In cases of massive weight loss, like that seen after bariatric surgery, the problem is less about fat and more about excess skin. The deflated, post-weight loss skin can hang like drapery around the trunk. The hanging skin is often very frustrating for patients and presents its own health problems, such as rashes, infections and general discomfort, not to mention the difficulty in finding comfortable clothes and supportive garments to manage activities of daily living.
What Is a Body Lift?
Think of the body lift as a tummy tuck which extends all the way around the body. After childbirth and smaller losses of weight, skin folds occur on the lower abdomen. The procedure of choice and gold standard to correct abdominal wall and skin laxity is the tummy tuck. When the skin folds extend around to the back, a body lift is the best option to circumferentially remove the excess skin.
The body lift goes by many names: circumferential lower body lift, truncal body lift, and belt lipectomy to name a few of the most common aliases. Each name is descriptive and gives insight as to what exactly your plastic surgeon is doing during the procedure, but none of them are completely accurate. There are upper and lower body lifts, but the term “body lift” almost always refers to a lower body lift.
Lower Body Lifts
What exactly is a lower body lift? At the risk of oversimplification, a belt of skin and subcutaneous fat is removed from the lower abdomen and back, and the remaining upper and lower skin edges are then sewn together. As a result, the skin of the abdomen, sides, lower back, and buttocks is tightened all the way around the body. The procedure is a combination of tummy tuck, lateral thigh lift, and buttocks lift.
Upper Body Lifts
There is also an upper body lift, sometimes called the “bra lift”. During an upper body lift, a belt of skin is removed from the mid-back. The lift is continued in the front beneath the breasts as part of a breast lift or breast reduction. By removing excess skin from the upper back, the upper body lift helps reduce skin folding at the bra line. This procedure is performed infrequently, as large amounts of redundant skin in this area is uncommon, and also because the resultant scar is more obvious.
Body Lift Presentation
Who Is a Candidate for a Body Lift?
Body lift candidates are almost exclusively patients who have lost a large amount of weight. After massive weight loss, the skin laxity extends all around the trunk. This skirt of excess skin is removed with a lower body lift. Pregnancy and smaller fluctuations in weight tend to affect the abdomen and trunk to a smaller extent, so correction is usually limited to tummy tucks and sometimes liposuction to remove stubborn fat deposits.
Candidates for a lower body lift usually have a significant amount of excess skin, so much that it often causes symptoms such as pain, swelling, rashes, skin breakdown or ulcers, recurrent infections, and problems with hygiene. Larger amounts of hanging skin may also interfere with walking, urinating, and sexual activity. These types of problems are very distressing for patients, causing both embarrassment and a lack of self-confidence.
Additionally, skin folds of the lower abdomen, often present after childbirth and smaller losses of weight, sometimes extend around to the back. In these cases, the tummy tuck incision is lengthened around the back to circumferentially remove all the excess skin from the lower trunk.
What Are the Risks of Body Lifts?
The body lift is an elective surgical procedure; therefore, you need to be in good health to minimize your risks. As a general rule, post-bariatric plastic surgery is deferred for at least one year after bariatric surgery. Also, for a predictable result, your weight must be stable. The procedure is performed in an accredited surgery center, under general anesthesia. Dr. Mele prefers to keep his body lift patients overnight for safety and comfort.
The risks of body lifts are the same as any surgery, but since the surgery and incisions are longer, the risks are greater than those of a routine tummy tuck. Because of this, sometimes the lift is staged as two operations: one in the front and one in the back.
Risks of the body lift include, but are not limited to: bleeding, infection, delayed wound healing, numbness of the skin, the risk of anesthesia, incomplete or overcorrection, and blood clots, which may cause deep vein thrombosis and pulmonary embolism. The risks of any procedure are always reviewed prior to surgery.
How Do I Prepare for a Lower Body Lift?
The first step is to seek the advice of a board-certified plastic surgeon who is experienced in post-bariatric plastic surgery and body lifts. Dr. Mele specializes in skin tightening and is an active member of the American Society of Bariatric Plastic Surgeons (ASBPS), a group of board-certified plastic surgeons dedicated to skin tightening surgery after weight loss.
There is no substitute for an in-person consultation. During your appointment, Dr. Mele will perform a physical exam, take a health history and discuss the pros, cons, and alternatives available for you. You will also have the opportunity to ask specific questions related to your care, expected outcome, and recovery.
The second step is setting realistic expectations. Without these, no surgery can be successful. Good results require teamwork. You need to follow all pre-operative and post-operative instructions, keep your follow-up appointments, and work to maintain your results for the long term.
Pre-operative preparation will include not smoking for at least four weeks before and after surgery and avoiding medications known to increase the risk of complications, including aspirin and other NSAIDs. Many herbal medications can also increase your risk of bleeding, so be certain to disclose all medications and supplements that you take.
The exact surgical plan will depend on your needs. Dr. Mele will discuss your goals, expectations, and necessary preparation before surgery to maximize the benefit of your procedure.
How Is a Body Lift Performed?
The body lift is performed in an accredited surgical facility with the assistance of an anesthesiologist. The excess skin and muscle laxity are diagrammed on the skin just prior to surgery. This sets the surgical plan and helps provide a predictable surgical result.
In the operating room, an anesthetic is given via the IV port and skin is thoroughly prepared so the operating team can get to work on your transformation. Excess skin is removed and the two skin edges are brought back together to provide a smooth, tightened result. In the front, the upper skin is drawn down, tightening the skin and smoothing the appearance of the abdomen. In cases where the muscle wall has also been stretched out, sutures are placed in the muscle casing to tighten the abdominal wall, like an internal corset.
On the sides and the back, the lower skin is brought up to lift the lateral thighs and buttocks. Excess skin from the lower back is also removed. This improves the skin laxity. Occasionally, some of the skin flap is preserved to help add volume to the buttocks for patients wishing to enhance their glutes.
What Is Recovery from a Body Lift Like?
Recovery from a body lift is similar to recovery from a tummy tuck. During the first few days, it may be difficult to get up from lying down or sitting without help, but by the end of the week, most patients are ambulating on their own.
You will stay in the center overnight. This allows us to provide you with better pain management and make sure you are ready to go home the next morning. Pain medication is prescribed to minimize your discomfort during the recovery period and help you get moving faster.
Surgical drains are often used to remove any fluid that may accumulate in the space between the skin and muscles. Removing this fluid allows the skin to stick down to the muscle faster and helps decrease post-operative swelling.
It takes a few weeks to get back to full activity, and lifting is restricted to 20 pounds or less for the first six weeks after surgery. This restriction protects the abdominal muscle repair.
You will see changes immediately after surgery, but it takes several months, if not a year, to get to the “final” result.
How Much Does a Body Lift Cost?
The cost of a body lift varies, depending on the amount of skin laxity and how long the procedure is expected to take. The cost consists of the professional fee, the operating room and anesthesia fees, and other miscellaneous items, including post-operative surgical garments and scar treatments. A price range is available upon request; however, an accurate estimate cannot be provided without information specific to your needs.
Our practice accepts a comprehensive variety of payment options, including plastic surgery financing plans available for qualified applicants who would like to pay for their body lift procedure in installments.
Contact Dr. Mele
For additional information on body lift procedures, or to schedule a consultation with Dr. Mele, please contact our practice online or call (925) 943-6353. We will be happy to answer any questions you may have.