After a full body lift, what is the skin tied down to? Is the skin sutured down to fascia or ligaments?

I was just wondering: after a full body lift, I know the upper body skin and lower body skin are obviously sutured together (thus creating an incision line) but how do you stop the newly closed skin from sliding around the body? Is it sutured down to the fascial covering the muscle? Or is the the only thing the skin is tied down to are the upper and lower portions of the skin itself?

Doctor Answers 5

Suturing after body lift

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Thanks for your great question.  It is clear you have done your research and know your subject.

The suturing usually involves a couple of different tissue layers.  

At the incision site, usually the fascial layer within the fat is sutured together and then the skin sutured together over that.  This technique was popularised by Lockwood and provides a strong repair and smooth contour.  Depending on the location this method anchors down the skin back to the body.

Around the body, particularly on the abdomen, "quilting" sutures are commonly used.  As you suggest, these anchor the skin and fat down to the underlying fascia that is covering the muscle or other deeper structures.   These quilting sutures are important and have a number of functions, including obliterating dead spaces, securing the skin, redistributing tension and may help improve the scar.  In my practice the use of quilting sutures means drains are not necessary in any body contouring surgery.

Kind regards,


Dean

 

Body Lift Sutures

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With a full body lift there is quite an open space created between the upper and lower flaps that can pose a problem with healing. While doing the dissection most surgeons try to leave as much natural attachment to the underlying facia as possible – especially along the sides under the under arm to hip area. In the back, it is common to tack down (or stitch) the deeper layers of the tissue (scarpas fascia) to the sacral fascia to close down the space, but we also rely on the drains and the compression garments to close down the open/dead space and allow the tissue to heal down. Minimizing twisting and lifting after surgery also helps give the skin flap a chance to adhere to the tissue underneath it. If the tissue does not stick down you can develop permanent pockets under the tissue that can fill with fluid and cause trouble healing (it’s called a seroma). This can cause bulges, irregular scarring and necessitate further surgery.

After a full body lift, what is the skin tied down to? Is the skin sutured down to fascia or ligaments?

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The skin is attached to the underlying tissue naturally and those deeper tissues are also sutured together.

Fascia sutures

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 In the Lower Body lift operation, a flap of tissues is lifted from the muscles.  The musculature is left under and you place several layers of sutures to close  the different layers.  The is no only one suture line

Body lift

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Hello and thank you for your question. Great question!   It depends on the type of body lift.  Often there are anchoring sutures to the fascia in order to try to prevent drifting  of the scar over time.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained 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.