Body Lift

Unfortunately, many people who lose massive amounts of weight, whether through diet and exercise or bariatric surgery, are left with sagging skin and stubborn deposits of fat on various parts of their bodies, especially around the midsection. This can make it difficult for them to embrace their new bodies and find clothes that fit properly, as well as making them more vulnerable to skin infections and causing self-consciousness and general discomfort. Fortunately, plastic surgery offers a highly effective solution in the form of body lift surgery.

Depending on the location of the surplus skin, patients may choose to undergo either an upper, mid, or lower body lift

Body lift is an extremely effective plastic surgery procedure for patients with excess skin, fat, and other tissues that linger after substantial weight loss. Depending on the location of the surplus skin, patients may choose to undergo either an upper, mid, or lower body lift. For patients with significant amounts of excess skin throughout the midsection, lower body, and extremities, a combination of these techniques called full or total body lift may be the best option.

As is the case with most other plastic surgery procedures, body lift surgery is highly customizable to the unique needs and goals of the individual patient. If you believe that body lift surgery might be right for you, it is important that you entrust your procedure to a skilled, experienced plastic surgeon with a history or producing outstanding results for patients with similar cases.

Prerequisites

Have lost between 30 and 50 percent of your peak weight.

Suffer from drooping skin, fat, and tissue around your abdomen (although if this is mostly fat, you may need to lose more weight before pursuing a body lift).

Have a stable weight, since fluctuations could interfere with the results of this procedure. Most plastic surgeons recommend waiting approximately two years after reaching your weight loss goals to pursue surgery, which gives your skin time to accommodate and helps to ensure that you will not regain weight after surgery.

Be in good overall health, able to undergo general anesthesia and recover well from surgery.

Do not plan to become pregnant after surgery, since this could reverse the outcomes of your body lift.

Are committed to maintaining excellent nutrition and exercise so that you can heal properly and continue to enjoy the benefits of your procedure.

Do not smoke or drink alcohol to excess.

Have realistic expectations for the results of the surgery. Although your surgeon will work to make them as subtle as possible, you will most likely have scars from your incisions, and your skin may begin to sag again with aging.

Are in good mental and psychological health, since plastic surgery can be a long and emotional process for some patients.

If you have lost weight due to bariatric surgery, your plastic surgeon will need your specialist’s approval to perform surgery. He or she will also likely collaborate with your general practitioner and nutritionist to keep you healthy and safe throughout this process.

Creating the Customized Treatment Plan

During and after your initial consultation, your plastic surgeon will develop a customized treatment plan for your body lift surgery.

Treatment Areas and Body Lift Types

This comprehensive procedure can involve removing excess skin, fat, and tissue in your:

• Groin
• Thighs
• Buttocks
• Midsection
• Hips
• Lower back
• Arms
• Breasts

The type of body lift surgery you choose will greatly depend upon the location of the excess skin on your body, as well as your overall aesthetic goals. Your plastic surgeon can focus on a specific part of your body, as is done in an arm lift or a thigh lift, or take a more inclusive approach and treat a larger area all at once. These “full-scale” kinds of body lift surgery serve to eliminate excess skin over large areas of the body. Even more complete are the body lifts that create an entirely new figure. These procedures are commonly referred to as total body lift surgery.

Although recovery from total body lift surgery is more involved than that of smaller-scale body lift techniques, doctors are often able to achieve the best results with this kind of treatment. To perform body contouring, your surgeon may use liposuction to remove excess fat cells before trimming away skin and tissue with an incision.

Factors in Planning Your Surgery

Your surgeon will use the data you provided to him or her during your initial consultation to personalize a treatment plan for you. He or she will take into account the following factors:

• Your overall wellbeing and any particular health risks involved.
• The type of anesthesia with which you are most comfortable.
• Where you live, especially if you are traveling for surgery.
• The amount of time you are able to take off of work for recovery.
• Your expectations and wishes, based on your conversation and any photographs you brought in.
• Your budget for surgery, including financing and insurance options.
• The areas of your body you would like to improve and thus the type of body lift surgery you would prefer to have.

Your surgeon will go over your customized treatment plan with you either at your initial consultation or at an appointment before your surgical date. Of course, if you have any questions about or objections to this plan, do not hesitate to discuss them with your doctor. It is much better to address your concerns before your surgery than deal with discomfort or dissatisfaction afterward.

Lower Body Lift

Technically called a belt lipectomy, a lower body lift is one of the most popular types. Many patients find that the majority of weight loss occurs in areas such as the buttocks, hips, and thighs. Extreme weight loss can leave large folds of skin that cause chafing and discomfort.

A lower body lift can not only remove this excess skin, but also lift the buttocks and add flattering contours to the patient’s body. It is a less invasive procedure than a full body lift and can help patients who have experienced massive weight loss as well as those whose lower body skin has begun to sag due to pregnancy or aging.

The Procedure

To begin your lower body lift, your surgeon will make an incision around the belt-line of your waist, across your lower abdomen, and down your inner thighs. The particular patterns for your incisions will depend on your specific needs and your surgeon’s expertise. Your surgeon will work to place your incisions such that your scars can be hidden by underwear or clothing. He or she will then use these incisions to access and remove excess fat and tissue before pulling your skin taut and trimming it. The incisions will then be sutured closed and covered with bandages and compression garments.

Because it is difficult to effectively tighten the lower body and not the abdomen, many patients choose to combine lower body lift surgery with a tummy tuck (abdominoplasty) or a mid body lift. After surgery, most patients are able to return to work within two to three weeks.

Mid Body Lift

Mid body lift, also called torsoplasty, treats the abdominal region in addition to the body parts addressed by a lower body lift (thighs, hips, buttocks). Many patients prefer this method of body lift surgery to a lower body lift alone because the surgeon is able to create smooth, continuous contours from the abdomen all the way down to the thighs.

The Procedure

To complete your torsoplasty, your surgeon will remove excess skin via incisions similar to those used in lower body lift. He or she will then use the incision around the waist to access the abdominal muscles. Your surgeon will pull them together and stitch them into place to create a trimmer waistline and a flatter stomach. This process can also repair any existing tears or damage to these muscles.

Once he or she has finished reshaping your muscles, removing surplus fat, and trimming excess skin, your surgeon will close and bandage your incisions. Your scars from a mid body lift will be very similar to those of a lower body lift, but this procedure may require a longer healing time due to the adjustments made to your muscles. Typically, patients can resume working in about three to four weeks.

Total Body Lift

Total body lift surgery is helpful for patients who have lost skin elasticity all over their body. Excess skin can cause severe chafing and discomfort, as well as prevent patients from wearing clothes in a smaller size or exercising properly. Total body lifts address every part of the body that commonly accumulates fat and surplus skin. Your arms, breasts, abdomen, hips, thighs, and buttocks can all be contoured to achieve a smooth, trim, and lifted appearance. Some surgeons refer to a full body lift as an upper and lower body lift. In an upper body lift,the arms are treated with an arm lift and the breasts are contoured with a breast lift. These two surgeries can be performed separately or during a mid or lower body lift.

Though a total body lift is the most comprehensive way to rejuvenate your figure after massive weight loss, you will need to take into account the extended recovery period required for such complex surgery. You should be prepared to remain at home for up to six weeks after your total body lift surgery and to follow all instructions given to you by your plastic surgeon. Once the swelling has gone down and the scars begin to fade, most patients are extremely satisfied with their new appearance.

The Procedure

A total body lift is a much more intensive procedure than an upper, lower, or mid body lift. Many plastic surgeons perform it in stages, as the full surgery can take between four and seven hours to complete. During total body lift surgery, your doctor will begin by completing a mid body lift, making an incision into your abdomen, around your waist, and down to your upper thighs. Once he or she has firmed your underlying muscles, removed unwanted fat, trimmed away excess skin, and pulled it smooth, your surgeon will close and bandage your incisions.

Next, he or she will perform an upper body lift, which may be done on the same day or at a separate appointment. During this part of the procedure, he or she will address sagging skin, fat, and tissue on your arms, back, and breasts according to your wishes. Your surgeon will make an incision into your underarms to tighten your muscles, remove excess fat, and trim the skin for a fitter look. He or she will do the same for your back by creating either a horizontal incision across it or two vertical incisions on either side.

For women, a total body lift can involve a breast lift, during which your surgeon will create an incision around your areola, down to the bottom of your breast, and across your breast crease to remove drooping skin and fat. If you wish, this procedure can also be combined with a breast augmentation, in which case your surgeon will also use these incisions to insert silicone or saline implants.

Some plastic surgeons may also be able to enhance your breasts with a fat transfer, using your own liposucted, purified fat cells from another part of your body to augment your breasts. Once he or she has finished modifying your breast size, your plastic surgeon will most likely need to reposition your nipple and areola for a natural look to complete your lift.

Men undergoing a total body lift may also remove surplus breast tissue with male breast reduction or gynecomastia surgery. If you simply suffer from small fat deposits in this area, this can typically be remedied with liposuction alone, which requires only a very small incision to insert the tube for suction. However, if you have too much fat or excess skin, your plastic surgeon may need to make an incision on either side of your chest. In more severe cases, your doctor will also need to move your nipple and areola.

The Procedure

As a customized surgery, each patient’s body lift procedure will be different. On the day of your appointment, you will need to have a friend or family member drive you to the clinic or hospital where you will undergo surgery. Once you have checked in, your plastic surgeon will go over your unique surgical plan with you one final time for your upper, lower, mid, or total body lift. He or she may make marks on your skin to show you where the incisions will fall and provide a guide during surgery.

Then, nurses will prepare you for your procedure by cleaning your skin and dressing you in a medical gown. Next, your surgeon or anesthesiologist will administer general anesthesia or local anesthesia and sedation, at which point you will become very relaxed and will typically not remember anything about your surgery after this point.

During your procedure, your plastic surgeon will perform liposuction if necessary, then make the incisions you discussed to remove remaining fat deposits, tighten your muscles, and trim excess skin before suturing it closed so it lays smooth. He or she will then place bandages, compression garments, and drains over your incisions as needed. This process often takes between two and seven hours, depending on the extent of your procedure.

Recovery

It may take between two weeks and two months for you to return to work after your body lift surgery, and you will likely need to avoid strenuous activity for several months. It is important to follow your surgeon’s post-operative care instructions so your skin and underlying tissue can heal properly for beautiful, healthy results.

You may return home on the same day, provided you have sufficient caretaking and nursing

Risks

As a comprehensive and intensive procedure, body lift surgery carries some risks. These can include:

Excessive bleeding. If your incisions do not close or heal improperly, you may experience excessive bleeding or even hematoma, blood clot formation. Most body lift patients do not suffer from excessive bleeding, but premature or overly intensive activity can increase your risk. Call your plastic surgeon immediately if you notice a large amount of blood on your bandages. You may need to undergo corrective surgery or even receive a blood transfusion to protect your health.

Unsatisfactory results. Most patients are pleased with the results of their body lift surgery, but there are many factors involved in this complicated procedure. Your scars may become very noticeable due to poor placement or the development of certain conditions such as keloid, bunched, or hypertrophic scarring. Depending on your surgeon’s expertise and your body’s reaction to the procedure, you may also suffer from asymmetrical results. If your surgeon did not remove enough excess skin or if you regain weight, your skin may become loose again. If you are unhappy with your results, your plastic surgeon may need to perform a revisional body lift to correct any issues.

Fat necrosis. Sometimes, body lift surgery can disrupt the fat cells deep within your skin and tissue, cutting off their blood supply and destroying them. These cells can become stiff or irregularly shaped, interfering with the cosmetic results of your surgery. Depending on the severity of your fat necrosis, additional surgery may be required to resolve this condition.

Skin necrosis. Similar to fat necrosis, the skin cells at your surgical sites may become deformed and discolored if they lose proper nutrients. Contact your plastic surgeon if you notice your skin blistering, peeling, or turning black. Typically, if you suffer from skin necrosis, you will simply have to wait for the affected cells to slough off so new, healthy ones can regenerate. Skin necrosis is linked to smoking, which is one of the reasons plastic surgeons do not perform body lift surgery on patients who currently smoke.

Phlebitis. If any anesthesia or medications are delivered into your vein through an injection, you have a very low risk of developing phlebitis, in which your vein swells. While uncomfortable, you can typically alleviate this condition by walking around and taking anti-inflammatory medications.

Infection. Body lift surgery involves the creation of multiple large incisions, so if your plastic surgeon’s tools and operating room are not perfectly sterile during every step of your procedure, you may develop an infection. You can also suffer from this condition if you fail to follow your surgeon’s instructions for cleaning and bandaging your wounds after your body lift. Properly sterilizing and placing drains in your incisions can also reduce your risk of infection. If you begin to experience any symptoms of infection, such as foul odors from your incisions, redness, consistent discomfort, or fever, contact your plastic surgeon for recommendations. You will likely need to take antibiotics.

Deep vein thrombosis. Large blood clots can form in your legs and put your heart, brain, or lungs in jeopardy if they travel to this area of your body. While very serious, deep vein thrombosis is an extremely rare complication from body lift surgery. Your surgeon will assess your risks for this condition during your initial consultation.

Rectus Diastasis. Modifying the muscle, fat, tissue, and skin around your midsection could weaken your abdominal muscles, which may sag or separate. The majority of patients who suffer from rectus diastasis can prevent muscle drooping and damage with exercise, but more extreme cases may require additional surgery to repair.

Umbilical complications. Modifying your abdomen may involve repositioning your navel to achieve a more natural appearance, a process that carries its own particular risks. Aesthetically, your plastic surgeon may move your navel too high, too low, or off center. While very rare, umbilical repositioning may also create skin or fat necrosis that can result in the loss of your navel.

Seroma. Necrosis and damaged blood cells can release fluids that build up in pockets of tissue along your incisions. Most often, this does not cause fluid accumulation, or seroma, because your surgical drains and compression garments allow this fluid to escape. If you suffer from seroma, the fluid may need to be surgically removed with suction or drained by your surgeon during an additional procedure.

Improper suture healing. Generally, your plastic surgeon will take your sutures out at a follow-up appointment about two weeks after your surgery. However, individual sutures may occasionally come up through your skin at the incision line. If this occurs, see your plastic surgeon so that he or she can remove them without disturbing your incision or interfering with your healing process.

Most of these risks are minimal, but you can further decrease them by working with a qualified, experienced plastic surgeon and following all of his or her directions for pre- and post-operative care. You can also lower your risks by openly discussing your concerns and providing full, accurate information to your plastic surgeon about your medical history and conditions.