Who is a candidate?

Lower body lift or a belt lipectomy can offer a dramatic change in appearance for massive weight loss (MWL) 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 with or without 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 resuspensionof 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 12 to 18 months for their tissues to completely stabilize prior to scheduling this surgery.

How is it done?

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. Rappaport 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. The closure of the incisions over drains, using permanent or long lasting absorbable sutures to reconstruct the deeper layers, is of prime importance.

Recuperation

Both the lower body lift and belt lipectomy requires at least one night stay in the hospital. You will have multiple drains placed during surgery. These stay in place for 5-14 days and are removed based upon the amount of drainage recorded. All of the stitches dissolve. The incisions are covered with surgical glue (Dermabond), and/or tapes. We will ask you to wear a compression garment for up to 6 weeks. Some numbness around the trunk region is common, but usually temporary. In general, it takes 10-14 days to comfortably perform daily activities. Driving is discouraged for 2 weeks. It may take several weeks to return to preoperative energy levels. A reasonable assessment of the results can be determined at about 3 months. The scar will take at least one year to mature and fade to a lighter color.

Other Options

Buttock lift, abdominoplasty

ASK DR. RAPPAPORT

I just have some fatty deposits along the outer thighs. Wouldn't liposuction be effective in treating this area?

For women, this is a common location of fat collection. It is common for MWL patients as well. Treating this area with liposuction alone, however, may not improve the appearance and contour. In patients with marked laxity of the skin and underlying soft tissue, I have found a lateral thigh lift to be effective. When MWL patients are having a lower body lift, the outer thigh often needs 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.

What kind of scars can I expect?

The scars extend circumferentially (in a complete circle) around the body. The scars may become slightly widened. Though rare, scars may become raised and thickened.

What complications are associated with the lower body lift?

Complications are a risk of all surgical procedures. It is important to carefully choose a surgeon experienced in this particular procedure. My patients have had few complications, however it is essential that all candidates understand the risks. Wound healing complications would be the most common. Patients having a body lift after massive weight loss understand their skin has been compromised. Reconstructing these tissues presents a surgical challenge and must be handled with care. When wounds result from separation of the incision, local wound care is required and can be revised at a later time if desired. Seromas are fluid collections under the skin. Although the drains are designed to prevent these from occurring, there is a possibility they can happen. Lower extremity edema (swelling) may be prolonged. Migration of the scar can also occur.

The most serious complication is deep venous thrombosis. This is a blood clot most often forming in the calf. If it breaks off, it can lodge in the lung. Since this procedure limits your mobility in the immediate postoperative period, the risk does increase. Sequential compression stockings worn during and after the procedure will help decrease this risk. Getting mobile early in the postoperative period helps the circulation, as will prescription blood thinners such as Lovenox, if indicated. Smokers are at greater risk and must stop completely for one month before and one month after the procedure in order to optimize the wound healing ability. Those with serious medical conditions must have clearance prior to surgery being scheduled.

When can I return to work?

This, of course, depends upon what you do for a living. In general, it takes at least 10 days to two weeks before returning to daily activities. Most patients do not return to their normal energy levels until a few weeks after the procedure. You will constantly be monitored and evaluated during your follow-up office visits and together we can determine what is best for you.