Body lift surgery (also known as “circumferential abdominoplasty” or “circumferential torsoplasty”) is a procedure designed to remove excess skin that has accumulated around the body, particularly in patients who have undergone significant weight loss. Patients may have lost weight through diet and exercise or through bariatric (weight-loss) surgery such as gastric bypass and lap band. After losing weight, patients may notice excess skin around the body. Areas can include anywhere from the abdomen in the front to the outer thighs or the back in severe cases. Essentially, the surgery removes excess skin to improving contouring and ensure that the skin does not have a wrinkled, “tree-trunk” appearance.
Good candidates for this procedure:
Patients who want to improve the shape and tone of their body
Bariatric patients that underwent massive weight loss and as a result have a lot of excess skin all over the body
Patients with significant skin laxity
What to expect: Consultation
All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for a body lift.
Dr. Hsu will first inquire about your weight loss story in order to understand the degree of changes your body has undergone during weight loss. He will then ask about your specific goals for the body lift, including what areas of the body you would like to improve. Then, he will examine the area together with you and assess the skin to determine its elasticity. He will also ask about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.
Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the surgical plan should be individualized for your anatomy. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results.
On the day of surgery, come in early to fill out paperwork, meet the anesthesiologist, and the staff will prep you for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last questions you may have.
Body lift procedures are performed under general anesthesia for a duration of approximately four hours, depending on the degree of skin removal. The lower body lift is conceptually similar to a tummy tuck (abdominoplasty) but is tailored for more skin excision and can go all the way around the body. Usually, body lift patients have a greater degree of excess skin than abdominoplasty patients, so the surgical plan is slightly altered.
In the front, excess skin is removed in either a vertical direction (similar to a tummy tuck), or in some cases, a combination of horizontal and vertical direction. The skin may even be removed in an “inverted-T” pattern, which is called a fleur-de-lys abdominoplasty. This technique is often the most effective way to remove excess skin in a horizontal direction. In the outer thighs and back, Dr. Hsu will remove excess skin as needed using an incision site that maximizes symmetry.
Recovery & Post-operative Instructions:
Following the surgery, you will wear a compression garment for a couple of weeks to aid the healing process. The surgicenter nurse will teach you how to manage the drains or tubes that Dr. Hsu placed during the operation. Following surgery, you will need to measure the amount of fluid that comes out of the drains every day. Once that amount drops below a certain level, Dr. Hsu will remove the tubes. Most patients keep the tubes in for two-three weeks; however, this time frame varies for each individual.
Most importantly, you should keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe around the surgical area. Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to gradually return to full exercise and activity.
During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any issues after surgery, Dr. Hsu is available 24 hours for any immediate concerns. For an extended period of time after surgery, Dr. Hsu will see you in follow up to make sure you are healing well. Follow up appointments are scheduled immediately after surgery and for up to a year afterward.
Dr. Hsu's view on a Body Lift.
The first thing I will typically do when I meet a patient for this procedure is to congratulate them on the weight loss. Weight loss is difficult to achieve and requires tremendous determination and will power, whether that is done via diet and exercise or even with the assistance of bariatric surgery. As much as I believe that plastic surgery can accomplish some incredible things, the weight loss is ultimately the more important part in these patients. It is the weight loss that improves their overall health and allows them to be more energetic and active. I tell patients that the recontouring procedures such as the body lift are “icing on the cake” and are particularly helpful if the excess skin is interfering with the ability to maintain an active lifestyle.
Often times, for the body lift procedure, I will divide the procedure into two stages, doing the front portion of the abdomen and outer thighs initially, and then the back at a second stage at a later date. The body lift is a big procedure, and I think that this keeps each surgery’s length to a reasonable time and does not overwhelm the body’s healing mechanisms. It is definitely possible to do the entire body lift at one sitting, but usually for those patients, I would prefer that they stay overnight for monitoring in a hospital or at the minimum, a recovery facility.
In general, body contouring surgery after weight loss is a multi-stage procedure that is tailored to each individual patient’s needs. The first stage usually addresses the “trunk”, which means the abdomen, outer thighs, and back if needed. After this is done, then later procedures can address areas of the body like the arms, breasts, inner thighs, and face.