Thigh and buttock lift after massive weight loss. 
Surgical and medical treatment of obesity involves a significant loss of weight (30-90 kg) during a short time (12-24 months).  The technical procedures for treatment of skin excess on the thigh create scars on the posterior buttock fold and the inguinal fold.  Since 1999, the authors have used a heart-shaped incision for buttock thigh lifts.  The authors have treated these regions with a two-step intervention.  First, abdominal lipectomy and lipoaspiration of the internal and external face of the thigh are performed.  Then after 6 months, the buttock thigh lift is performed using a heart-shaped incision traced previously in an anterior direction from the perianal region on the inguinal fold and spread the iliac crest to the intergluteal fold posteriorly.  The skin dissection is performed on the scarpa aponeurosis so as not to damage the lymphatic system.  In their experience with 15 patients, the authors had no infectious complications, or lymphorrea.  The operative time was generally 3(1/2) h. The patients did not require blood transfusions and were on sick leave for 3 to 4 weeks.  The surgical procedure that we propose reduces the complications and the surgical time with a good result.