100+ Pound Loss, Apple Shape, Stubborn Back/Stomach Fat: LBL or LBL with Anchor?

33, 5'5, 155. How do you as a surgeon, irregardless of extra scars, decide whether to do LBL or LBL with fleur de lis, and why are some surgeons able to get rid of significant upper abdomen fat with LBL alone and get a feminine shape and some surgeons can't?

Doctor Answers 8

Lower body lift or lower body lift with fleur-de-lis?

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The short answer is that every patient is different and every surgeon has different skills and experience. Only physical examination will allow an experienced plastic surgeon to make the best recommendation for you. Many patients on this forum have found that there are often different opinions on just about every topic imaginable. That is why careful research into the training, years of experience, ABPS-certification, type of practice, numbers of body lift procedures performed, and before-and-after photographs is critical. Comments from other patients (seen in the reviews) can also give you a "feel" for the type of surgeon you are dealing with, as well as the staff that helps your surgeon shoulder much of your care.

I'm sorry I am not able to answer in more scientific detail, but without actually seeing a photograph (adequate at best), or examining you in person (really needed to evaluate laxity in multiple dimensions), no on-line expert is able to answer this in the detail you require before making this important decision! See the link below for more discussion. Note that the fleur-de-lis patient is one who had (just) a frontal panniculectomy, NOT a lower body lift, or a lower body lift plus fleur-de-lis modification.

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Lower Body Lift Options

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It's not unusual for women to have loose saggy skin following a 100 pound weight loss. This loose skin can affect almost any area of the body.

Although it's difficult to make a specific diagnosis without pictures or a physical examination, your history suggests several problem areas. These include an apple shape with redundant abdominal tissue with a roll of tissue that extends circumferentially around your back. This is most likely associated with buttock sag. In addition, there appears to be significant fat accumulation of your back and abdomen.

A large variety of surgical options are available to treat this type of problem. Under these circumstances, a lower body lift would be appropriate, augmented at a later date with additional liposuction of the abdomen and back. In the majority of patients, a fleur de lys excision won't be necessary. Unfortunately, this decision can't be made without a physical examination.

The lower body lift circumferentially removes excess skin and fat from the lower abdomen and back. It simultaneously tightens the abdominal muscles while lifting the lateral thighs and buttocks in an upward direction. It's associated with excellent clinical results and high levels of patient satisfaction.

If you're considering a lower body lift, it's appropriate to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic deformity and achieves your aesthetic goals.

Lower Body Lift to remove loose skin

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Its really difficult to tell what you need without a  physical exam.  If you are considering a lower body lift - this procedure (LBL) is also referred to as  circumferential body lift = belt lipectomy.  This procedure is essentially 3 procedures in one: extended tummy tuck + waist/lateral thigh lift + buttock lift.  The buttock lift can also include buttock augmentation.  The lateral thigh lift will help contour the lateral aspect of your thighs.  The procedure can taken between 5-7 hours depending on the amount of tissue/skin that needs removal/treatment.  Please see a board certified plastic surgeon to learn more about your options.

Dr. Sugene Kim

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Body Lifts Should Be Tailored to YOUR Body

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Every body lift is (or should be) different and tailored to the individual. What gives a result for one person's successful weight loss may not apply to another.  Whether or not you can achieve an hour glass shape with a body lift has a lot to do with the relationship of your waist to your hips.  If you have narrow hips , your waist line will not seem as small as if yoiu have wider hips.  A midline vertical scar, fleur de lis pattern, can add time on to the length of your surgery and can create blood supply issues.  It is good to use this approach when there is significant benefit to be gained.  I will use it for people who already have a large midline scar or in people who have a very stretched skin envelope that may not respond to a belt style removal of skin. 

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Incisions and scars for lower body lifts

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Congratulations on losing 100 pounds.  Lower body lifts, like any type of cosmetic surgery, must be customized to each patient's situation.  If pulling dowward on the abdominal skin does not leave significant upper abdominal excess skin, then a lower incision is all that is needed.  But, if there is still a lot of loose skin above the umbilicus, the vertical excision is required to get the best result.  I have never had a patient upset with the vertical scar when it is presented as a trade-off for better skin tightening.

Bruce E. Genter, MD, FACS
Abington Plastic Surgeon
4.3 out of 5 stars 17 reviews

All lower body lifts are not the same

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The changes that occur to one's body following massive weight loss are highly variable depending upon your own body type and fat distribution. These differences need to be accounted for in the planning of the lower body lift procedure. Patients will often have horizontal as well as vertical skin excess which may require the fleur-de-lis approach. This needs to be determined on a case-by-case basis. There is no one approach that fits all patients and this is where the experience of your surgeon is of vital importance. I think it's important to understand that the approach to post bariatric patients is very different from non-weight loss patients. These type of situations are best approached by a surgeon experienced with post weight loss plastic surgery. Certainly, you have some excellent surgeons in the New England area that can guide you through this process. Participation in forums such as this or others such as those on obesity help can provide valuable guidance in finding the best surgeon for your situation.

Best of luck to you.

Mitchel Krieger, M.D.

Mitchel Krieger, MD
Fairfax Plastic Surgeon

Lower Body Lift

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Congratulations on your fantastic weight loss.  It sounds as if you would be an excellent candidate for a LBL which is a procedure that I have found to be very useful in removing large amounts of excess skin in a circumferential fashion.  You have a number of excellent surgeons in the Boston area with whom you can discuss benefits/risks of this procedure.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Lower body lift

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These type of decisions are made based on the amount and distibutuin of the excess skin and fat for a particular patient

David L. Abramson, MD
New York Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.