Hello, and thank you for your question regarding whether a body lift is required to remove the loose skin after a 120-pound weight loss. Thank you for your history and your pictures. A 360 circumferential lower body lift is also known as a belt lipectomy or extended tummy tuck with a posterior butt lift. It’s an incision that goes from the front, around your lower body, and joints at the top of the butt crack. In your case, a 360 circumferential body lift would be perfect. During a 360 circumferential lower body lift, an abdominal plasty, hip lift/reduction, and buttock lift/reduction are performed. During your abdominoplasty, the pubic region is lifted and reduced. The rectus abdominis muscles are pliacted and the muscles are brought together. Excess abdominal skin and fat are removed, and the belly button is reconstructed. With a lower body lift also the excess skin of your hips would be removed, and your butt would be lifted. With the butt lift, a lot of the butt wrinkles would be permanently removed. If your chest bothers you, you could have the procedure done simultaneously. This would include a formal breast reduction. This can either be done with an incision underneath the breast as it joins the upper abdomen or an incision from the armpit down your side. Your chest reduction could be considered treatment for gynecomastia. However, most of your breast tissue is probably leftover residual fat from weight loss. Gynecomastia tissue is usually much firmer than residual fat. Either way, with your breast reduction, you would achieve significant improvement. If you choose the horizontal incision, the incision would be placed underneath the breast. However, this incision position leads to a quite visible scar. Most patients prefer the stealth incision. The stealth incision is made from the armpit down the side of your body. The chest is lateralized and flattened. The skin is removed, and the upper back is tightened. The nipple area complex is then relocated. Good luck.
