‑hip ratio (WHR), and patient satisfaction. Follow‑up was 6 months. Results Thirty-three females (94.3%) and two males (5.7%) with a mean age of 34.4 ± 5.9 years and mean BMI 33.7 ± 1.7 kg/m² were included. The mean pre-operative waist-hip ratio (WHR) improved significantly from 0.93 ± 0.11 to 0.79 ± 0.06 post-operatively (p < 0.001). Overall complication rate was 14.3%, including seroma in 11.4% and minor wound dehiscence in 2.9%, with no infections, revisions, or return to the operating room. Scar quality at 6 months showed a mean Vancouver Scar Scale (VSS) score of 4.8. Patient satisfaction was high, with 60% extremely satisfied and 40% satisfied. Conclusion OFLA is a safe and effective contouring technique for patients with flank and abdominal deformities after massive weight loss, achieving improved waist definition and posterior trunk shape with low complication rates. Level of Evidence IV (Prospective Case Series). Oblique flankplasty Lipoabdominoplasty Body contouring Massive weight loss post-bariatric surgery Waist–hip ratio Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 30 Mar, 2026 Read the published version in European Journal of Plastic Surgery → Version 1 posted Editorial decision: Revision requested 21 Feb, 2026 Reviews received at journal 20 Feb, 2026 Reviewers agreed at journal 20 Feb, 2026 Reviewers agreed at journal 24 Jan, 2026 Reviewers agreed at journal 19 Jan, 2026 Reviewers invited by journal 14 Jan, 2026 Editor assigned by journal 14 Jan, 2026 Submission checks completed at journal 14 Jan, 2026 First submitted to journal 27 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8463389","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":566695817,"identity":"899f469d-c7c7-47f9-a665-0a3428a65cd9","order_by":0,"name":"Ahmed 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Series","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-plastic-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejps","sideBox":"Learn more about [European Journal of Plastic Surgery](https://link.springer.com/journal/238)","snPcode":"238","submissionUrl":"https://submission.nature.com/new-submission/238/3","title":"European Journal of Plastic Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Oblique flankplasty, Lipoabdominoplasty, Body contouring, Massive weight loss, post-bariatric surgery, Waist–hip ratio","lastPublishedDoi":"10.21203/rs.3.rs-8463389/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8463389/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMassive weight loss often results in residual flank and abdominal redundancy not fully addressed by standard abdominoplasty or belt lipectomy. Recent studies show that oblique flankplasty with lipoabdominoplasty (OFLA) can effectively enhance lateral waist contour and posterior skin laxity with low complication rates.¹⁻³ This study aims to evaluate aesthetic and functional outcomes of OFLA in post–massive weight loss patients at a single center.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA prospective observational case series of 35 patients with Type II–III Pitanguy abdominal deformities and Grade 2–3 flank deformities (Pittsburgh classification) who underwent OFLA between June 2024 and June 2025 at Tanta University Hospitals. Data included demographics, BMI, complications, Vancouver Scar Scale (VSS) scores, waist‑hip ratio (WHR), and patient satisfaction. Follow‑up was 6 months.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThirty-three females (94.3%) and two males (5.7%) with a mean age of 34.4 ± 5.9 years and mean BMI 33.7 ± 1.7 kg/m² were included. The mean pre-operative waist-hip ratio (WHR) improved significantly from 0.93 ± 0.11 to 0.79 ± 0.06 post-operatively (p \u0026lt; 0.001). Overall complication rate was 14.3%, including seroma in 11.4% and minor wound dehiscence in 2.9%, with no infections, revisions, or return to the operating room. Scar quality at 6 months showed a mean Vancouver Scar Scale (VSS) score of 4.8. Patient satisfaction was high, with 60% extremely satisfied and 40% satisfied.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOFLA is a safe and effective contouring technique for patients with flank and abdominal deformities after massive weight loss, achieving improved waist definition and posterior trunk shape with low complication rates.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLevel of Evidence\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIV (Prospective Case Series).\u003c/p\u003e","manuscriptTitle":"Oblique Flankplasty with Lipoabdominoplasty for Truncal Reshaping after Massive Weight Loss: A Prospective Case Series","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-06 09:04:58","doi":"10.21203/rs.3.rs-8463389/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-21T15:45:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-20T19:46:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"194985127933959921673532697429843322338","date":"2026-02-20T19:08:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"212051451966978165196940962848936025820","date":"2026-01-24T17:58:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"64956585005098698690667832932815472144","date":"2026-01-19T23:36:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-14T12:21:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-14T10:43:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-14T10:43:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Plastic Surgery","date":"2025-12-28T00:04:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-plastic-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejps","sideBox":"Learn more about [European Journal of Plastic Surgery](https://link.springer.com/journal/238)","snPcode":"238","submissionUrl":"https://submission.nature.com/new-submission/238/3","title":"European Journal of Plastic Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"485bbc83-81fb-4fd0-b940-6af469f4257c","owner":[],"postedDate":"January 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T16:03:16+00:00","versionOfRecord":{"articleIdentity":"rs-8463389","link":"https://doi.org/10.1007/s00238-026-02420-y","journal":{"identity":"european-journal-of-plastic-surgery","isVorOnly":false,"title":"European Journal of Plastic Surgery"},"publishedOn":"2026-03-30 15:59:44","publishedOnDateReadable":"March 30th, 2026"},"versionCreatedAt":"2026-01-06 09:04:58","video":"","vorDoi":"10.1007/s00238-026-02420-y","vorDoiUrl":"https://doi.org/10.1007/s00238-026-02420-y","workflowStages":[]},"version":"v1","identity":"rs-8463389","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8463389","identity":"rs-8463389","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}