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Body: Lower Body Lift

(Belt Lipectomy)

The indications

Lower body lift or a belt lipectomy can offer a dramatic change in appearance for MWL (massive weight loss) patients, or those who are victims of time, gravity or genetic predispositions. This procedure is tailored toward those who not only have excess skin in the abdominal area, but sagging tissue extending 360 degrees around their torso. Body lift surgery helps elevate the entire lower body by tightening the abdominal wall, removing excess skin on the tummy, thighs and buttocks followed with liposuction for additional contouring. Most patients will come into the office and lift their skin to demonstrate the look they are seeking—this mimics the potential “resuspension” of tissues that can be accomplished with this surgery.

Smokers are not good candidates for this procedure because of the detrimental effects on wound healing. Patients, who do smoke, will have to stop completely for one month prior to and after the procedure in order to optimize their healing process. Patients with bleeding disorders, heart disease, diabetes and high blood pressure have higher risk factors that will be discussed during the consultation. This is not an operation to counter obesity. Those over 50% of their ideal body weight are not good candidates. Patients who have experienced massive weight loss may be asked to wait 6 to 12 months for their tissues to completely stabilize prior to scheduling this surgery.

The procedure

The lower body lift is done under general anesthesia. Think of it as a facelift for your trunk region. The procedure can take 4-6 hours depending on the size of the patient. Immediately before surgery, Dr. Watanabe will mark the skin in order to have a map or blueprint for the incisions. The amount of tissue to be removed is actually determined in the operating room. The patient is placed in several different positions during the procedure to remove as much tissue as possible.

A belt lipectomy incision is placed a bit higher on the trunk and extends circumferentially (all the way around) at or just above the level of the pelvic bone. This allows the surgeon to enhance the waistline more effectively. A lower body lift, on the other hand, has an incision which is lower on the trunk extending circumferentially. This would be easily hidden by a bikini. This type of lift has a greater effect on the outer thigh and buttock contours. When MWL patients are having a lower body lift, the inner and outer thighs often need to be treated with liposuction in order to optimize contour. With the accompanying lift, there is little chance the tissue will fall—the results are more permanent.

Liposuction is not a substitute for a body lift. Liposuction may improve appearance and contour, but does not address skin sag.
The closure of the incisions is identical, using permanent stitches to reconstruct the deepest layer. The upper two layers are closed with dissolving stitches and a skin closure is performed with permanent removable sutures.

You can expect

Both the lower body lift and belt lipectomy require at least one night stay in the hospital. It is not unusual for patients to stay two nights. You will have four to five drains placed during surgery. Two are placed in the front and the others are placed in the back. These stay in place for 7-14 days and are removed based upon the amount of drainage recorded. Suture removal is done 7 to 10 days following the initial procedure. Right after surgery and usually for the first one to two weeks, dressings are used to cover the incisions. We will usually ask you to wear a compression garment after all of the drains are removed. Most patients report tightness in their abdominal region and have difficulty standing upright for several days. Some numbness around the trunk region is common, but usually temporary.

After massive weight loss, skin is compromised and wound healing is not as efficient. Fluid collections under the skin, called seromas are usually prevented by using drains, but can still occur. Lower extremity swelling may be present for a prolonged period. Deep vein thrombosis (blood clot) is a complication we work to prevent through compression stockings and encouraging mobility early in the postoperative period to help with circulation.

In general, it takes 10-14 days to comfortably perform daily activities. Driving is discouraged for 2 weeks. It may take up to two months to return to preoperative energy levels. Swelling may take 4-6 weeks to begin to resolve. A reasonable assessment of the results can be determined at about 6 months. Scars extend circumferentially (in a complete circle) around the body. These scars will take at least one year to mature and fade to a lighter color.

Other Options

Buttock lift, abdominoplasty (Tummy Tuck)

A word about financing

Lower body lift can be made very affordable through our partners at CareCredit. Visit them at Lupe or Ellies would be happy to answer any of your questions or assist you with the necessary paperwork.

Insurance Notes

Lower body lift is considered a cosmetic procedure and is not covered by insurance.


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