Lower Body Lift (Belt Lipectomy)

A Body Lift, also known as the Belt Lipectomy or Lower Body Lift is a surgical procedure which offers the most dramatic transformation of the mid and lower body. It removes excess skin and fat from the abdomen, hips, outer thighs, and buttocks. To remove the skin and fat, and incision is placed around the entire lower body, in a circumferential fashion. Skin and fat are removed, your stomach muscles are tightened, and the incision is closed to tightly contour the body.

Broken into its components, the Lower Body Lift includes a tummy tuck (abdominoplasty), a thigh lift, and a buttock lift. The lower body lift can be performed in one surgical session or performed in stages.

What are the Pre-Operative requirements?

During your consultation with a board certified plastic surgeon it's important to listen to all of the pre-op instructions your surgeon gives and discuss all of the surgery and outcome concerns you have.

Your procedure should be performed by a Board Certified Plastic Surgeon in an accredited surgery center. The most highly recognized accreditation agencies are Medicare, AAAASF, and JCAHO. Be sure that your facility is accredited by at least one of these organizations! In many cases, a facility will have accreditation from Medicare, and either AAAASF or JCAHO. Our surgery center is accredited by both Medicare and the AAAASF.

Pre-Operative preparations

• Post bariatric patients must be at least 18 months after the weight loss surgery date
• Stable weight for 2 months
• BMI index less than 40
• H&P (history and physical) and a CBC blood test for medical clearance, 2 weeks prior to surgery
• Stop smoking 2 weeks prior to the surgery
• Stop taking aspirin, herbal supplements, and multi vitamins 2 weeks prior to surgery
• NPO after midnight the night before surgery

How is the Lower Body Lift procedure performed?

I perform a Tummy Tuck, Outer Thigh Lift, and Posterior Butt Lift in one operative session. If the patient also desires an Inner Thigh Lift, that is usually performed in a second surgical session.

Type of Anesthesia

The Body Lift procedure is done under either IV sedation or general anesthesia. I prefer to perform the procedure with IV sedation as patients have a quicker recovery compared to General Anesthesia. Another advantage of IV anesthesia is that it reduces the risk of pulmonary embolism, most commonly associated with General Anesthesia.

In my surgery center we use only Board Certified Anesthesiologist. With the use of IV anesthesia, all patients during the past 8 years have been able to return to the comfort of their home on the same day as the surgery. This is possible because once the surgery is over, patients are awake, alert, and stable within one hour following the surgery.

Where is the incision located?

On the morning of surgery, I mark the location of the incision lines with you standing in front of a mirror. I will mark the upper boundary and the lower boundary. The area between those boundaries (shown in pink in the image to the left) is the skin and tissue that will be removed. The upper and lower margins are then joined together and sutured together with dissolvable stitches. The final single horizontal incision will be around the front and back of your midsection.

I ask all of my patients to bring a bathing suit or something to serve as a guideline for my markings. After the surgery, there is no way to avoid having a scar, but I am very aware of the need to place the scar as low as possible so that it is hidden with low cut panties or jeans.

Tissue dissection and wound closure

The goal of the wound closure is to make the closure as tight as possible without causing tension on the top layer of the skin. If there is too much tension when suturing the top layer of the skin, it can cause the scar to stretch wider and thicker. To avoid this, we put the tension on the deeper levels, instead of the top layers.

In addition, I try to minimize the amount of dissection (lifting of the tissues). When there is too much dissection of the tissues, fluid tends to accumulate and this can lead to complications such as seroma or hematoma. In the drawing below, the area dissected is illustrated in pink. You can see that the Lockwood technique has less tissue dissection than the traditional tummy tuck technique.

For this reason, I use the Lockwood technique for both the tissue dissection and the wound closure. The tissue is dissected less and the incision is closed with the tightest suturing at the deeper layers (instead of the surface). With the Lockwood technique, the following results are achieved:

• Thinner scar, and less risk of the scar widening (scar spread) with time
• Lower complication rate with fluid accumulation that usually results in seroma or hematoma
• Flatter stomach and better results!

Over the past 20 years I have tried different techniques and I always come back to the Lockwood technique for the best results. This technique has the least amount of complications and provides the best surgical result.

Use of Pain Pump to decrease pain

Before you leave the operating room, we will insert a pain pump in the abdomen area. This is a device that you will wear for approximately 5 days. The pain pump will dramatically reduce the pain from the tummy tuck by pumping small quantities of local numbing medication into the abdomen area. This is not a narcotic, but simply a local anesthetic which will keep the area numb to reduce the sensation of pain. You can read more about how they work in my 2009 blog post on pain pumps.

Watch my Body Lift video to get an overview of the dramatic results that can be achieved for patients who have lost weight or have excess skin around their midsection.

What is Body Lift Post-Op recovery like?

The Body Lift procedure is a major procedure and all normal activities may not resume for 6-8 weeks. Patients should plan to be out of work for 3-4 weeks. No driving is allowed for 4 weeks. A key component during your post operative recovery period is the wearing of a compression garment, which is custom fitted at your pre-op appointment.

Post-Operative recovery instructions

• Day 1-7: Bed rest with only walking to the bathroom
• First 5 days: Compression garment is worn continuously
• Until day 5: No showering or bathing, do NOT remove the bandages or compression garment!
• Day 5: Pain pump and drains are removed, compression garment changed
• Day 5: You can shower!
• First 3 weeks: No work or planned activities
• At 3-4 weeks: Return to light work
• First 4 weeks: No driving
• At 6-8 weeks: Resume normal activities

How much does a Lower Body Lift cost?

Total cost for the Lower Body Lift procedure is approximately $18,000 to $20,000. This includes the surgeon's fee, operating room fee, anesthesia fee, garments, and all post op visits. Different types of financing are available and the entire body lift procedure can be financed. Many patients use several forms of payments for the total cost.