Do I need a body lift?
Patients who have had major weight changes, child birth, skin and soft tissue redundancy, or over 40 years of age may be candidates for a body lift. Patients considering body lifts need to decide if the risks are worth it or not? Some patients look better with a small bit of skin redundancy than with a body lift scar. In most cases, the need for a body lift is obvious, but in other cases it may not be clear. Patients are typically concerned about constant bulging, lower abdominal and flank fullness, and skin overlap at the waist and hips. Patients not planning future pregnancy with stable weight are the best candidates. Patients with significant skin around the waist or lateral thigh often seen after major weight loss may require an inner or outer thigh lift or mid-trunk lifts as well. Some patients choose a standard tummy tuck with liposuction over a body lift due to concerns about the scar length, surgical risks, and recovery. Dr. Lowe always combines liposuction during body lifts to ensure the best results.
Are body lifts covered by health insurance?
Body lifts by definition are cosmetic surgery procedures. The procedure is not covered by medical insurance plans. Some patients have large abdominal pannus or abdominal roll resulting in physical limitation and chronic rash. These patients may be candidates for pannus removal to address this medical problem. A pannus removal through insurance can be combined with a formal body lift if approved. It is important to remember that all body lifts remove the pannus, but not all pannus removals are body lifts. Body lifts are defined as a pannus removal, tummy tuck, liposuction, and two flank resections. Many patients undergoing body lifts will need significant skin or tissue removed all around the waist. Patients are encouraged to look at photos of body lifts or other body contouring online or in our office before scheduling surgery. Dr. Lowe will discuss these issues during the course of the consultation and consent process.
What is the difference between a tummy tuck and a body lift?
There are a number of different types of body lifts. Most surgeons define a tummy tuck as a procedure involving skin removal and tightening of the abdomen only. Some body lifts are more extensive requiring more undermining, skin removal, muscle reconstruction, and liposuction. Patients that have a lot of flank and buttock redundancy are good candidates for body lifts or extended tummy tucks. The natural break in the skin that determines scar location is usually best determined in consultation with a board certified plastic surgeon. The patient’s age and health will also determine the best operation. Most patients considering body lifts require a circumferential incision, extensive liposuction, midline tightening, and belly button repositioning.
Patients should take time to decide what areas of the abdomen and flank are of concern. Patients may want a smooth flat abdomen and flank, and others only want small improvements. In most cases it is best for patients to have as much skin and fat removed as possible to ensure a lasting result. The longer the surgical incision the more skin and soft tissue may be removed. Some patients prefer shorter incisions that do not extend around the flank and back. Standard tummy tucks cannot improve the lateral thigh, flank, and buttock without extending the incision. The best option depends on the patient’s anatomy, preference, and willingness to compromise.
Where are the incision placed?
Standard body lift incisions are circumferential but rarely cross the midline of the back. Current trends and changes in surgical techniques have resulted in changes in the way surgeons deal with the redundancy in the flank, lower back, and buttock. Plastic surgeons have increasingly placed surgical incisions lower along the pelvic rim and across the back just above the gluteal crease. This allows the lateral thigh and buttock to be lifted and in some cases enhanced. The exact placement of the surgical incision depends on the clinical situation and patient desires. Patients who have had major weight changes, multiple children, large fat deposits, or over 40 years of age usually require an extension across the lower back. In the front patients also require a small incision around the belly button. The belly button is reset just like a standard tummy tuck to allow for removal of skin in the upper abdomen and back. Patients should discuss these issues during consultation with a board certified plastic surgeon.
One of the biggest concerns for patients considering body lifts is the scars. Elective body lifts are marked before surgery to ensure the patient understands scar position and length. Patients should take some time to look at photographs of patients who have undergone a body lift. Scars are often raised, red, irregular, and displaced over time. Scars typically look their worst at 2 months and then improve at 8-12 months. Most patients considering body lifts are willing to accept the scar in order to improve extreme excess of skin and fat around the abdomen and flank. Major weight loss patients are usually able to fully understand the tradeoffs of surgery after consultation with a board certified Plastic Surgeon.
Where and when should I have surgery?
One of the most important decisions for patients considering body lifts is where and when. Body lifts can be performed at a hospital with overnight stay or surgical facility with home care. The benefit of a hospital setting is the overnight pain management and care. Patients in a surgical facility will be given a period of recovery and then go home the same day. In general, smaller body lifts are better in the outpatient setting, and bigger body lifts are better in an in-patient setting. Most patients undergoing body lifts have surgery in the outpatient setting. Most patients require significant assistance at home for several days, feel better at one month, and recovery fully by three months. Each patient’s pain control and recovery is different and cannot always be determined in advance.
What are the restrictions after surgery?
It is also important to be aware of the recovery associated with body lifts. Patients undergoing body lifts are asked to limit activity for 6-8 weeks. Patients will need to wear a support garment or abdominal binder for 2 weeks day and night and for 2 weeks at night thereafter. Most patients require surgical drains to help decrease fluid collection and control swelling. Most drains stay in place for at least a week, but bigger surgery may require drains for months. Sutures usually stay in place for 2-3 weeks and staples are sometimes required to provide addition support. Patients report swelling, numbness, significant scarring, and minor pain for about 6 months after body lifts.
What about patient safety?
There are a variety of safety concerns related to body lifts. Many of the concerns are related to post-operative wound healing, bleeding, and pain control and have been reviewed. However, in most cases the safety of body lifts with liposuction is most dependent on the surgeon and surgical facility. Body lifts are a significant elective operation reserved in most cases for patients in good health in an inpatient setting. Dr. Lowe is a real plastic surgeon, who performs real surgery, in a real surgical center or hospital. As a member of the American Society of Plastic Surgeons (ASPS) he is required to follow guidelines designed to ensure the best patient safety and outcomes. Dr. Lowe proudly performs cosmetic surgery in accredited hospitals and surgical facilities. Most cosmetic surgery is performed at his certified in-office operating suite, Associates Surgery Center of Oklahoma (ASCO). ASCO is fully certified by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). It is not intended for overnight stays or longer operations. For further information about safety and credentials go to: www.AAAASF.org or www.drjlowe.com
Should I wait and think about my options?
It is important prior to surgery for patients to spend some time educating themselves about the pros and cons of body lifts (extended abdominoplasty). Although patients who undergo body lifts are typically very happy, this elective operation is not for everybody. The big risks of surgery are pain, infection, bleeding, delayed healing, and scarring. Patients require a period of recovery and long term scar treatment. Patient should choose a board certified plastic surgeon that they trust, takes time, reviews risks, and puts safety first. One of the most important aspects of the surgery is patient care and follow-up. Some patients will require a hospital stay or other significant clinical interventions such as blood transfusions. When possible, patients should talk about their plans with physicians, family members, and significant others. Patients should have realistic expectations regarding the surgery, recovery, long term care, and results.