Aging, sun damage, large variations in weight, and certain genetic factors can all contribute to poor elasticity of the skin, leading to sagging skin and fat in the lower waist areas.
A lower body lift (or belt lipectomy) consists of a combination of surgical procedures designed to treat this increasingly common problem. More specifically, a belt lipectomy combines a tummy tuck, a thigh lift (internal and external sides), buttock lift, and occasionally liposuction, in one surgical operation. During the operation, a continuous peripheral band (“belt” shape) of excess loose skin and subcutaneous fat is removed from the bottom of your body, and the underlying tissue is repositioned and tightened, improving the shape and appearance of your abdomen, waist, lower back, buttocks and thighs.
Before & After photographs shown on this site are actual patients of Dr. James Lee who have given their permission to have their photos published online. They are for illustrative purposes only; individual results vary. We do not guarantee outcomes and no prediction of outcome is implied. Individual healing characteristics and unexpected complications can affect the outcome of any surgery.
2. Ideal Candidates
Ideal candidates for a buttocks lift procedure are healthy, non-smoking adults who:
- Have a relatively stable body weight
- Have a healthy and active lifestyle (i.e. proper diet and regular exercise)
- Have realistic expectations with regards to what surgery can accomplish, and
- Are bothered because they have significant skin laxity (with or without excess fat) in multiple areas of your lower body.
Women who are contemplating future pregnancies should postpone an abdominal body lift or abdominoplasty procedure for the time being, since pregnancy will ultimately have an impact on your final results.
3. THE PROCEDURE
Body lift procedures (i.e. thigh, buttocks, arm lifts) can be combined with liposuction to further improve your overall body contour. As only one to two areas of the body are addressed in a single operative setting, overall skin and fat tissue reduction may have to be staged.
Operative times for a lower body lift procedure can vary between 3 to 5 hours depending on the amount and location of skin/fat to be removed, as well as if liposuction will also be performed.
- The procedure is performed under general anaesthesia.
3.2. APPROACH and INCISIONS
- Complete lower body lift procedures generally require extensive incisions.
- The length and pattern of your incisions will depend on the amount and location of excess skin to be removed. The lower body lift technique best suited for your particular body shape and aesthetic goals will be determined and discussed during your consultation with Dr. Lee.
- Regardless of the chosen technique, an effort is always made the place incisions in strategic locations on the body so that scars can be concealed by most types of clothing and swimsuits.
- A complete lower body lift treats the buttocks, abdomen, flanks, hips, and thighs in one procedure. This generally requires a circumferential (hence the name “belt” lipectomy) incision around the body, so that a continuous strip of excess skin and subcutaneous fat can be removed.
- Once incisions have been made, excess skin and fat is removed circumferentially.
- The remaining skin and subcutaneous tissues (i.e. where the lower and upper incisions were made) are then released from the underlying soft tissue and advanced towards one another, such that closure can be achieved along the underwear/bikini line.
3.3.1. UMBILICAL TRANSPOSITION
- To avoid distorting the final appearance of the abdomen, an umbilical translocation (ie. repositioning of the navel) must be considered in cases where the abdominal skin and subcutaneous fat have to be significantly advanced in order to achieve wound closure.
- This is accomplished by first freeing the umbilical stock from the surrounding tissue. A new opening for the umbilicus is then made within the abdominal skin and soft tissue to be advanced. Next, the umbilicus is brought to the surface of the abdomen through the new opening and sutured into position.
- This is a standard component of a complete lower body lift procedure, and will leave a small scar around the navel.
3.3.2. CLOSURE OF INCISIONS
- Deeper support sutures help define and maintain a smooth and tightened body contour.
- Two to four drain tubes are placed and closure of skin incisions is achieved in multiple layers around the circumference of the waist with absorbable sutures.
- As the surgical wound may be under tension, skin staples may also be applied to further reinforce the closure.
4. PREOPERATIVE CONSULTATION
Dr. Lee will perform a thorough medical evaluation during your consultation to ensure that you are medically fit for surgery. He will also revise your medication list as certain medications may need to be temporarily stopped before your surgery.
After carefully evaluating the shape and proportions of your mid- and lower body, and assessing your aesthetic goals, Dr. Lee will review your available options and help you choose the best treatment plan for achieving your desired outcomes.
Since smoking is known to be associated with poor/delayed wound healing, wound dehiscence, wound infections, and increased scarring postoperatively, smokers will be asked to stop smoking prior to surgery, and continue to refrain from smoking postoperatively .
Depending on your age, pre-existing medical conditions, overall health status, and the type of anaesthesia required for your procedure, you may be scheduled for routine pre-operative blood testing and possibly an electrocardiogram approximately 1-2 weeks before surgery. If necessary, additional recommendations will be made once the results of these tests have been reviewed.
A complete lower body lift procedure generally requires an overnight stay.
Following your procedure, dressings will be applied over your incisions. There will also be a compression garment over your dressings around your waist/abdomen to minimize post-operative swelling and to support the new contours during the first 6 weeks of your recovery. You will also have 2-4 thin plastic tubes beneath the skin to drain any excess blood and fluid from the treatment site. These drains, as well as any sutures or skin staples, will be removed in our clinic during one of your follow-up appointments. Drains are usually kept for 2-3 weeks, depending of their output.
A lower body lift is a major surgical procedure, and consequently requires a considerable amount of recovery. Recovery times vary according to the extent of the procedures performed. Discomfort, swelling, and bruising are expected, and most noticeable after the first day. You will receive pain medication throughout your stay at our facility, and then given a prescription for pain medication to help manage your discomfort throughout the remainder of your recovery. An antibiotic will also be prescribed to minimize your risk of infection while the drains are still in place. Bruising will usually resolve after 3-4 weeks; and although swelling will have considerably decreased in this same time frame, it may take at least 4-6 months for it to completely resolve, and for you to see your final results.
Before leaving our facilities, you will be given detailed instructions to follow throughout your recovery in order to optimize your healing, minimize the appearance of your scars, and to ultimately achieve your best possible results. These include:
- Keep your legs elevated when lying down, by placing two pillows beneath your knees. Try to avoid placing your hips in flexion when attempting to raise your legs so as not to place any unnecessary tension on your back incisions.
- Your compression garment should be worn at all times, except while bathing.
- Rest is important as the body needs to recover.
- Although walking is encouraged, avoid strenuous exercise for 6 to 8 weeks.
- It is important to maintain a relaxed position, with approximately 30° of flexion at their hips when lying down or walking for 2-3 weeks postoperatively.
Most patients are able to return to their normal daily activities after 3-4 weeks; however, vigorous activities and exercise should be avoided for at least 6 weeks following surgery.
6. RISKS AND COMPLICATIONS
As with any surgery, there are risks associated with a lower body lift procedure. Smoking, diabetes, peripheral artery disease (poor circulation), as well as heart, lung, or liver disease may increase your risk of perioperative and/or post-operative complications.
Risks and complications include:
- Risks associated with anesthesia
- Bleeding (hematoma)
- Poor wound healing
- Fluid accumulation (seroma)
- Altered skin sensation or numbness
- Wound dehiscence
- Fat necrosis
- Post-operative pain and/or swelling in the legs or at the surgical site
- Deep sutures may be palpable or irritate the skin
- Recurrent skin laxity
- Possible need for revision surgery
- Deep vein thrombosis
- Cardiac and pulmonary complications
Dr. Lee will thoroughly discuss these risks (and possibly others) with you and answer any questions you might have prior to obtaining your consent for surgery.
7. Post-operative scarring
Scars form as the body’s natural response heal tissues. As with any scar, the extent of post-surgical scarring depends on a number of modifiable factors (i.e. avoidance of UV light exposure, tension-free wound closure, appropriate wound care, etc.) and non-modifiable factors (i.e. patient age, comorbidities, skin type, genetics, etc.). While it is not possible to perform scar-free surgery, Dr. Lee makes every effort to minimize the appearance of your post-surgical scars through careful pre-operative planning, the use of meticulous surgical technique, and by ensuring appropriate wound care and follow-up post-operatively.
It is not unusual for scars to appear red and be slightly raised/firm for the first 4-6 weeks following surgery. Scars will flatten and become more pale over time, and can take up to 12 months before achieving their final appearance.