Body Lift/Post-Bariatric Body Contouring

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Body Lift/Post Bariatric Newport Beach

Surgical weight loss procedures like the Lap Band, intragastric balloon, gastric bypass, gastric sleeve resection, and others are helping the most weight challenged patients realize their goals of getting to healthy, sustainable weight. But what about all the extra skin left behind after a successful weight loss course? For many patients, the bariatric surgery journey is not really complete until they are able to shop for a new wardrobe that makes them really feel their best, and it can be hard to find well-fitting clothing when you are wearing an apron of extra tissue. This is where plastic surgery can have some of its most dramatic effects. Here we will focus on describing the basics of the lower body lift, one of the most popular post-bariatric body contouring procedures after massive weight loss.

The lower body lift can be thought of as an extension of a conventional tummy tuck. However, it is more complex than that, because a true lower body lift often requires removing tissue around the whole circumference of the body. Sometimes we call this a “360″ lift (or just a “360″ for short). The back part of the procedure, which helps to lift the buttock region and improve the appearance of the lower back, is formally called a “belt lipectomy,” or removal of a belt-like area of fat and skin. Lower body lift procedures often include removal of tissue on the inner, or “medial” thighs, in order to create a more harmonious balance between the core abdominal region, the pubic zone, the upper thighs, the hips, and the buttocks.

Components of a lower body lift can include:

  • Removing extra skin from the abdomen, especially in the lower area
  • Tightening the musculature and correct laxity of the core structures (not always required but common in many such techniques)
  • Removing an overhanging belly (called a “pannus”), including removing extra tissue in horizontal and vertical directions
  • Bring up the pubic triangle if it has become saggy
  • Removing loose tissue on the inner thighs
  • Bringing up the hip saddlebag area
  • Supporting and rounding out the buttock
  • Reducing the love handle area, particularly when combined with liposuction
  • Improving the appearance of the belly button in many cases (although some patients may actually have to have a totally new belly button constructed after having their original one stretched by previous obesity)
  • Reduce the patient’s weight to a modest degree ( this is NOT a weight loss operation but a certain amount of weight does come off with the removed tissue, of course)
  • Improving hygiene under the lower abdomen and pubic regions

Body Lift 101

The lower body lift incisions are fashioned low in the abdomen and may extend in continuity to incisions on the inner thighs. The incision is carried around to the back to connect to the belt lipectomy part of the operation, creating the 360 degree correction of excess tissue.

A small incision around the edge of the belly button (itself nature’s most common scar, if you really think about it) is typical. there are a number of different designs for a belly button that can be selected, as well.

Tightening of the internal fascia overlying the rectus abdominis muscles (think of it as the tendon-like sheath around the abs) is a component of many body lifts and helps bring in the waistline and reduce bulginess. Sometimes the tightening has to be done in more than one direction, and hernias are not uncommon in these patients. You may be asked to get a CT scan of the abdomen before surgery if there is a concern.

Lower Body Lift FAQ’S

1. How do I know if I am a candidate for body lift surgery?​

​Some of our selection criteria to include you as a body lift candidate include:​​

  • Extra skin and fat in the lower abdomen, bulging of the central abdomen, love handles, loose thigh tissues, redundant gluteal and lower back fat and skin
  • A history of bariatric surgery followed by massive weight loss, or similar weight loss achieved nonsurgically
  • No hernias on physical exam – although we can repair them in some cases. We may request a preoperative CT scan in many cases
  • General good health, meaning you do not have major uncorrected cardiovascular, respiratory, kidney or other major organ conditions, and would be able to be medically cleared for general anesthesia by an internal medicine physician, who will order preoperative laboratory studies and perform a comprehensive physical examination
  • Not pregnant or immediately planning to become pregnant
  • Nonsmoker or willing to commit to NO NICOTINE IN ANY FORM for at least 3 weeks preop and for the duration of your recovery
  • A body mass index below 35 and ideally below 30 for optimal results, with rare exceptions – we may stage your procedures depending on how many areas you need treatment and how long we expect surgery to take, as we try to limit surgery to 6 hours or less
  • Available support system of friends, family, caregivers or others who can help you to keep your appointments, complete your preop and postop tasks, and emotionally bolster you through this exciting journey
  • Reasonable expectations of how much breast enhancement is possible with specific techniques

2. How long does body lift surgery usually take?​

​Most lower body lift procedures take at least 4 hours and up to about 6. We try to limit the scope of procedures that we combine in order to keep surgery at 6 hours or less in duration. You may require a blood thinner medication and some patients have their surgery performed in a hospital facility. The gluteal (back/butt) portion of the procedure usually takes less than an hour, and the abdominal component takes 2 to 3 hours in most patients. Dr. Sayed may utilize a surgical assistant to help with the procedure in order to use time most efficiently, as there is a lot of suturing involved in these procedures.

3. What is recovery from tummy tuck surgery like?​

​Most lower body lifts are performed either on an outpatient basis in a AAAASF-certified operating room, meaning the facility is up to very high standards of accreditation, or in a hospital, depending on the patient’s medical factors and the scope of the procedure. Patients usually spend up to a couple hours in the postoperative suite. Many patients may be advised to spend the night in hospital, although occasional patients are good candidates for ambulatory surgery. Dr. Sayed gives a 24 hour phone number to all patients who can reach him for urgent questions, and we also issue access to a patient engagement application that allows the patient or companion/caregiver to send SMS messages, photos, video and other content to our team in a secure, private digital format. This keeps us mutually informed on your recovery and allows us to update your instructions while requiring a respectful number of face-to-face visits in the office.

Early postop recovery findings can include abdominal pain, muscle cramping, mild nausea, back discomfort from walking in a semi-bent position, bruising and swelling, numbness or diminished sensation in the skin, and some mental adjustment to the process of healing which most patients undergo. Most patients are advised to take up to 3 weeks out of social circulation and we’d prefer that you not drive yourself in the first 14 days or as long as you are taking any prescription pain medication. Most sutures are dissolvable but there may be a few that need to be removed at around 14 to 21 days postop. You will probably have drains in place which are usually removed in the office at 10-14 days. While Dr. Sayed has occasionally performed abdominoplasty without drains, he has never been convinced that such a technique gives better results and he feels he can avoid some of the nuisance issues of fluid collections best by using drains, as do most plastic surgeons.

We ask that you abstain from exercise for 4 weeks and then return to light fitness routines after that. It is very important that you get up and walk even the first night following your procedure. You may have to walk doubled-over for the first week or so as the muscle tightening accommodates. You will be asked to wear a surgical garment for about 3 months, and it will be easiest for you if you wear tops that button down in the front in the first3 weeks or so. Dr. Sayed and his team provide close postop care in the office and with our remote engagement tools. You will be asked to take some supplement medications to aid in your recovery, which may include medications for pain, bruising, swelling, constipation, and dietary optimization.

4. How long do lower body lift results usually last?​

The final scars from a lower body lift may not be mature for about a year. There is a lengthy healing process for this surgery, as you can imagine, due to the extent of skin and tissue removal. Assuming you maintain your weight within a reasonably stable range, you can expect lifelong improvement from body lifting when compared to how your body would have looked if you never had the procedure. Scars may or may not fade fully, but the contouring change is often so dramatic that it literally changes the patient’s outlook on life. A whole new world of activity, fashion, and life options may open up to patients after the combination of dedicated weight management and appropriately performed post-bariatric surgery. We are not exaggerating when we say these are some of our most grateful patients who spread the word about Dr. Sayed!​

5. How can I prepare for my lower body lift surgery?

  • Have a reasonable expectation of what surgery can accomplish – understand that this is not a surgery for weight loss
  • Maintain your weight at a stable range (within + or – 10 pounds, ideally) for at least 6 months preop
  • Look at before and after photos and understand what kinds of techniques you are interested in
  • Don’t smoke or take nicotine in any form for at least 3 weeks and ideally longer before (and after) surgery
  • Stay well rested and well hydrated and eat a nutritious diet balanced with plenty of protein
  • If your diet is lacking in vitamins, take vitamin C and zinc supplementation but ask Dr. Sayed about other supplements
  • We have a list of ingredients we ask you to avoid in the immediate preop phase to optimize healing and minimize bleeding risk
  • Designate a caretaker who can help you through the first 2 to 3 weeks after your procedure – you WILL need the help
  • Identify whether you think you might have a hernia bulge in your belly button or abdomen

6. How much does a lower body lift cost in Southern California or South Florida/Miami?

​We don’t like to publish pricing as it is subject to market changes and dependent on the types of procedures you consider. We do have a fee schedule available in the office after your consultation, and we can give you an estimate through virtual consultation tools available on this site like our Zwivel® page. Feel free to contact us for a pre-consultation and we are happy to provide more information. The cost of your surgery will partly depend on where you have it, and whether you elect to have thigh lifting done at the same time as your abdomen and belt lipectomy portions. Some patients stage these components and/or combine them in a series of procedures with other things like arm lifts (brachioplasty), facelifts, correction of the upper back/batwing area, etc. We can present a variety of options during consultation.