Lower Body Lift Surgey is a becoming popular treatment in plastic surgery after bariatic surgery or massive weight loss. There are three groups of patients that can get benefits from lower body lift or belt lipectomy. Firstly post bariatric mass weight loss patients. Secondly, 20-30 pound overweight group. Thirdly normal weight group who desire more dramatic improvement in lower truncal contour. These patient can present with different situations. That include hanging panniculus, ptotic mons pubis, vertical and horizontal skin excess of abdominal skin. Furthermore, lack of demarcation between lower back and buttock, upper back rolls, middle back rolls, lower back rolls inculde in it.
In lower body lift the overall circumferential wedge of resection is located lower onto the lower trunk. A plastic surgeon In Lahore can also perform thigh lift with this. This has the following advantages
- Lifting the trunk
- Very aggressive thigh lift
- Reduces the amount of surgery. That may be sequentially needed on thighs
- Lower scar position to be covered by low lying swim/ underwear
- But it has some disadvantages that can be
- Blunt the waist inpatient
- Scar violates the buttock unit posteriorly
- Lack of demarcation between the lower back and buttock
- Bulge over the anterior superior iliac spine in a patient with thick panniculi
Belt Lipectomy/ Centra Bodylift
It has an overall more superiorly based wedge of excision when compared with a lower body lift.
Firstly, it lifts the trunk
Secondly, it leads to waist narrowing
Thirdly, it improves the buttock contour
Fourthly, it demarcates the lower back from the buttock
Firstly, the high position of scar out of swimwear/underwear
Secondly, thigh reduction is not as aggressive
Massive weight loss patients present with multiple areas of deformity. That include arms, breast, upper back roll, thighs, face and lower trunk with hanging panniculus. Detail weight history is important in evaluation. A plastic surgeon also takes a careful history of the medical problem. That includes diabetes, heart problem, high blood pressure, bleeding disorder, smoking, DVT, previous surgery, Bariatric surgery. Furthermore, he also takes psychiatric problems. Subsequently, on examination, important points to be evaluated include:
- Degree of skin laxity
- Amount of subcutaneous fat
- Translation of pull
- Presence of scar
- Waist definition
- Presence of abdominal or back rolls
- Degree of recti diastasis
- Presence of hernia
- Degree of buttock projection and ptosis
- Degree of anterior and lateral thigh lipodystrophy and ptosis
The best plastic surgeon selects the appropriate patient. He discusses all the procedure to the patient with all detail including outcome and complication. He advises necessary investigations for fitness.
Goal Of Surgery Include
- Elimination of panniculus / flattening the abdomen
- Elimination of mons pubis ptosis and redundancy
- Creation of waist definition
- Lifting the anterior and lateral thighs
- Elimination of lower back rolls
- Lifting the buttock
- Creation of better buttock contour
Performs under general anaesthesia. Before the surgery, a plastic surgeon makes marks in standing position. The body lift surgery performs after infiltrating of local anaesthesia. This procedure helps the incision site to decrease bleeding during surgery with less pain postoperatively. A plastic surgeon makes dissections, He also removes the excess skin and subcutaneous tissue. plication of recti muscle also does if it is required. Hemaostasis secured. He makes a new position for the umbilicus and places the drain. The wounds of the plastic surgeon close with dressing. He also applies the compression garment. This body lift surgery performs firstly, with its prone position. secondly, supine position. Thirdly, during surgery. DVT prophylaxis also does in this surgery.
Post Operative Care And Recovery
The patient is advised in postoperative care not to move or by staff unless completely awake. After that patient is advised to ambulate in a way to avoid tension on a wound to prevent dehiscence. Folleys Cather and drains remove after 1-2 days. A plastic surgeon gives him a pain killer and antibiotics. The patient discharges home after 2-3 days. However, for the first-week patient ambulates bent at the waist and then allowed to straighten up over next week. Activity is restored after 2 weeks with regular non-physical work in 4 weeks. Compression garments are continued for 4-6 weeks for better results. Initial swelling and bruising are resolved in 1-2 weeks but edema is better in 3 months with more good results in 3-6 months. Final contouring is achieved about 1-year post-surgery.
As a general rule higher the BMI, higher the complications rate. However, with good care preoperative, intraoperative and postoperative the complication can be minimized. So, these complications may include
- Wound dehiscence
- Tissue necrosis
- Scar widening
All of these complications are in the range of 3-10 percent. But these can be managed in a conservative way.
Cost Of Lower Body Lift In Lahore, Pakistan
However, Cost of lower body lift depending upon conditions and combination of operation/ Range is 150000-300000 rupees