{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:49:42Z","timestamp":1773726582733,"version":"3.50.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Health Sciences"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aesth Plast Surg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>As the frequency of bariatric procedures rises, so does the demand for breast contouring operations. Massive weight loss results in ptotic breasts that are challenging to shape. However, concentrating solely on the breasts in the upper body leads to a state of imbalance. In this study, we aimed to add additional volume to the breast tissue by utilizing the lateral chest folds\/back folds with combined upper body lifting procedures and show the long-term results.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Between January 2018 and June 2024, 24 patients presented to our clinic with a complaint of breast deformity due to massive weight loss. They were evaluated as a whole. Upper body lift and autoaugmentation mastopexy with a lateral thoracic region perforators-based flap were planned in a single stage. Dorsal soft tissue was also utilized for autoaugmentation in selected patients. The viability of the extended dorsal flaps was examined with the intraoperative indocyanine green angiography.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The body contouring surgery was performed an average of 2.2\u00a0years after bariatric surgery. Autoaugmentation with extended fasciocutaneous flap procedures was performed in combination with other upper body lifting procedures according to the patient\u2019s needs. The postoperative follow-up period was 1\u00a0month to 5\u00a0years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In postbariatric patients, focusing only on the breast leads to aesthetic disharmony in the upper body. Using subcutaneous tissue in the autologous augmentation method eliminates sagging in the upper body and provides the desired volume to ptotic breasts. The five-year follow-up results demonstrate that this method provides long-lasting, satisfying results with minimal complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence IV<\/jats:title>\n            <jats:p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.springer.com\/00266\" ext-link-type=\"uri\">www.springer.com\/00266<\/jats:ext-link>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00266-025-04795-y","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T10:54:07Z","timestamp":1743418447000},"page":"3107-3120","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Integrated Approach to Upper Body Shaping: Long Time Results"],"prefix":"10.1007","volume":"49","author":[{"given":"Huseyin Emre","family":"Ulukaya","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6511-9609","authenticated-orcid":false,"given":"Sabri","family":"Ozturk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamuran Zeynep","family":"Sevim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burak Tunahan","family":"Ekincikli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"4795_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2005.01.004","author":"HJ Sugerman","year":"2005","unstructured":"Sugerman HJ. The pathophysiology of severe obesity and the effects of surgically induced weight loss. Surg Obes Relat Dis. 2005. https:\/\/doi.org\/10.1016\/j.soard.2005.01.004.","journal-title":"Surg Obes Relat Dis"},{"key":"4795_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2007.08.004","author":"JL Sebastian","year":"2008","unstructured":"Sebastian JL. Bariatric surgery and work-up of the massive weight loss patient. Clin Plast Surg. 2008. https:\/\/doi.org\/10.1016\/j.cps.2007.08.004.","journal-title":"Clin Plast Surg"},{"key":"4795_CR3","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjv008","author":"CK Herman","year":"2015","unstructured":"Herman CK, Hoschander AS, Wong A. Post-bariatric body contouring. Aesthet Surg J. 2015. https:\/\/doi.org\/10.1093\/asj\/sjv008.","journal-title":"Aesthet Surg J"},{"key":"4795_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-020-05100-3","author":"RI Rocha","year":"2021","unstructured":"Rocha RI, Junior WC, Modolin MLA, Takahashi GG, Caldini ETEG, Gemperli R. Skin changes due to massive weight loss: histological changes and the causes of the limited results of contouring surgeries. Obes Surg. 2021. https:\/\/doi.org\/10.1007\/s11695-020-05100-3.","journal-title":"Obes Surg"},{"key":"4795_CR5","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1097\/00006534-197555030-00010","volume":"55","author":"L Ribeiro","year":"1975","unstructured":"Ribeiro L. A new technique for reduction mammaplasty. Plast Reconstr Surg. 1975;55:330\u20134.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s002660010057","author":"R Graf","year":"2000","unstructured":"Graf R, Biggs TM, Steely RL. Breast shape: a technique for better upper pole fullness. Aesthet Plast Surg. 2000. https:\/\/doi.org\/10.1007\/s002660010057.","journal-title":"Aesthet Plast Surg"},{"key":"4795_CR7","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-007-9062-1","author":"RM Graf","year":"2008","unstructured":"Graf RM, Mansur AEC, Tenius FP, Ono MCC, Romano GG, Cruz GA. Mastopexy after massive weight loss: extended chest wall\u2013based flap associated with a loop of pectoralis muscle. Aesthet Plast Surg. 2008. https:\/\/doi.org\/10.1007\/s00266-007-9062-1.","journal-title":"Aesthet Plast Surg"},{"key":"4795_CR8","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.bjps.2004.04.015","volume":"57","author":"M Hamdi","year":"2004","unstructured":"Hamdi M, Landuyt KV, Monstrey S, Blondeel P. Pedicled perforator flaps in breast reconstruction: a new concept. Br J Plast Surg. 2004;57:531\u20139.","journal-title":"Br J Plast Surg"},{"key":"4795_CR9","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000176892.38430.8a","author":"JL Levine","year":"2005","unstructured":"Levine JL, Soueid NE, Allen RJ. Algorithm for autologous breast reconstruction for partial mastectomy defects. Plast Reconstr Surg. 2005. https:\/\/doi.org\/10.1097\/01.prs.0000176892.38430.8a.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR10","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.bjps.2015.01.008","volume":"68","author":"SJ McCulley","year":"2015","unstructured":"McCulley SJ, Schaverien MV, Tan VKM, Macmillan RD. Lateral thoracic artery perforator (LTAP) flap in partial breast reconstruction. J Plast Reconstr Aesthet Surg. 2015;68:686\u201391.","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"4795_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.10.046","author":"M Hamdi","year":"2009","unstructured":"Hamdi M, Landuyt KV, Blondeel P, Hijjawi JB, Roche N, Monstrey S. Autologous breast augmentation with the lateral intercostal artery perforator flap in massive weight loss patients. J Plast Reconstr Aesthet Surg. 2009. https:\/\/doi.org\/10.1016\/j.bjps.2007.10.046.","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"4795_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.asj.2006.01.010","author":"JP Rubin","year":"2006","unstructured":"Rubin JP. Mastopexy after massive weight loss: dermal suspension and total parenchymal reshaping. Aesthet Surg J. 2006. https:\/\/doi.org\/10.1016\/j.asj.2006.01.010.","journal-title":"Aesthet Surg J"},{"key":"4795_CR13","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000208935.28789.2d","author":"DJ Hurwitz","year":"2006","unstructured":"Hurwitz DJ, Agha-Mohammad S. Postbariatric surgery breast reshaping: the spiral flap. Ann Plast Surg. 2006. https:\/\/doi.org\/10.1097\/01.sap.0000208935.28789.2d.","journal-title":"Ann Plast Surg"},{"key":"4795_CR14","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1097\/PRS.0b013e3181858fa4","volume":"122","author":"JP Hunstad","year":"2008","unstructured":"Hunstad JP, Repta R. Bra-line back lift. Plast Reconstr Surg. 2008;122:1225\u20138.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR15","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000200800.81548.37","author":"DJ Hurwitz","year":"2006","unstructured":"Hurwitz DJ, Holland SW. The L brachioplasty: an innovative approach to correct excess tissue of the upper arm, axilla, and lateral chest. Plast Reconstr Surg. 2006. https:\/\/doi.org\/10.1097\/01.prs.0000200800.81548.37.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR16","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000182606.92069.13","author":"AY Song","year":"2005","unstructured":"Song AY, Jean RD, Hurwitz DJ, Fernstrom MH, Scott JA, Rubin JP. A classification of contour deformities after bariatric weight loss: the Pittsburgh rating scale. Plast Reconstr Surg. 2005. https:\/\/doi.org\/10.1097\/01.prs.0000182606.92069.13.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR17","doi-asserted-by":"publisher","DOI":"10.1097\/AS9.0000000000000317","author":"A Alsuhibani","year":"2023","unstructured":"Alsuhibani A, Jonathan RT, Patricia RW, Jeff JBG, Alex CL, Marepalli BR, Ana LH. Metabolic and bariatric surgery utilization trends in the United States: evidence from 2012 to 2021 national electronic medical records network. Ann Surg Open. 2023. https:\/\/doi.org\/10.1097\/AS9.0000000000000317.","journal-title":"Ann Surg Open"},{"key":"4795_CR18","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-010-9479-9","author":"DJA Thornton","year":"2010","unstructured":"Thornton DJA, Fourie LR. Autologous augmentation-mastopexy after bariatric surgery: Waste not, want not! Aesthet Plast Surg. 2010. https:\/\/doi.org\/10.1007\/s00266-010-9479-9.","journal-title":"Aesthet Plast Surg"},{"key":"4795_CR19","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s00266-002-1478-z","volume":"26","author":"JF Pascal","year":"2002","unstructured":"Pascal JF, Le Louarn C. Remodeling bodylift with high lateral tension. Aesthet Plast Surg. 2002;26:223\u201330.","journal-title":"Aesthet Plast Surg"},{"key":"4795_CR20","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000244906.48448.5d","author":"AS Colwell","year":"2007","unstructured":"Colwell AS, Borud LJ. Autologous gluteal augmentation after massive weight loss: aesthetic analysis and role of the superior gluteal artery perforator flap. Plast Reconstr Surg. 2007. https:\/\/doi.org\/10.1097\/01.prs.0000244906.48448.5d.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR21","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31819ba1a8","author":"JP Rubin","year":"2009","unstructured":"Rubin JP, Gusenoff JA, Coon D. Dermal suspension and parenchymal reshaping mastopexy after massive weight loss: statistical analysis with concomitant procedures from a prospective registry. Plast Reconstr Surg. 2009. https:\/\/doi.org\/10.1097\/PRS.0b013e31819ba1a8.","journal-title":"Plast Reconstr Surg"},{"key":"4795_CR22","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000278004.24650.e6","author":"A Losken","year":"2007","unstructured":"Losken A, Holtz DJ. Versatility of the superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique. Plast Reconstr Surg. 2007. https:\/\/doi.org\/10.1097\/01.prs.0000278004.24650.e6.","journal-title":"Plast Reconstr Surg"}],"container-title":["Aesthetic Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-025-04795-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00266-025-04795-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-025-04795-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T19:27:11Z","timestamp":1751484431000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00266-025-04795-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["4795"],"URL":"https:\/\/doi.org\/10.1007\/s00266-025-04795-y","relation":{},"ISSN":["0364-216X","1432-5241"],"issn-type":[{"value":"0364-216X","type":"print"},{"value":"1432-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]},"assertion":[{"value":"7 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no financial interests to disclose in relation to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Written informed consents of analysis and publication of personal data were obtained from all patients.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}]}}