Avoiding Pulling Incisions After Lower Body or Inner Thigh Lift

I commend you on your research before surgery. Postoperative activity and position is critical. For my patients who undergo a 360 lower body lift or circumferential body lift with a medial thigh or spiral thigh lift, I have them do minimal activity. It is critical that you do no stairs for approximately three weeks after a 360 lower body lift and medial thigh lift. In the postoperative period, there are essentially only three reasons why you need to get out of the recliner. The three reasons are to urinate, defecate, and go to get food. To minimize activity from needing to go to the bathroom to urinate, I have my patients use a bladder catheter. This eliminates the need to go to the bathroom to urinate. For approximately 3 to 5 days after your 360 body lift, you will be constipated. This will therefore eliminate the need to get up to defecate. To minimize the need to go to the kitchen, I suggest my patients purchase a small college dormitory style refrigerator. This refrigerator should be placed next to your bed or recliner. This minimizes the need to go to the kitchen. It is essential to have minimal activity for 7 to 10 days after your 360 circumferential or lower body lift and medial thigh lift. From these procedures, less activity is better than more activity.

The sensation of pulling along suture lines following body lift and thigh lift surgery is often unavoidable. These procedures remove significant amounts of tissue from the involved areas and out of necessity require some tension along the wound closure. During these procedures, wounds are closed in multiple layers to minimize tension. This, hopefully, decreases the potential for wound breakdown, but in some cases, wound breakdown may occur anyway.In the post-operative period, it's important to use good judgement and avoid excessive activity. However, it's also important not to be sedentary because this can increase the potential for lower extremity blood clots and they're life threatening complications.It's, therefore, important to thoroughly discuss post-operative activity levels with your surgeon. Your surgeon should be able to give you specific directions that will, hopefully, optimize your post-operative course.

Good question regarding recovery after a body lift or thigh lift.  Your surgeon will discuss timing of surgery and choice of surgery to minimize the impact of the sutures and surgery on postoperative activity.  In my practice, I recommend a more conservative approach as a more rapid recovery and resumption of activity usually leads to healthier patients and more salient results. 

It's true you want to avoid activity that puts tension on your incision lines after surgery. The more tension you place on your incisions, the more likely you are to have a widened scar or wound healing problems. Some tension is unavoidable, but you will need to make some changes in the initial postoperative period. You will have drains in place, and will have dressings or garments that you will need help with. You are correct in recognizing it will be difficult to go to the bathroom initially, and you will need help with some basic activities early on.
I typically have my patients go to either an aftercare facility or hospital for the first night or two. Some patients prefer to stay longer, especially if they are in a situation where they do not have enough support at home, or if they have too many demands on them at home to allow time for peaceful recovery. (This is often the case when the patient is the primary caretaker of everyone else at home!) Afterwards, I would recommend temporarily staying with a family member or friend so you are not tackling 3 flights of stairs right after surgery.
Keep in mind you can also have surgery in two stages, with the circumferential body lift (or belt lipectomy) in one surgery and the thigh lift in a separate surgery. How many areas you include in one operation does affect your recovery process and recovery time.
I would recommend consulting with a board certified plastic surgeon to see what you are a good candidate for, come up with a plan that fits your needs and life demands, and go from there.
Good luck!

Pulling on incisions are a concern following lower body lifts and inner thigh lifts. To some degree, tension on the wounds are unavoidable and so the goal is to limit this with assistive devices such as abductor wedges, toilet seat risers, walkers, etc. Certainly, loose clothing will also be less likely to irritate or pull on the wounds.
A third floor residence is an imposing situation and you may want to consider alternative living arrangements such as an extended care facility or residence.

Often when there are multiple regions of the body that are in need of skin removal the procedures are performed in stages.  Lower body lifts are usually performed early on, because these operations also begin the correction of the loose skin of the thighs.  Thigh lifts are done later and build upon the improvements achieved with the lower body lift.  All incisions are closed in multiple layers, making disruption of the incisions unlikely with normal and unstressed movements of the body.   Of course, it is good practice to avoid pushing, pulling, or other stressed movements of the body.  Stair climbing is ok, but keep this activity as limited as possible.  After a few weeks of healing, the incisions begin to get stronger and depend much less on the sutures to hold them together.

In performing a lower body lift, the way I do it is that the back is not flexed in any extreme way, but the front is closed with some flexion. Patients may feel pulling in a seated positoin , and may be better off flat or slightly flexed at the waist like in a beach chair position.

Hello,

I prefer to do lower body lifts in stages (extended tummy tuck first and later buttock lift) and with this design I have not had an incision pull apart in the twelve years I have been doing them. Different docs will have different opinions on this one for sure.

 

Best Regards,

 

John Di Saia MD

There is going to be a pulling on these incisions, you worry about it. We worry about it.
You have to be very careful, and you need help for almost two weeks. Sit on the toilet straight, no bending.
Urination in the shower and shower after have to use the bathroom use surgical scrub soap.
For inner thigh lift, avoid spreading the legs open.