Best Surgical Option for Dispropotion Lower Body After Major Weight Loss?

Hello. I have lost 310lbs through dieting and exercising, and I had a tummy tuck a year ago, but still not satisfied with the results. My upper body is dispropotion with my lower body. I had a lot of consultations with board certified doctors after my operation, and some of them agrees that i need a belt lipectomy, and others said I need an ultrasound liposuction. I'm Lost! what is the best surgical option for dispropotion lower body after major weight loss for my case?

Doctor Answers 10

Best Surgical Option for Dispropotion Lower Body After Major Weight Loss?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Congratulations on your massive weight loss. It is not uncommon to have a disproportionate body after a 360 body lift or a lower body lift. Since you did not include your pictures, I am only guessing that what bothers you are your hips and buttocks.After losing 310 pounds, I can only imagine that you have a significant amount of excess skin and fat of the hips and buttocks. Considering your massive weight loss, I do not think that ultrasound liposuction would do the job.Your skin just does not have the elastic qualities to recoil after that amount of weight loss. I do think you would do better with removal of this skin and fat. This would probably result in the continuation of your tummy tuck around the backside resulting in a 360bodylift. If your abdomen bothers you, I would revise it at the same time.
You mentioned disproportionate lower body after major weight loss.I assume you mean that your upper body is "acceptable" but your lower body is still "unacceptable". However, what often happens after a 360 body lift is that if your lower body becomes smaller while your upper body remains "larger". If your lower body does not match your upper body after a 360 body lift, you may need a upper bodylift. Typically, the upper body lift is done after the lower body lift. This can include an arm lift or brachioplasty. You may also need what is called the torsoplasty to eliminate the excess skin and fat along the lateral torso and along the bra strap line. In addition, if you have a lot of excess skin and fat of the upper back you may need an upper bodylift. This incision goes around the back to eliminate skin and fat from the upper back. If you are a female you may need a mastopexy; if you are male and have gynecomastia after weight loss, you may need a complete breast reduction.
You should try to look at the big picture. The most important thing is that you have lost the weight and ideally, this will significantly improve your lifestyle and significantly lengthen your life. Hopefully, your tummy tuck was a big step in the right direction. The completion ofreconstructive plastic surgery may require the conversion of your previous abdominoplasty into a 360 lower body lift. These are just stepping stones to achieve your ideal body. Congratulations on your massive weight loss. Good luck with your weight loss journey.


Dr. Katzen

Los Angeles Plastic Surgeon
5.0 out of 5 stars 254 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
First, congratulations on your weight loss!  Losing 310 lbs is an epic achievement.  Next, for massive weight loss patients it is not uncommon for the lower body to remain larger than the upper body.  In my experience, massive weight loss patients benefit the most from a belt lipectomy.  Liposuction can be done in conjunction with the belt lipectomy to provide additional contouring by removing any stubborn fatty deposits that remain after the excess skin and tissue has been removed.  However, without a physical examination or photos it is difficult to give an opinion as to whether you would need a lower body lift or just liposuction.  Typically liposuction alone does not provide adequate contouring for massive weight loss patients.  Liposuction will only address the stubborn fatty deposits that you have been unable to lose through diet and exercise.  Liposuction will not remove any excess sagging skin you may have as a result of your significant weight loss.  I am pleased that you researched for board certified plastic surgeons before beginning the consultation process.  In addition I recommend researching board certified plastic surgeons that have experience working with massive weight loss patients.  Be sure to review any before and after galleries as well.  Again, congratulations on your incredible success.

Be well and good luck!


Lower Body Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A lower body lift is also referred to as  circumferential body lift = belt lipectomy.  This procedure is essentially 3 procedures in one: extended tummy tuck + waist/lateral thigh lift + buttock lift.  The buttock lift can also include buttock augmentation.  The lateral thigh lift will help contour the lateral aspect of your thighs.  The procedure can taken between 5-7 hours depending on the amount of tissue/skin that needs removal/treatment.  Please see a board certified plastic surgeon to learn more about your options.
Dr. Sugene Kim

310 lb Weight Loss and Belt Lipectomy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

   If you have residual skin issues, then a belt lipectomy would make more sense.  An exam or pictures would be necessary to make any real determination.  Kenneth Hughes, MD Los Angeles, CA

Body contouring after weight loss

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A physical exam is needed to make any clinical recommendations.  Given your massive weight loss, I'm assuming you would most benefit from a body lift.

Most plastic surgeons refer to a body lift as a circumferential body lift = belt lipectomy.  This procedure is essentially 3 procedures in one: extended tummy tuck + waist/lateral thigh lift + buttock lift (with the option of buttock augmentation).  A physical exam would be needed to make any recommendations.  Please visit with a plastic surgeon certified by the American Board of Plastic Surgery to learn more about your options.
Dr. Basu
Houston TX

Body lift and weight loss

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you lost that much weight, you are unlikely a good candidate for liposuction. Usually massive weight loss patients require skin excision procedures. Best for you to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Body lift after massive weight loss

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The best procedure for your case is to do a body lift and some lipo in your back areas , maybe fat grafting to the buttocks if that is the situation 

Eduardo Gongora, MD
Mexico Plastic Surgeon
4.7 out of 5 stars 62 reviews

Best Surgical Option for Dispropotion Lower Body After Major Weight Loss?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It would be really helpful to have some photos to help answer your question properly. 

I doubt that liposuction is a sensible alternative. The options may be  continuing the TT all around the back as a belt lipectomy, or perhaps a vertical TT with a vertical incision from chest down to the TT scar to remove more excess tissue.

Please consider reposting this question with some photos;. Thanks, all the best.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Weight loss

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are to be congratulated for the amount you lost on your own.

With that amount of weight loss, you probably still have areas of fat resistant to weight loss and you also probably have a lot of excess skin.

Decide what areas of the body you want to improve, it could be multiple areas. Then communicate that to your plastic surgeon and the plastic surgeon may recommend skin excision surgery with or without liposuction to achieve the results  you want

Samir Shureih, MD
Baltimore Plastic Surgeon

Massive weight loss management

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

310 lbs is a great deal of weight, and that degree of weight loss will lead to laxity from head to toe. An abdominoplasty is not adequate as a stand-alone operation. Typically liposuction alone is not the answer with weight loss of this magnitude. I would recommend you meet with a Board-certified plastic surgeon and you can find one on Best of luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 57 reviews

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.