Not only has body contour surgery emerged and increased in numbers, but the age spectrum for both male and female body contour surgery has also been greatly expanded to include much younger patients on one end of the spectrum and much older patients on the other. Lower body lift are performed usually in patients that have undergone massive weight loss as a consequence of surgery in which the tire of hanging skin and tissue is removed from around the entire midbody. These patients usually present with large quantities of abdominal fat and skin excess, a descended or hanging pubic area, back rolls, flat and saggy buttocks, excessive laxity on the lateral thighs, and no waist definition. Usually these patients will also require surgical procedures on the face, arms, breasts, inner thighs, and back.
Surgical procedure
A lower body lift usually requires between 6 to 8 hours of surgery. The patient is marked on the standing position just before the surgery. The excess skin is grasped at the level of the flanks with both hands trying to join each other, putting an important amount of tension. The horizontal lines of resection and the final incision placement are marked. These incisions are continued both anteriorly from hip bone to hip bone and posteriorly until they join with the markings of the contra lateral side. At this time areas that need to be sculpted with liposuction are also marked. These markings will guide us at the time of surgery and will make operative times quicker.
This surgery is carried out under general anesthesia and the patient is placed on the operating bed on one side first and then on the other side. Incisions are made following the previously marked lines. The removal of excess skin and fat is performed at this time. There is a moderate undermining of the tissues inferiorly. Once this is done, liposuction is performed at the level of the upper lateral thigh, flanks, posterior trunk andor other areas previously chosen. Then, the incision is continued at the abdominal area just above the pubic area, running from hipbone to hipbone and a second incision is made around the navel to loosen it from the surrounding tissue. After separating the skin from the abdominal wall up to the sternum and ribs, the separated muscles (rectus abdominus) will be pulled together and sutured from pubis to sternum. The apron of excess skin and fat in this area is removed and the navel will be repositioned.
The tissues are approximated placing the highest-tension on the wound closure laterally at the level of the flanks, and less medially. Two to Four drains are placed alone the incision lines to evacuate any old blood and prevent fluid accumulation. The incisions are sutured and a dressing is applied.
POSTOPERATORY
A one to three night stay at our center is recommended. Expect to be sore for about one week and require prescription medication. After one week any residual discomfort is easily controlled with over-the-counter medications. Sponge baths are mandatory until the drains are removed, which might be up to a week after the procedure. You will continue to wear the support garments night and day for approximately five weeks, and will be removed only to shower. Strenuous body activity is not recommended for the first 4-6 weeks, although walking is encouraged starting on the day after the surgery.
An iron supplement is recommended after the surgery for at least two months to help replenish any blood lost during the operation and will help you regain your preoperative energy levels at a faster pace.
