Lower Body Lift - Post Massive Weight-Loss Body Contouring


Lower Body Lift – Post Massive Weight-loss Body Contouring

This article discusses the work horse of post massive weight loss body contouring: the lower body lift. Also known as the belt lipectomy, circumferential abdominoplasty and body lift, the lower body lift is the most sought-after procedure following massive weight loss.

Why is this procedure called a lower body lift? The “body” part comes from the 360-degree incision all the way around the body which allows lifting of the mons pubis and the front of the thighs, lateral thighs on the side, and buttocks in the back. “Lower” comes from sometimes having to address skin laxity of the upper abdomen and mid back. This is called an upper body lift and will be discussed in a future article.

Technically speaking, there are some differences between a lower body lift and a belt lipectomy. The incision for a lower body lift is lower than that for a belt lipectomy and therefore has a better pull on the lateral thigh area. However, the higher incision for the belt lipectomy helps create a narrower waistline.

Personally, I choose the lower body lift incision as I believe there are more advantages to this incision than a higher one. These include:

1. The ability to auto-augment the buttocks (use your own fatty tissue to create a mound and augment the buttock)
2. Makes a rounder buttock rather than a long and square one as is the case in a belt lipectomy.
3. The ability to auto-augment the hips (a variation of a buttock flap that I thought up after noticing a boxy appearance of the hips in some of my earlier patients following a lower body lift). This not only augments the hips but also makes the waist look narrower.

What can you expect as far as a contour improvement following a lower body lift?
Obviously this is heavily dependent on your anatomy as well as the experience and expertise of your surgeon. It is also dependent on whether you have reached your ideal body weight or not.
I help patients assess what to expect by showing my patients pictures of previous patients with similar shapes to theirs.

The Operation
We do the patient’s blood work and usually run an EKG test. Next we’ll discuss home medications, including which medications they should stop post-operation and which to continue. At a preoperative visit, I mark the patient, take photos, and give the patient prescriptions for pain medication and antibiotics. The patients are instructed to go on a liquid diet two days before the surgery. All final questions are answered at that time.

At surgery in the pre-operative area, Ted hose stockings are worn and sequential compression devices (SCD’s) are prepped for use.

I reserve anticoagulants for certain patients whom I feel are at a higher risk for DVT and subsequent pulmonary embolus. Not everyone receives them because of the risk of bleeding when making such long incisions accompanied by a significant amount of dissection. One has to make a judgment call on which patients the risk of DVT outweigh the risk of bleeding.

Surgery starts on the back, by performing buttock and/or hip augmentation if needed. The patient is then carefully turned onto their back and the tummy tuck portion gets completed with the use of drains. All sutures are buried and dissolvable so there is no need for suture removal later.

Post-Operative Care
I book the patient for a two-night hospital stay although they can be discharged after one night, or even three nights, if necessary. All my surgeries are performed in an accredited hospital.

Patients are seen back at the office when their drains are ready to be removed. My nurse keeps in touch with the patient on a daily basis and patients are also encouraged to call with any questions they may have.

This article has been written by Dr. Peter Fisher, a board certified Plastic Surgeon in private practice since 1990. He has specialized in post bariatric body contouring since 2000, with some unique innovations of his own. Contact us today for more information! He currently resides in San Antonio, Texas.

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San Antonio Plastic Surgeon