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Body Lift – After Massive Weight Loss

Reviewed by Dennis J. Hurwitz, MD, FACS

body lift

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Body lifts are plastic surgery procedures intended to shape and tone the abdomen, buttocks, thighs and breasts. A lower body lift (belt lipectomy) involves the tummy, the thighs, buttocks and back, while an upper body lift focuses primarily on the breasts, chest and middle back areas. If lower and upper body lifts are combined, the procedure is known as a total body lift.

Body lifts can be used to treat excess skin, cellulite and sagging fatty tissue, meaning the procedure may be performed on people who have sustained massive weight loss after bariatric surgery such as gastric bypass or Lap Band. In addition, these surgeries can help mothers get their pre-pregnancy bodies back.

Is a Body Lift Right for Me?

The best candidate for a body lift has maintained a stable weight for a minimum of three months – preferably six months to a year – and should be participating in a healthy exercise and dietary program. Candidates who have had gastric bypass, Lap-Band or other gastric restrictive procedures should wait at least one year after weight loss surgery so that the common health problems associated with obesity have had time to improve.

Women who plan to have children may be advised to postpone treatment until after childbearing. Normal-weight women in their 30s and 40s may opt for body lift surgery to remove remaining skin and tissue after reducing excessive post-pregnancy weight.

Consult a Qualified Plastic Surgeon

Since this is an emerging area of plastic surgery, relatively few plastic surgeons have had formal training or developed extensive expertise in this field. Instruction and education regarding post-bariatric body contouring and the body lift procedure are provided by organizations such as the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.

The type of certification is also important. There are more than 150 self-designated boards, but only a handful that are designated by the American Board of Medical Specialties (ABMS), such as the American Board of Plastic Surgery.

Here are some tips to consider when consulting a plastic surgeon:

  • Review the doctor's credentials, education, training, type of certification held and number of times that the procedure has been performed.
  • Ask about any published articles or presented lectures that the doctor has made about the procedure to medical audiences.
  • View before-and-after photos of patients with similar conditions who have undergone a body lift and alternative surgical procedures. Ask if you may speak with other patients who have undergone a body lift.
  • Inquire about the surgeon's preferred technique and possible complications that may result from surgery. Techniques can vary depending upon the patient's condition and the doctor's preferences.
  • Ask if the procedure will be performed in a fully accredited facility, what type of anesthesia will be used, and how long the procedure will take to complete.
  • Ask for a list of pre- and postoperative instructions. These instructions may include avoiding the sun, diets and aspirin for two weeks prior to surgery.
  • Inquire about the surgeon's policy if the procedure needs to be repeated or a secondary procedure is required. Some patients may require follow-up procedures at a later date to address skin that has relaxed and lost its tone over time.

The Body Lift Procedure

The operation is typically performed in a hospital. However, some procedures may be performed in a fully accredited outpatient surgical center. This might depend on your body mass index (BMI) at the time of the procedure. Time in surgery ranges from four to seven hours and is usually performed under general anesthesia, while you are asleep.

A lower body lift starts with a belt-like excision above the outer thighs and buttocks. Your surgeon may further separate the thigh skin to help with the procedure. He or she will then suture this area and start the tummy tuck (abdominoplasty).

The next step involves a horizontal incision made along the pubic area, which is followed by the removal of the tissues that span from the underlying muscles to the belly button. The skin in between the belly button and central rib cage will then be separated.  Next, your surgeon may suction out any remaining fat in this area with liposuction.

Your surgeon will tighten the stomach muscle after the extra skin is detached. The skin that remains is then repositioned and sutured at the pubic area; after which the belly button is returned to its original location.

An upper body lift starts with a broad bra-line skin removal. After your surgeon closes this excision, they will eliminate the back fat rolls and narrow the waist. Any extra skin under the breasts or over the lower rib cage can now be removed. When closing, your surgeon will tighten the skin under the breasts, and the raised abdominal skin will be sutured to the lower rib cage.

As part of an upper body lift, men can undergo male breast reduction.

Total Body Lift and Follow-Up Procedures

As the name implies, the total body lift combines upper and lower body lifts along with supplemental procedures. This can be done as one surgery, or at separate intervals.

The surgeries may be broken up because risks tend to increase when multiple surgeries are performed at the same time. The sequencing intervals are not set in stone. Different surgeons have different methods for performing total body lifts. Some surgeons start with a lower body lift, and then perform a breast lift, which is followed by a complete inner thigh reconstruction. Next surgeons may tackle the face, neck and arms.

Two of the more commonly performed body lift follow-up procedures include:

  • Arm Lift (brachioplasty). An arm lift usually involves an incision along two areas: the armpit and the inside surface of the arm from the elbow to the armpit, in an inconspicuous location. Excess fat is removed through liposuction. The excess skin is trimmed away, pulled together and sutured in place. Dressings will be applied to the incision areas. A compression garment may be required for several weeks after surgery.

  • Inner Thigh Lift (medial thighplasty). In most cases, excess fat and hanging skin is removed from the upper, inner thigh through an incision placed at the junction of the thigh with the groin. However, for individuals with more severe thigh contour problems, an incision may also be necessary which extends from the groin area along the inside of the thigh down to the knee. Excess fat is removed through liposuction. The excess skin is trimmed away, pulled together and sutured in place. Dressings will be applied to the incision areas. A compression garment may be required for several weeks after surgery.

After Body Lift Surgery

Body lift is a major surgical procedure and requires significant recovery time. Most patients remain in the hospital for one to three nights.

Pain and discomfort are first managed with intravenous or intramuscular medications, and later with oral pain medication. A specific dietary plan may be encouraged. The doctor will supply a complete instruction list that must be followed to reduce the risk of complications.

Drainage tubes are inserted, which will require personal home care for up to two weeks. These tubes can be safely removed when the output of drainage fluid is low.

The doctor may provide you with a medical compression garment to wear at all times except while bathing. This should be worn until your doctor lets you know it is no longer needed. Dressings are generally removed two days after surgery and showering is allowed at that time.

Your post-surgery activities will likely be restricted until you have adequately recovered. This could include no exercise and no lifting of five pounds or more. Walking is encouraged after surgery; however, further exercise is not recommended until sufficient healing has occurred.

Most people require four to six weeks' recovery before returning to normal activities, and generally from six to eight weeks before exercising. There cannot be any pressure placed on the treated area. Approximately 75 percent of the swelling dissipates at six weeks and 90 percent at three months.

Complications and Risks

With every medical procedure there is a possibility of complications, which can cause a longer recovery period. The most common body lift complications include seromas (fluid accumulating under the skin) and small skin separations. Your surgeon will help to resolve these issues.

Some patients experience reduced sensation in the treated area, which can be permanent. Infection, bleeding and blood clots are much less common. The abdominal scars will appear to worsen during the first weeks or months, and may take up to 18 months before they flatten and lighten in color. The scars never completely disappear, but can be hidden by clothing. Ask your doctor to explain the risks and treatments for complications.

Costs

The cost of a body lift consists of three primary fees: the anesthesia fee, the hospital facility fee and the surgeon's fee. The surgeon's fee and hospital facility fee are the most difficult to predict without first knowing the extent of the procedure. In rare instances, insurance pays 100 percent of the body lift cost. Medical necessity is the main factor for insurance companies, which your doctor can determine.

Average fees for the body lift (abdominoplasty, thigh and buttock lift) range from $12,000 to $50,000 (including hospital, surgeon and anesthesia fees). These costs vary based on the extent of the procedure and length of recovery.

As with most medical procedures, many surgeons offer payment plans. Many payment plans allow monthly installments over extended periods. For financing options and tips, continue reading about Patient Financing.

About the Reviewer of This Article

Dennis J. Hurwitz, MD, FACS is the director of the Hurwitz Center for Plastic Surgery in Pittsburgh, Penn., where he specializes in body contouring, facelift, rhinoplasty and cleft lip repair. Dr. Hurwitz is a clinical professor of surgery at the University of Pittsburgh, and board-certified by the American Boards of Plastic Surgery and Board of Surgery. He is a member of the American Society for Aesthetic Plastic Surgery, the American Society of Plastic Surgeons and the American Association of Plastic Surgeons. Dr. Hurwitz is the author of Total Body Lift: reshaping the breasts, chest, arms, thighs, hips, back, waist, abdomen, and knees after weight loss, aging and pregnancies. He is also past medical director of the University of Pittsburgh Cleft Palate Craniofacial Center.

[page updated May 2009]