Body Lift

Body Lift (Circumferential Abdominoplasty/Belt Lipectomy))

What is a body lift?
Substantial weight loss is the most common cause of profound deflation and excess skin. However, pregnancy, and age can also contribute to profound skin excess and deflation.

The abdominal skin can become loose, excessive and saggy, while the outer thighs and buttocks descend and droop. A body lift is a procedure to circumferentially remove excess skin and fatty tissue all the way around the lower abdomen, flanks and lower back.

The surgical scar is hidden below the pant line, running around the body along the lower abdomen, flank and lower back, just above the buttocks. There is an additional incision around the belly button.

Pre Surgery Instructions

Before the procedure
No aspirin or blood thinning medications for two weeks prior to surgery. Fasting begins at midnight the night before surgery. Any medications that you take in the AM may be taken with a sip of water (except for blood thinning medications). If you get ill prior to surgery please notify us.

The Surgery

During the procedure
A body lift is done under general anesthetic and takes 5-6 hours, and is generally followed by an overnight stay in the hospital. Very often the anesthetists will combine the use of regional anesthesia (epidural and general anesthetic) to improve post op pain relief and limit the amount of general anesthetic required during the procedure.

The surgery begins with the patient on their stomach for the buttock and lateral thighs lift portion of the body lift. The procedure begins with liposuction to remove the excess fat. A central mound of fatty tissue is kept and shaped to create buttock projection. Following this, the skin is excised to elevate the buttock and lateral thigh over top of the shaped underlying fatty tissue. Liposuction of the mid and lower back is done at the same time.

With the patient still asleep under general anesthetic, the operating room team uses a mobile bed for the intra-operative position change. The patient is now on their front for the abdominal portion of the procedure begins. This is very similar to an abdominoplasty involving additional excision of skin along the flanks. If the abdominal muscles are spread (a rectus diastasis), they are tightened, and the excess skin is removed. Liposuction is performed to the flanks and when necessary the abdominal wall and pubic area. The use of two drains may be needed- this is determined during surgery. All of the stitches are dissolving and skin tapes, a dressing and a compression garment are put on at the end of the procedure.

After Your Surgery

Post procedure
While In Hospital or Clinic
You will be in the recovery room anywhere from 1-3 hours where the team will ensure you are comfortable, eating and drinking, walking and able to urinate if you are being discharged home on the same day. If you are being admitted overnight, you are then transferred to you room where you will be encouraged to take mobilize.
On discharge home
Immediately upon discharge from either the recovery room or the hospital or clinic, you are encouraged to rest under supervision and start a light diet as tolerated.

You will have been given a prescription for antibiotics that is started when you return home from surgery and is taken for 1 week.

The best position when lying down is with 2-3 pillows behind your head and 1 pillow under your knees
Day 1
You should be up and walking, drinking fluids, taking your antibiotics and pain medication as described below. Increase activity as tolerated, but there is no heavy lifting for 4 weeks. Leave the dressings alone. Many patients feel more comfortable walking slightly hunched over, which is fine, but not necessary. Some patients will find being in a full sitting position is tight on the back incision and may find it easier to partly lay backwards while sitting.
What do I take for pain?
If you have pain, you are encouraged to start with:

Two Tylenol extra strength (total of 1000 mg of Tylenol) and one Advil extra strength (400 mg of Advil) to be taken at the same time as they work by different mechanisms and work very well together.

You can take the above three pills (two Tylenol extra strength and one Advil extra strength) every 8 hours around the clock for the first day or two. This is often sufficient for pain medication and can avoid the need for stronger medications such as narcotics (Percocet, Tylenol #3 etc.).

However, you will also have a prescription for a stronger pain medication that can be taken as needed if the Tylenol and Advil combination mentioned above does not suffice. This stronger pain medication may be taken on top of the above regimen. Please ensure the maximum dose of Tylenol in 24 hours does not exceed 4000 mg.

** Please be aware that with any medication and particularly Advil (a type of non-steroidal anti-inflammatory) there are risks of allergy, severe allergy, gastro-intestinal bleeding and stomach ulcers. Taking your medication with food can sometimes help with some of the stomach symptoms.

A post-operative compression wrap and the underlying gauze dressings are left in place for 2-4 days. During this period of time, you may use a hand held shower or sponge bath but the dressings must stay dry.
First post-operative appointment
The initial dressing change is done on day 2-4 after surgery. If drains were used, they are typically removed at this visit unless there is a lot of fluid in the collecting bulb. The gauze is removed and the white skin tapes are left on. Dry gauze or padding can be used daily to protect the tapes from the compression garment. You will use a small amount of polysporin or fucidin and gauze for the belly button (umbilicus).

The compression garment/wrap is worn day and night for 4 weeks (except in the shower). You will be given two garments so that they can be alternated and washed.
Second post-operative appointment
The second appointment is close to 2 weeks after surgery and the white skin will be removed and changed to new skin tapes. Dry gauze is no longer needed. The belly dressing is no longer needed and a post-operative marble or bead is often used to help with swelling of the umbilicus.

Post-operative swelling and bruising begins to subside after 7-10 days but can take up to 2-4 weeks for the initial 70% of swelling to resolve.

As swelling can persist for 6 months, it will take that long to see the final results particularly where liposuction has been used.

Patients usually require 2 weeks of downtime and should avoid strenuous exercise for 4-6 weeks.
Third post-operative appointment
The third appointment is close to 4 weeks following surgery. The second set of skin tapes that were placed at the prior visit are now all removed and left open to dry for 4-5 days before silicone gel sheeting is used for scar management (you will get this from the office).

The compression garment is no longer needed but can be used if you like, particularly for exercise or activity.

The scars will take 12-18 months to fully mature and fade. Silicone gel sheeting is the best product to help with scar maturation and is used for 2-3 months following surgery.
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