CloudHospital

Last updated date: 09-Mar-2024

Originally Written in English

Lower Body Lift

    Overview

    Significant progress has been made in the knowledge of aesthetic body abnormalities in the elderly over the last 15 years, resulting in novel body lift designs based on current surgical concepts. Multiple parts of the trunk and thighs are typically involved in body shape abnormalities.

    In these individuals, the optimum surgical strategy addresses the complete circumferential trunk and thigh aesthetic unit in one or two stages. Lower-body lifts involve a circumferential bikini-line incision to raise relaxed trunk and thigh tissues at the same time.

     

    What is Lower body lift?

    Lower body lift surgery

    Lower body lift surgery is used to remove extra skin from the outer thighs and buttocks. It is a technique that is widely used in people who have lost a significant amount of weight and have sagging skin. The loose skin on the outer thighs and buttocks can be significantly tightened with this technique.

    The employment of cutting-edge procedures allows for the retention of volume in the buttocks, avoiding a flattening effect. This treatment is usually combined with an abdominoplasty to contour the whole waist line. The scar is normally hidden beneath the underwear.

    There are some similarities between a lower body lift and a tummy tuck. Both treatments aim to tone your abdomen by removing extra skin and tightening abdominal muscles. There are also several distinctions. A belt lipectomy, in contrast to a tummy tuck, involves a big wrap-around (360-degree) incision and tightens both your lower abdominal area and buttocks (the back).

     

    Why do people get a Lower body lift?

    Weight Loss

    Skin does not usually tighten on its own after a significant weight loss. A lower body lift removes extra tissue and tightens regions in ways that diet and exercise alone cannot.

    Sagging skin below the waistline is commonly caused by dramatic weight loss, weight fluctuation, pregnancy, or natural aging. If you've lost weight or had bariatric surgery, you may still be unhappy with your look if you have extra skin on your lower belly and loose skin on your thighs and buttocks. A lower body lift may be ideal for you if you wish to substantially address regions of drooping skin below the waistline.

    The following are some of the advantages of a lower body lift:

    • Remove excess fat or skin
    • Tighten loose and sagging skin
    • Reveal the results of your weight loss
    • Eliminate painful chafing, rashes, and infections from overhanging skin
    • Look better in clothes
    • Improve your self-image and self-confidence

     

    Who are the best candidates for Lower body lift procedure?

    Lower body lift procedure

    You may benefit from belt lipectomy if you:

    • Live with loose skin along your waistline and buttocks.
    • Have maintained a healthy weight, are stable and don’t plan on losing or gaining more.
    • Can live with the appearance of surgical scars on your waist and lower back.
    • Don’t have medical conditions, such as uncontrolled diabetes, that can complicate your recovery.
    • Aren’t a smoker.

     

    What happens before Lower body lift surgery?

    Before lower body lift surgery

    Your weight should have been steady for at least a year, with no additional weight reduction anticipated. Body contouring should not be done until two years following the commencement of any substantial weight-loss program for best outcomes. This period allows your skin to shrink as much as possible while also optimizing your diet, which will assist in your recuperation. Slender people with excess fat and loose skin in the lower body are the greatest candidates; if you are overweight, you should lose weight before attempting a lower body lift.

    Your plastic surgeon will examine your lower body thoroughly, including any scars from past surgery. Your plastic surgeon will provide you with particular instructions for preparation for surgery, such as:

    • Smoking cessation
    • Medications to avoid
    • When to take your prescribed medications
    • Proper washing techniques
    • Restrictions regarding eating and drinking the night before surgery

    Your plastic surgeon will carefully consider your concerns regarding extra skin on your thighs and buttocks, as well as your surgery objectives and expectations. The length and location of the scar on your thighs and buttocks will differ depending on whether the extra tissue is high above the buttocks or down around the saddlebags.

    Liposuction is a popular option to skin removal. Although this approach often avoids extensive scars, it may exacerbate loose skin. At your initial appointment, the risks and advantages of all procedures will be reviewed in further depth.

    Although the lower body lift has a substantial influence on the outside section of the thighs, it has no effect on the look of the inner thighs. A thigh lift is the greatest way to treat the inner thighs. To enhance safety and get the greatest outcomes, your surgeon will usually recommend conducting the lower body lift and the inner thigh lift at different times.

    In addition to the cosmetic examination, the surgeon will carefully assess your general health as well as potential consequences, such as:

    • Your blood pressure
    • Bleeding tendencies
    • History of adverse scar formation after previous surgeries

     

    How is Lower body lift performed?

    Lower body lift performed

    A lower-body lift is a surgical technique that provides the most significant mid and lower body alteration. Excess skin and fat are removed from the belly, hips, outer thighs, and buttocks. To remove the skin and fat, a circumferential incision is made across the whole lower torso.

    Skin and fat are removed, abdominal muscles are strengthened, and the incision is closed to shape the body firmly. The Lower body lift is made up of three parts: a tummy tuck (abdominoplasty), a thigh lift, and a buttock lift. Lower body lifts can be done in a single surgical session or in phases.

     

    Markings for Lower-body Lift

    Because each side of the thigh/buttock lift is performed without the capacity to reference the opposing side, accurate and symmetric preoperative marks are important to the success of lower-body lifts. The patient is in the standing posture when the markings are created. First, high-cut bikini margins are drawn; the final incisional scar should always be drawn inside these lines.

    The superior anchor-resection line extends posteriorly along the lateral body contour. While the patient's knees are 6 to 10 inches apart, the amount of vertical tissue redundancy superior to the desired line of closure is calculated. This is often 4 to 5 cm of stretched skin, which represents approximately one-fourth of the vertical surplus along the lateral body.

    The redundant tissue inferior to the line of closure is then calculated. This is often 10 to 18 cm vertically along the lateral contour, resulting in a total vertical excision of 14 to 23 cm of stretched skin. Although the exact extent of resection is established during surgery, symmetric estimated resection lines are utilized as a guide to assist maintain the final scar's postoperative symmetry.

    To resect inguinal redundancy inferior to the final scar line, an inferior anchor-resection line is marked anteriorly. At the umbilical level, a superior reference line is drawn across the abdomen.

     

    Anesthesia

    Lower body lifts can be done under IV sedation or general anesthesia. However, because of the duration of the procedure, surgeons prefer IV sedation since the danger of pulmonary embolism is considerably minimized.

     

    Operative technique

    Following general anesthesia, the patient is put on a vacuum beanbag positioner in the lateral decubitus position, with hips flexed at a 45-degree angle and thighs abducted with foam blocks to maintain the knees 15 to 18 inches apart. If necessary, lipoplasty of the posterolateral trunk and circumferential thigh is done. Through the superior resection line, an incision is created. The superficial to muscular fascia undermining begins along the lateral contour anterior to the iliac crest (the upper border of the ilium, the biggest of the three bones that make up the pelvis).

    After that, the dissection sweeps posteriorly in the same plane, leaving deep fat posterior to the iliac crest. Direct undermining should only go beneath the resected flap. Except for the trochanteric area, no direct undermining is conducted beyond this line over the buttocks or into the thigh. To facilitate distal transmission of the lifting forces, the fibrous adhesion in the trochanteric area must be removed with direct undermining.

    If the aesthetic deformity continues into the lower portion of the thigh, discontinuous blunt undermining is done farther distally. After superficial fibrous system (SFS) anchoring sutures are applied, resecting more fibrous tissue than skin allows for minimal-tension skin healing. After the second thigh/buttock lift, the patient is positioned supine for the last part of the treatment. With the thighs broadly abducted and the knees supported by blanket rolls, the hips stay flexed at 40 to 45 degrees.

    The inferior anchor-resection line incision is used to initiate the high-lateral-tension abdominoplasty. Direct undermining is restricted to the inferior tissue to be excised and the borders of the rectus diastasis centrally above the umbilicus. The tissue is resected with the greatest strain along the lateral thirds of the anterior incision during diastasis correction.

    A last drain is inserted into the epigastrium and exits through the mons pubis. Braided nylon sutures are used to repair the SFS, while running PDS sutures, deep-dermal sutures, and running Prolene sutures are used to repair the skin.

    Light dressings are used. A compression garment is not worn. Postoperatively, the hips are flexed and the thighs are abducted to relieve stress on the incision. At least one drain on each side should be left in place for 14 to 21 days after surgery. Antibiotics are used until all drains are removed.

     

    What happens after Lower body lift surgery?

    After lower body lift surgery

    Lower-body lifts typically take 6 to 9 hours to do, depending on the amount of trunk and thigh lipoplasty. Preoperatively, 1 to 2 units of autologous blood are often donated. Lower-body lift patients are followed on an inpatient basis for 4 to 5 days after surgery, depending on the extent of lipoplasty and lifting.

    Preoperative antibiotics are administered and maintained until the final drain is removed (10 to 20 days). Dressings are removed 1 to 2 days following surgery, and silver sulfadiazine cream is administered twice daily on the wound. Patients are allowed to stand at the bedside and begin a regimen of increasing ambulation with a walker after 24 to 36 hours. Stool softeners and protein beverages are introduced on the first postoperative day, followed by a high-protein diet. After 2 to 3 weeks, an exercise bodysuit or leotard is worn for comfort and support for many weeks.

    Most patients can resume a limited work schedule in 3 to 4 weeks and full strenuous physical activity in 2 months. Suture reactions/infections, seromas, hematomas, delayed wound healing, wound infection, wound dehiscence, prominent or enlarged scars, paresthesia or anesthesia, and recurrence of aesthetic deformity due to underresection are all possible complications. Major problems, such as a pulmonary embolus or death, are uncommon.

    Unwanted outcomes can be avoided with good preoperative planning and patient selection. Despite its complexity, lower-body lifts give predictable and satisfying results with a minimal chance of major consequences.

     

    What are the possible complications following Lower body lift surgery?

    Lower body lift surgery

    There is an increasing number of individuals who have lost a significant amount of weight as a result of bariatric surgery or lifestyle adjustments. As a result, there is an increase in people with redundant skin folds, which can create medical and psychological issues. Lower body lift surgery corrects abnormalities in the belly, mons, flanks, lateral thighs, and buttocks. Complication rates are relatively high, which may have an adverse effect on the beneficial outcomes.

    Postoperative pain or stiffness, numbness of the skin flaps, bruising, overall weariness, and discomfort due to increased skin tension for a few weeks postoperatively are all common symptoms of lower body lift treatments.

    Hematoma, seroma, wound infection, fat necrosis, wound dehiscence, paresthesias, and persistent numbness are all examples of local complications in all areas. Seromas are a prevalent condition in the abdomen region, and they are often treated with several punctures and drainage. Seromas that persist may necessitate a subsequent surgical operation. Seromas, in general, should be discovered early and treated with simple suction to avoid superinfection or wound separation.

    Minor wound dehiscences are frequent and, for the most part, self-limiting. Patients in the intergluteal cleft region typically have wound healing issues and the conservative therapies that go with them. To minimize wound separation induced by shearing pressures, wound closure in this location is reinforced by non-resorbable simple interrupted sutures.

    Because resorbable sutures are used to close wounds, surgeons frequently observe single or many local wound-healing disorders across the area; however, they occur more frequently in the gluteal region. Because tension in this location cannot be alleviated as well as in the abdominal region, wound separation in this area is more likely. To promote wound healing, surgeons commonly conduct everting wound closure, which decreases wound healing abnormalities by reducing suture material interference on the skin level.

    Increased tension or wound-edge necrosis can induce significant dehiscences. The appropriate treatment for wound necrosis is conservative wound care until the necrosis region has been delineated for surgical revision. Further advancement of the flap may allow for adequate secondary wound closure. As long as the umbilical stalk is fitted on the skin level, any compromise of umbilical perfusion should be addressed conservatively.

    Additional local issues include dogears, hypertrophic or misaligned scars, and aesthetic umbilicus difficulties in the abdominal area. The majority of these complications may be prevented with proper preoperative planning and attention to surgical detail. Liposuction treatment may result in postoperative contour abnormalities and dermal tethering, as well as severe edema in cases of circular liposuction of the extremities.

    Deep vein thrombosis, pulmonary embolism, fat embolism, respiratory impairment due to increased intra-abdominal pressure in abdominal cases with fascial tightness, and systemic infections, including toxic shock syndrome, are examples of systemic complications. All of these issues have the potential to be fatal. Abdominal tightening operations, in general, have a greater incidence of systemic complication than any other form of standard cosmetic surgical surgery.

    Unilateral or bilateral soft-tissue relaxation or rupture of the reconstructive gluteal sutures can be corrected with a subsequent treatment, or with the introduction of a mesh for tissue support. In situations of overall fascial deficit, a mesh support during initial gluteal auto-augmentation may be a future alternative.

     

    Outcomes of Lower body lift

    Outcomes of lower body lift

    Postoperative results in male patients for scar course and look, as well as body shape enhancement, are typically favorable, with stable results lasting for years. A very low scar course from the anterior and posterior views, a maximum reduction of abdominal tissue excess, and a maximum decrease of localized adipose tissue of the lateral and posterior flank area ("love handles") are all significant points.

    As a result, in individuals who have had considerable weight reduction, the vertical midline scar may be unavoidable. In general, the doctors reported better skin quality in male patients after weight loss, with a lower rate of secondary relaxation, most likely due to a greater prevalence of conservative weight loss in the male group.

    Female patients, particularly those who have lost weight, are concerned with improving the abdominal region, including the mons pubis. In this regard, doctors have seen excellent patient satisfaction following abdominal tightness since this surgery allows for maximum tissue reduction.

    Because the subcutaneous fat tissue layer in the central upper abdomen is entirely excised, the remaining abdominal subcutaneous tissue is maximally thinned out, resulting in the most beautiful abdominal and waist shape enhancement. To avoid a tissue mismatch between the mons pubis area and the abdomen, a significant reduction is recommended using liposuction, direct excision, or a wedge excision design.

    Female patients' second major emphasis is gluteal reshaping. Because each patient has a unique set of preoperative problems, an individualized treatment plan must be devised. Because most patients have enough gluteal fat tissue, the repair via tissue transpositioning allows for a stable remodeling of the buttocks.

     

    How much does Lower body lift surgery cost?

    Lower body lift surgery cost

    Because a lower body lift is considered elective cosmetic surgery, insurance usually does not pay the costs. However, if your operation is deemed "medically essential," your insurance carrier may pay part of the costs. Insurance companies often have severe standards for each service they cover.

    If your pannus is interfering with your functioning, your insurance company may pay for a panniculectomy (removal of the overhanging "apron" of belly tissue). Each insurance provider has its own set of requirements, which may vary depending on the plan you have with them.

    Prior to your operation, make sure to check with your insurance provider to see what charges they cover. Many surgeons offer patient financing strategies to make treatments more accessible if insurance does not cover the costs.

    Lower body lift prices vary depending on the surgeon, geographic location, and technique employed. During your appointment, be sure to question your surgeon about the approximate cost of your specific lower body lift procedure. A lower body lift costs on average $7,269.

     

    Conclusion

    Lower body lifts

    Lower body lifts are a highly successful technique for body rejuvenation and reshaping. Aside from the benefits and improvements in the abdominal region, the whole body and gluteal form can be greatly enhanced.

    In terms of trans-positioning of the subfascial lateral gluteal, lateral thigh, and hip adipose tissue, gluteal auto-augmentation (gluteoplasty) is an effective and dependable procedure for gluteal augmentation. It may be included into any body lift treatment without requiring any significant time or financial investment.

    If clinical routine is followed, the lower body lift may be performed safely with less operating time and, as a result, fewer problems, as well as high patient satisfaction and optimum cosmetic results. These expectations, however, are dependent on the patient's preoperative circumstances and tissue features.