Can a Full Body Lift Be Done in Seperate Surgeries Instead of One?

Question

I recently went to get a consultation from a plastic surgeon and he informed for the best to get most benefit would be to get an upper and lower lift, a circumferentual body lipectomy.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding if a full body lift can be done in separate surgeries instead of one. Thank you for your history. First, we need to clarify what a full-body lift entails. In my mind, a full-body lift entails the upper and lower bodies. Regarding the lower body, this would be a 360 circumferential lower body lift combined with a thigh lift reduction. During a 360 circumferential lower body lift, the pubic region is raised and reduced, the abdominal wall is sutured, and the abdominal muscles are plicated. Excess skin and fat are removed. The hips are lifted and reduced, and the buttocks are lifted and also reduced. This winds up with a scar going ultimately around your lower body. Some plastic surgeons call this a belt lipectomy. In addition, a vertical medial thigh lift can be performed simultaneously.
The vertical medial thigh lift includes thigh liposuction and an incision from the groin to the knee. This is a full day and should not be combined with other surgeries. Please give yourself at least two to three weeks to recover from this procedure before your second surgery. The second surgery would entail your upper body lift. An upper body lift would typically entail an arms reduction/lift or brachioplasty. This would include arm liposuction and an incision from the armpit to the elbow. In addition, you may need an upper back lift. This would be an incision that goes across the back or an incision that goes down the sides to eliminate skin and fat from the upper back. If you need a chest reduction, this can be performed simultaneously. This may require removing excess skin and fat if you are a male. If you are a female, it may require a lift and implants. This can all be performed at the same time. Therefore, if you are looking for a total body makeover to include the arms, chest, back, buttocks, hips, tummy, and thighs, this would require two separate surgeries or more. I would not suggest you have an upper or lower body lift simultaneously. This is too much. I hope my answer helps to clarify whether a full body lift can be done in separate surgeries instead of one. Good luck. 
Sincerely,
Dr. KAtzen

Larry S. Nichter, MD, MS, FACS · Answer

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 and often use a surgical assistant for efficiency, 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. #bodylift#postweightlosssurgery

Lewis Albert Andres, MD · Answer

Thank you for your question!  These procedures may be safely combined at one setting, given you are healthy and without significant medical comorbdities.  I would consult with a plastic surgeon who would examine you and discuss the various options and assist you to decide if you wish to undergo all of the procedures at once or at a two-staged procedures - I believe it is safe and reasonable to perform this at one procedure.  An examination of the amount of work to do with each will also make the decision.  There would obviously be a cost saving and recovery benefit for a one-stage procedure.  However, your safety should not be sacrificed for these reasons.If it was deemed wisest to stage these procedures, you will have to decide which procedure(s) are most important to you.  You should devise a priority list and discuss this with your surgeon and several of these procedures will still likely to be combined at the same procedure.  Thank you for your question!  Hope that his helps and best wishes for a superb result!

Christian A. Prada, MD, FACS · Answer

My preference is to perform both the Abdominoplasty and Body Lift together in one stage. I find in my hands it is far more cost effective and easier in terms of a single recovery for both procedures to be performed together. In addition, most patients usually require additional procedures such as a breast lift, facelift or thighlift, which can more easily be performed at the second stage surgery. Find a surgeon who performs several of these a year and look at several pictures of patients. Getting the scars to look as even as possible is a priority in my practice.

Thomas Fiala, MD, FACS, FRCSC · Answer

What are the basic principals of body lifting in general?

	1)  excise the most lax skin possible,

	2)  do it with a minimum of complications,

	3)  make it look nice.

	Separate procedures allow you to maximize the skin resection in each area.  Combining procedures (i.e. tummy tuck with lower body lift) tends to make the surgeon be more conservative with one of the areas of skin resection, for fear of wound separation.  It's a matter of competing priorities and skin tension.

	Studies clearly show that longer surgeries (combined) tend to have more post-op complications (hospitalization, transfusion, DVT/ PE, etc.).  Using a team approach with different surgeons can reduce the time, but has the disadvantage of sometimes LOOKING like different surgeons did different things!

	Of course, fewer surgeries is more convenient for the patient.  

	It's a trade-off.  I prefer to do a better, safer job with multiple procedures.

Joseph Michaels, MD · Answer

Every surgeon has their own preference for combining or separating procedures. I prefer to separate upper and lower body lift procedures. The main reason for this is that the tension for the lower body lift is in the opposite direction as the tension for an upper body lift. Since the procedures pull against one another, I feel I cannot optimize the tension for either procedure meaning you may have some residual skin laxity. The advantages of staged procedures is that the surgeries are shorter and the recovery quicker and it will also give the opportunity to make any revisions to previously performed surgeries if needed. The down side is that it may cost slightly more to do separate surgeries and you need to take time off a second time.

	I hope that helps. Good luck

	Dr. Joseph Michaels

Tom J. Pousti, MD · Answer

Thank you for the question.

	Yes a full body lift can be done in separate stages or in a single stage depending on the specific situation. The patient and/or surgeon may have reasons to prefer one route over the other.

	It would behoove you to seek consultation with well experienced board-certified plastic surgeons to address your specific concerns.

	Best wishes.

Kamran Khoobehi, MD · Answer

The patients pot massive weight loss will need body lift and lower body lift. I prefer circumferential body lift at the first setting and do the lower body lift 3-6 months later. Dr. Michael's explained it very well.

George Commons, MD (retired) · Answer

Should a body lift be one surgery or multiple. MULTIPLE usually. Certainly if a member of my family had a body lift I would want it staged. Long involved surgeries come with MORE complications. Be smart and go the staging route. Pain control is also much better. Dr George Commons, MD

H. Michael Roark, MD (retired) · Answer

Yes, There are logical reasons to perform complex multi-part surgeries in stages. Length of time under anesthesia, the necessity of turning the patient over multiple times, adverse tensions on adjacent anatomical regions, and incapacitation of the patient all have to be planned. Possible complications, as well as predicated results must be considered. Corrective secondary surgery, such as a scar improvement may be done with the second stage procedure.

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