Lower Body Lift - Better All at Once or Two Separate Surgeries?

I am 39 yrs. old lost 70 pounds. Had a Board Certified Plastic Surgeon recommend for best results a lower body lift as opposed to my originally planned tummy tuck. So far I have decided only on the extended tummy tuck due to fear that the lower body lift is more serious. He also said that I could come back if I decided to in the future to complete the other areas towards a lower body lift. What's the diff. between doing it all at once or seperately as far as safety? recovery?

Doctor Answers 18

Body Lift Best in One Stage

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If you truly feel your backside (hips and buttocks) need correction, then I recommend doing it in one stage.  Personally, I feel this allows me to more accurately re-drape and tailor the skin.  Pulling the front and sides of the skin up is also easier this way. In fact, most of my body lifts also incorporate a breast lift at the same time.

I have two dedicated assistants who help me full-time, so our team is very efficient.  Our surgery times are under 6 hours in almost all cases.  In the right facility, this has worked out well for my patients and allows them to experience only one downtime, one recovery, and one expsoure to anesthesia.

Houston Plastic Surgeon
5.0 out of 5 stars 276 reviews

Lower Body Lift - Better All at Once or Two Separate Surgeries?

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Regarding: "Lower Body Lift - Better All at Once or Two Separate Surgeries?
I am 39 yrs. old lost 70 pounds. Had a Board Certified Plastic Surgeon recommend for best results a lower body lift as opposed to my originally planned tummy tuck. So far I have decided only on the extended tummy tuck due to fear that the lower body lift is more serious. He also said that I could come back if I decided to in the future to complete the other areas towards a lower body lift. What's the diff. between doing it all at once or separately as far as safety? recovery

The debate on the advisability of doing a STAGED Tummy Tuck followed a few months / years later by a Buttock/thigh Lift VS. a Lower Body Lift / Belt Lipectomy has been going on for years and a LOT of truths and half truths have been circulated.

Let me make it easier on you to choose.

How lucky do you feel? The lower body Lift is a MUCH more involved operation which WILL require 2-3 days of hospital stay (Expensive) and a longer recovery (expensive) BUT IF you do not have medical complications (blood clots, wound infection, wound separation, bleeding requiring emergency surgery - ALL VERY EXPENSIVE) then - you may some money by doing it in one stage. Treating a "simple" complication (IE pneumonia with intravenous antibiotics) will MORE than eat up any potential "savings".

 If you are a tough person who can put up with more pain and a longer recovery and are willing to gamble that this operation will NOT be associated with costly complications, then by all means, you should have it done in one stage.

There are however several real advantages to doing this operation in 2 stages separated by a few months.
- Tummy Tuck is an OUTPATIENT operation (a money saver)
- Shorter operation = cheaper
- shorter operation = less chance of complications (cheaper)
- shorter operation = quicker recovery (cheaper)
- Coming back 6-8 months after a Tummy Tuck allows the surgeon to do touch up procedures on the front (such as scar revision if needed, Liposuction, if needed etc) and do the Buttock / Thigh Lift for a higher degree of precision.

And now for the "dark side" consideration that no one wants to talk about. Surgeons make their living by being in the OP - operating. Not by being in the office driving their office staff to distraction. Cosmetic Surgery, like buying a car, can be an impulse buy. We the surgeons make much more money by doing bigger operations. It has been demonstrated time and again that only a minority of women who could benefit from a Lower Body Lift return for a Buttock Lift AFTER a Tummy Tuck. The vast majority are happy enough and do NOT come back for Part II. Surgeons are aware of it and some advise "getting it all done at the same time" option based on economic considerations.  

I present the 2 options fully to EACH one of my patients and strongly feel they should choose what is best for them rather than my imposing my will on them. I will support them in whichever path they choose.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Lower Body Lift v. Extended Tummy Tuck

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A lower body lift will give you more skin tightening benefit than an extended abdominoplasty.  You may find that it takes out excess rolls in your back, lift your buttocks and may give pull along your thighs and waist line.  I do not think the recovery is so much more difficult that it would be worth doing a procedure that gives a lesser result.  A careful examination of where your skin is loose might help with the decision, but I would not shy away from the body lift if that will truly give you a better outcome. 

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

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One or two stage lower body lift after major weight loss?

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Congratulations on your weight loss!

Lower body lifting done in a hospital setting with hospital inhalation anesthesia is costly, requires 1-3 days hospitalization (in most cases), and exposes you to all of the "sick" patients and hospital bacteria (can we say "resistant" everyone?) during the time when your incisions have not yet healed, and nurses touch not only you but also those other sick patients. Splitting the operation into two only doubles those concerns! Which part of that list I just wrote do you find interesting? The sad thing is that even the careful hospital-based surgeon who moves along with celerity, precision, and excellent control of blood loss STILL has to expose his or her patients to the anesthetic "routines" of the hospital and the less-than-bacteriologically-ideal environment!

How about outpatient lower body lift at a single stage for around $16000 TOTAL cost, with anesthesia techniques that allow you to walk to your car (assisted of course, and you not driving) an hour and a half after surgery is completed, with 2% risk of nausea or vomiting, good pain control (via multiple methods, each designed to help deal with a specific area or type of discomfort), NO exposure to sick patients, hospital bacteria, or operating rooms that are used for ruptured appendices, dead bowel, or "dirty" cases, a surgical team that does ONLY cosmetic surgery cases (and has 14 years of experience with outpatient lower body lifts), and did I mention that you get this superior and safer procedure for thousands less than the hospital version?

We have done over 250 outpatient lower body lifts in our accredited office surgical facility over the past 14 years, so who would recommend that you do two operations, with double the (minimal, but still double) risks, double the time off work, and increased cost? The answer is that only those surgeons who routinely have or anticipate more blood loss, increased chances of nausea and vomiting that mandate overnight admission. or lack of experience that (understandably) makes them more cautious. If you have other medical issues, then of course, outpatient lower body lifting  may not be for you, but I truly have only needed to do hospital lower body lifts in a handful of cases, and greatly prefer the safety, anesthesia skill, staff experience, and confidentiality of my office surgical facility. Lest you think I am some sort of surgical "cowboy" that takes unnecessary risks, I can truthfully tell you that we have performed over 16000 operations in our facility in the almost 20 years we have offered general anesthesia--all  without any deaths, heart attacks, or strokes. We routinely employ active anti-embolic foot pumpers to reduce the risk of blood clots, ambulate our patients early (obviously, since they go home!), and utilize full anesthesia monitoring and skilled CRNA anesthesia providers (Mayo Clinic cardiac experience, Twin Cities metro level 1 trauma hospital experience, etc.), not to mention our recovery room RNs with ACLS skills and over 45 years of combined experience (2 RNs).

Just so you know this isn't just to brag up my own practice, there are other skilled plastic surgeons who provide similar care and facilities; these practices, however, are in a very select minority and you must search a bit to find plastic surgeons with these capabilities and experience. But that is why I must humbly submit that just because there are those who do not operate at this level, you should simply accept what's out there. Interview several ABPS-certified plastic surgeons with acknowledged experience in lower body lifting and see what sounds good and what sounds bogus! Good luck and best wishes for a great result!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

One Operation: Save Time and Money

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The most transforming BODY CONTOURING LIFT FOLLOWING WEIGHT LOSS  is a Lower Body Lift. No single body lift procedure seems to restore a patients self confidence as does the circumferential Lower Body Lift.

However, many patients do not have the financial resources or the recovery time to devote to proceed with the LOWER BODY LIFT. In my experience and those of other large University Medical centers in Pittsburgh and Dallas, a Lower Body Lift can be safety performed in a reasonable operative time with the appropriate surgical team. Be sure to choose a surgeon who has a team to assist her/him in the operating room to both reduce the operative time and to perform the "extra" procedures (Auto-Augmentation of the Buttocks) that will result in an outstanding surgical outcome. Other than your own weight and general health, the experience of your surgeon and the surgical team is the most important factor in determining a safe and satisfying outcome.

Tummy Tuck vs. Lower Body Lift- A LOT depends on your surgeon

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hi there-

There really is no right or wrong answer to this question, and in the end you should do what you are most comfortable with...

It IS important to realize, however, that a LOT of what you might be told about these options (including what you are told here on this forum) is going to be heavily based (appropriately so) on the individual experience of the surgeon answering your question at the time...

In other words, some surgeons take 6 hours to complete a tummy tuck and much longer to complete a lower body lift- and their patients would therefore be at greater risk of postoperative complications related to the length of the surgery. They would also be more prone to need expensive hospital stays...

Other surgeons are able (for many reasons) to be more efficient- and by shortening the time of surgery are therefore doing the same operation with less risk for their patient.... (a 3 hour tummy tuck would have MUCH lower risks than a 6 hour tummy tuck).

So a lot of the answer to your question is going to be dependent on the surgeon you choose.

If you choose a surgeon that is able to safely complete a lower body lift in a reasonable period of time (less than ~5 hours), the risks are NOT significantly greater than for a tummy tuck. 

But either option could lead to an equally safe, good outcome in the right hands.

Lower Body Lift in 1/2 Stages

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I have on one occasion performed a lower body lift in stages when the patient originally felt she wanted only a tummy tuck despite my recommendaion for the lower body lift.  She got a nice result, but at a increased cost.  If you are otherwise healthy and a good surgical candidate, I would generally recommend  a one-stage procedure.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Combination Massive Weight Loss Surgery

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It's not unusual for patients who undergo massive weight loss to develop loose saggy abdominal and back skin. This is often accompanied by weakened abdominal muscles and buttock sag posteriorly. When this situation arises, a variety of treatment options are available.

In some cases, it may be possible to address the abdomen and back simultaneously by performing a circumferential lower body lift procedure. When this approach is taken, there's improved synergy, less expense and only one recovery.

In other cases, it may be appropriate to stage these procedures. Under these circumstances, an abdominoplasty would be performed first followed by a buttock lift at a later date

When these procedures are performed together, safety has to be the first priority. For this reason, we believe it's important to minimize the length of these operative procedures. An experienced surgeon, first assistant and surgical team that focus on efficiency can minimize the length of the procedure and reduce the potential for complications.

When these resources aren't available, it's appropriate to stage these procedures. Combination surgery isn't for everyone. Patients may have co-existing health problems which prevent this approach. If you're considering this approach, it's important that you discuss these issues with your plastic surgeon. Your surgeon should be able to formulate an appropriate surgical plan.

Lower Body Lift - one or two surgeries?

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As you surmised there are pros and cons about doing many surgeries at once vs separately. One surgery, one recovery speaks for doing many surgeries at once. However there are more risks such as blood clots in your veins (DVT or PE), increased risk for infection, etc.  Typically, I do a combination of surgeries but limit my operative time to less than 6 hours, BMI within normal range, non smokers, use anticlotting strategies to prevent blood clots. The informed consent with your surgeon should cover in great detail all of the above and more.


Tummy tuck or body lift

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Thank you for your question. A consultation would help determine which of the following procedures is the right one for you:

1) Traditional tummy tuck: Reduces a great amount of skin laxity, tightens the abdominal wall muscles and keeps the incision hidden in the underwear line.
2) An extended tummy tuck: Same as a tummy tuck, but helps to reduce more skin laxity around the flanks.
3) A corset tummy tuck: Adds a vertical scar and breast fold scar, but reduces a significant amount of vertical skin laxity in addition to the horizontal skin laxity and creates the most hour-glass type figure. Downside is more visible scar
4) A belt lipectomy (or lower body lift) helps lift the outer thighs and buttock in addition to the benefits of an extended tummy tuck.

Options 3 and 4 usually have a significant amount of skin laxity that is being addressed. Liposuction is usually added to all of the procedures to help improve the results. I would recommend visiting with a board certified plastic surgeon who can spend time with you to explain the different options in more detail.

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.