Is it possible to do a 360 lower and upper body lift at the same time? (Photo)

Question

I had an extended tummy tuck after a 150 lb weight loss and my surgeon said I didn’t need a circumferential body lift because I didn’t have too much skin around my hips/back. That turned out to be a lie and now my tummy tuck seems to have failed as I have loose skin on my upper and lower abdomen again with this giant tire of excess skin around my hips.

Randal Haworth, MD, FACS · Answer

If you’re dissatisfied with the results of your tummy tuck and believe there may be issues, it’s crucial to discuss your concerns with your surgeon. They can evaluate your situation, explain the reasons for the outcome, and explore potential options for improvement or revision surgery. Seeking a second opinion from another qualified plastic surgeon may also be beneficial.

Best of luck !

Best of luck !

J. Timothy Katzen, MD, FACS · Answer

Hello,
Thank you for sharing your history and pictures. Based on what I see, an extended posterior body lift would be suitable for you. You might also want to consider having a 360 circumferential lower body lift with a revision of your tummy tuck, as your pictures show excess skin and fat on both hips and buttocks.
Alternatively, an extended posterior body lift could involve an incision from the lateral aspect of your prior tummy tuck, extending over your hips, across the top of your buttocks, and meeting at the top of the vertical gluteal cleft. This procedure would address issues with your hips and buttocks. Additionally, a vertical tummy tuck, involving an incision from the xiphoid process through the umbilicus to the pubic region, could be considered. This is essentially a Fleur de Lis (FDL) procedure, addressing excess skin and fat in the upper abdomen. However, most plastic surgeons would agree that a well-performed, complete 360 circumferential lower body lift would be sufficient, eliminating the need for the vertical incision.
I hope this information is helpful in deciding whether to undergo a 360 lower and upper body lift simultaneously.
Sincerely,
Dr. Katzen

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question!
I am sorry to hear about the frustrations along the way of your journey. A circumferential body lift would help with the problem areas that you demonstrate on the second photo. An upper body lift commonly includes a breast lift/mastopexy on the anterior/front part of the body with an upper back lift with an incision situated near the bra line to remove extra, loose skin across the mid/upper back. The lower body lift has an incision situated across the top of the gluteal/hip bone region to remove extra loose skin across the lower back as well as lift the buttocks. In general, we would not want to do two procedures that have an opposite direction of pull at the same time, as this could cause excess tension at both sites.

Murat Diyarbakirlioglu, MD, FEBOPRAS · Answer

To be honest, although you have done tummy tuck, but we need to make a tummy tuck revision and extend the scar to the back, so complete 360 body lifting will be done. 
From the photos examined and amount of weight lost, Fleur de Lis will be recommended since you have excess skin in the upper abdominal area.
Upper back lifting can be done at the same session. Of course, a blood test will need to be done before the surgery to check the HGB.

Rodolfo Castillo, MD · Answer

The images reveal that the tummy tuck addressed the surplus of vertical skin; however, there remains an excess of horizontal skin that necessitates a fleur-de-lis procedure: a vertical incision from the ribs to the pubic area. Additionally, to get the best results possible it is crucial to eliminate excess skin on both the hips and buttocks, achieved by extending the original tummy tuck incision to 360 degrees. This extension enables improvement, encompassing both buttocks lift and lateral thigh lift.
Best, Dr Rodolfo Castillo.

Jeffrey M. Darrow, MD · Answer

Thank you for your photographs. From your photographs, it appears that the area which is of most concern for you is mostly on your lower body. A circumferential lower body lift should alleviate the vast majority of what you’re concerned about, ie, laxity of your abdomen, laxity of the lateral portion of your abdomen, hips, and  ptosis of the buttocks.  This very powerful operation will correct nearly all of what you’re concerned about.  The major concern when considering a lower bodylift at the same time as an upper body lift, is the blood supply to the skin between the two incisions.  This should be discussed in detail with a plastic surgeon so that you fully understand your choices and how combining or staging procedures can be in your best interest and safest.

Daniel Barrett, MD · Answer

Dear yaragil85,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Carmina Cardenas, MD · Answer

Dear Yara. 
You have developed excess of skin in different vectors and different anatomical areas: 
Saggy outer thighs, lateral abdomen, saggy lovehandles, saggy buttocks, all above will be corrected with Lower Body lift, performing a 360 incision to correct the excess of skin (above incision) and lifting (below the incision: buttocks and saddle bags). 
Upper body lift means the combination of a totally separated anatomical areas: breast lift , lateral torsoplasty, arm lift and back lift in order to achieve a smooth and tight back, lifted and perky beast, rejuvenated arms and smooth lateral chest. 
At the end Inner Vertical Thigh tightening. 
All of the surgical stages you need represent very extensive and invasive procedures and must be done separately to prevent or reduce the possibility of complications. 
Be encouraged!!!
Dr. Cardenas

Camille Cash, MD · Answer

Based on your photos it appears you will have an improvement in your results from a lower body lift.  This would address the skin laxity that concerns you both in the front and back.  You may be a candidate to revise the tummy tuck as well.  An upper body lift which involves a horizontal scar along the bra line to address upper body skin laxity.  That procedure would typically be performed in a separate stage from the lower body lift.

Heather Vande Ven, DO · Answer

Performing a 360 lower and upper body lift procedure simultaneously is technically possible, but it is a highly complex and extensive surgical procedure that carries significant risks and requires careful consideration. A 360 lower body lift typically involves removing excess skin and fat from the abdomen, hips, buttocks, and thighs, while an upper body lift addresses excess skin and fat on the back, sides, and chest.Combining both procedures into one surgery can reduce overall recovery time and potentially lower costs compared to undergoing them separately. However, it also increases the duration of surgery, anesthesia exposure, and the risk of complications such as blood loss, infection, and poor wound healing.Before undergoing such a procedure, it's crucial to consult with a board-certified plastic surgeon who specializes in body contouring surgeries. They can evaluate your individual situation, discuss the potential risks and benefits, and help you make an informed decision about whether a combined 360 lower and upper body lift is appropriate for you. Additionally, ensure that you are in good overall health and have realistic expectations about the outcomes of the surgery.