Body lift (Lower body lift, Belt lipectomy)

What is a Body lift?

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, an 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. This procedure can be performed under monitored IV sedation or General anesthesia. However, due to the length of the surgery, I prefer to use IV sedation as the risk of pulmonary embolism is greatly reduced.

For surgical technique, I use the Lockwood technique developed by Dr. Ted Lockwood, as described at Wikipedia. This technique results in the thinnest scar and the least amount of postoperative complications, to make for the best possible surgical results.

What problems does a Body lift address?

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, an 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. Candidates usually have these signs or symptoms:
  • Significant weight loss which changes body contours: Weight loss can be a result of diet and exercise, as well as Gastric Bypass Surgery
  • Loose skin around abdomen, outer thighs, and posterior buttocks: This can be a result of aging, pregnancy, or significant weight loss. Patients sometimes refer to the hanging skin as feeling like they have a tire around their waist.
  • Excess fat tissue: Fat deposits exist one or more of these areas: stomach, outer thighs, hips, and posterior buttocks.
  • Abdominal muscle separation: The muscle in the stomach is separated, and no amount of exercise can join it back together. The muscle must be surgically tightened.

Finding out if a Body lift is right for you

Before & after body lift profile photo.To determine if you might be a candidate for a Body Lift, stand in front of a mirror so that you can evaluate the three areas that the procedure entails: abdomen, outer thighs, and posterior buttocks. Abdomen: First, look at your abdomen. Use your thumb and palm of your hand to hold one edge of skin on your lower abdomen and then grasp the lower skin with all four fingers. If you like how your skin tightens, and the way your pubic mound lifts, you are a candidate for the Abdominoplasty procedure. Outer thighs: Now pinch the loose skin around your hips. See how it lifts the hips and thighs and elongates and slenderizes the shape of your legs? If you like this maneuver, you are a candidate for the outer Thigh lift. In combination with a tummy tuck, this is called an Extended abdominoplasty. Posterior buttocks: Stand facing away from the mirror and look over your shoulder so you can see as much as you can of your backside. Reach back with the palm of your hand and lift the butt. This approximates what a posterior Butt lift can accomplish. The traditional butt lift will lift the butt by excising a wedge of skin and pulling up the skin so that the butt is lifted. Occasionally, patients also want fat injection into the buttocks if the butt has become very flat as a result of all the weight loss. The technique of transferring fat into the buttocks is called a Brazilian butt lift. If you want improvement in all three of these areas, the Lower body lift is the cosmetic surgery procedure for you!

How is a 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 monitored 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 15 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?

Body Lift skin excision locationOn 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. There is no way to avoid having a scar, as an incision must be made to remove the excess skin. However, 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. Every patient has slightly different preferences of exactly where the scar will be located. We will discuss this these details the morning of surgery, so that there will be no surprises of where the scar is located.

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 (on the right side) has less tissue dissection than the standard Tummy tuck technique. An illustration showing the Tummy tuck Lockwood 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 25 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 inject the area with Exparel, which is a long lasting numbing medication.  The Exparel will dramatically reduce the pain from the tummy tuck for the first few days. It will allow you to breath better. This is not a narcotic, but simply a local anesthetic which will keep the area numb to reduce the sensation of pain.  The injection works in the same capacity as a pain pump. You can read more about how pain pumps 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 are the preoperative requirements?

No smoking sign.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. Additional pre-op requirements include:
  • Post bariatric patients must be at least 18 months after the weight loss surgery date
  • Stable weight for 2 months
  • BMI index less than 35 kg/m-2
  • H&P (history and physical) and a CBC blood test for medical clearance performed within 30 days of surgery
  • Stop smoking 3-4 weeks prior to the surgery
  • Stop taking aspirin, herbal supplements, and multi vitamins 2 weeks prior to surgery.
  • Schedule a pre-op appointment with your surgeon to ask questions and review the post op instructions
  • Read and sign the Informed Consent document which explains the risks and complications.
  • Get your post op medications filled out prior to your surgery date.
  • NPO after midnight the night before surgery

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 postoperative recovery period is the wearing of a compression garment, which is custom fitted at your pre-op appointment. In summary, the post operative recovery includes the following:
  • Day 1 - 7: Bed rest with only walking to the bathroom, drink plenty of fluids
  • 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 - 6: Post op office visit to remove pain pump and drains, and change the compression garment
  • Day 6 - 7: You can shower!
  • Day 1 - 14: Report any fever greater than 101 degrees Fahrenheit, as this may be indicative of an infection
  • First 3 weeks: No work, planned activities, no driving
  • At 3-4 weeks: Return to light work
  • At 6-8 weeks: Resume normal activities

What are the risks and possible complications?

As with any surgery, there are risks and complications for Body lift surgery. These include, but are not limited to the following:
  • fluid accumulation
  • hematoma
  • seroma
  • infection
  • poor wound healing
  • skin loss
  • asymmetry or unfavorable scarring
  • DVT, or deep vein thrombosis (primarily with General Anesthesia)
  • revision surgery

Body lift complication and revision rates

A June 2017 publication (Vol 139, issue 6) in Plastic and Reconstructive Surgery entitled “Safety of Outpatient Circumferential Body Lift: Evidence from 42 Consecutive Cases” analyzed 42 consecutive outpatient Lower body lift procedures to determine complication and revision rates for the procedure. Average follow up period for patients was 10.4 months. The takeaway of the study was:
  • 36% of all patients who undergo Body lift procedure will have a complication
  • 1 in 4 patients will have wound separation during the post op period (and can be addressed in the office or clinic)
  • 1 in 4 patients will necessitate a revision in the months following the surgery
Complication rate among the 42 patients was 36% with all complications resolved post operatively in the clinic. The diagram below shows the types of complications experienced by the 36% of patients: Body lift complications and revisions chart.
24.0% wound separation (generally wounds over the sacrum)
4.7% seroma requiring drainage
2.4% abscess requiring operative drainage and antibiotics
2.4% cellulitis
2.4% urinary retention
This publication also calculated the Body Lift revision rate. Revision rate among the 42 patients was determined to be 26% with the majority of revisions to improve the appearance of the scar. In this study, there were no deaths, venous thromboembolic events, hematomas, transfusions, or hospitalizations among the 42 lower body lift patients studied.

How much does a Lower body lift cost?

The Body lift cost varies depending on the number of hours required in the operating room. Some patients have more excess skin than others, and the procedure operating room time can be longer. Total Body Lift prices for 2024 are as follows:
Body Lift Prices 2024 Price (exp 5/1/24)
Body Lift- 7 hr $17,500
Body Lift- 9 hr $21,000
Prices include the surgeon's fee, operating room fee, anesthesia fee, garments, Exparel injection, and all post op visits.

Pink money box.Can I finance my Lower body lift?

Yes, we work with a number of finance companies so that you can have a low, affordable, monthly payment. Please call the office at 410-494-8100 or see our financing section for more information.

Dr. Ricardo L. Rodriguez's signatureModified on |
Board Certified Plastic Surgery, ASPS Member


Patients depicted in our before and after galleries have provided their written consent to display their photos online. Every patient is unique, and surgical results may vary. Please contact us if you have any questions.