Lower Body Lift
The lower body lift is designed to remove excess skin and fat from the entire circumference of the lower abdomen, waist line and buttocks to achieve firmer, smoother and more youthful contours in the abdomen and thighs. The procedure is suitable for both males and females, and is particularly suited to patients with loose skin or following substantial weight loss.
Before and after photographs
The New Zealand Medical Council has banned New Zealand doctors from using "Before and After" photographs in any form of public communication, including websites. The only permissible use of such photographs under the New Zealand Medical Council rules is during a medical consultation.
Dr Masters will show you examples of previous patient's "Before and After" photographs during your consultation.
The Procedure
The lower body lift is more extensive than either a standard tummy tuck (anterior abdominoplasty) or the extended tummy tuck (circumferential abdominoplasty or belt lipectomy) as in addition to removing excess fat and skin from the circumference of the lower torso it also elevates the thigh tissues; it is best suited to patients who are near to their goal weight and who have descent of the skin and soft tissues of their abdomen, waist, thighs and buttocks.
The best candidates are people who have reached a steady state in terms of their weight and size, and are no longer gaining or losing weight/size. Although the operation can be performed on people who still have some weight to lose, the best results are always seen in people who are already at their best sustainable weight. That is, the weight at which their body gravitates towards when they are performing realistically sustainable (long-term) amounts of exercise and are not actively pursuing a weight-loss diet.
Although it is possible to have a successful pregnancy following a lower body lift, this is not advised, as much of the post-operative improvement is likely to be lost when the abdomen is enlarged with pregnancy. People who are not in generally good health should not contemplate this procedure.
Benefits
- A return to a more youthful and balanced physique.
- A decrease in physical symptoms attributable to the excess and skin and fat around the abdomen.
- Improved self-confidence in social settings.
- A change in body image allowing a wider range of clothing possibilities.
Relevant Anatomy
The abdominal wall, buttocks and thighs are composed of many layers including the skin, the fat below the skin and then the muscles. The fatty layer is subdivided into two layers: a superficial and a deep layer, which are separated by a thin but very strong layer of tissue called a fascia; it is this stretch resistant fascia layer that is tightened to create a permanent result.
The two rectus abdominis muscles (the ‘six-pack’ muscles) run vertically, side-by-side down the midline. The ‘tummy button’ (umbilicus) can be traced back from the skin surface down to the midline between the two rectus abdominis muscles. With pregnancy and/or excessive weight gain, a number of anatomical changes can occur. The two midline abdominal muscles begin to separate from each other. This separation reduces the efficiency of the abdominal muscular system, and also causes a decrease in the definition of the abdomen. Furthermore, in extreme cases, the abdominal contents can cause a bulge between these two muscles through the stretched region – an abdominal hernia.
The skin, which is also stretched with weight gain, has a limited ability to retract back again to its original size, once it has been over-stretched. ‘Stretch marks’ are an indication that the skin has been either over-stretched or stretched too rapidly. The presence of extensive stretch marks indicates the skin is unlikely to ever retract back to its normal shape and size.
Anaesthetic Used
This surgery is performed under a general anaesthetic (you are asleep). As a routine part of the procedure, Dr Masters infiltrates a large amount of local anaesthetic both through the tissues and also around the margins of the surgical site. This local anaesthetic means that most of the stimulation due to the procedure is numbed out when you awaken. It also means the anaesthetist can help you have a far smoother transition from anaesthetic to recovery. Furthermore, post-operative pain is vastly diminished with the extensive use of local anaesthetic.
Where is the Surgery Performed?
This is a significant surgical procedure, as such Dr Masters performs them in a fully equipped and appropriately expertly-staffed operating room at Southern Cross Hospital in Newtown, Wellington.
Pre-operative Preparation
Dr Masters will provide you with precise instructions well in advance of your surgery to allow you a smooth and stress-free preparation for the procedure. Take the time to read your consent form thoroughly, along with any other written information Dr Masters has provided for you with regard to your surgery. This will allow you to have all of your questions answered prior to the procedure, and ensure there are no unexpected surprises during the post-operative period.
You will be encouraged to wear an abdominal binder continuously for one week prior to your procedure (except when bathing). This is to allow your lungs, abdomen and venous system to become accommodated to the extra tightness/pressure they will be under post-operatively. Anecdotal evidence suggests it vastly diminishes the likelihood of post-operative complications.
If you are the main domestic executive in your home, or you live alone, you should plan ahead with regard to housework and meal preparation. Do your grocery shopping, cleaning, etc the day before your surgery and plan to have meals that require minimal preparation and/or cooking time.
If you are a smoker, stop smoking at least one month pre-operatively (see the “Disclaimer� page). Do not take any aspirin or aspirin-containing products for at least one week prior to the surgery. If you are on any other medications, ensure that Dr Masters is aware of the medications (including homoeopathic remedies) so that any other medications that require cessation during the pre-operative period can be discontinued .
The Procedure
With you laying on your side on the operating table, the excess skin and fat from the waist line to the midline of the back is removed down as far as the muscles. The skin and fat of the outer thighs and buttocks are loosened and elevated to close the incision under tension. Depending on the patient, typically 12 to 25 cm of vertical height of skin is removed at the waist line! You are turned to the opposite side and the procedure repeated.
You are then turned to a face up position and an incision is made around the tummy button so that it remains in its current position (fixed to the underlying abdominal muscles). The lower incision is completed across the abdomen either within or close to the natural skin fold; this incision meets up with the ones at each waist line. Through this the skin and the layers of abdominal fat are lifted off the muscle layers. The two midline rectus abdominis muscles are strongly sutured together in the midline. The excess skin and fatty tissue are then pulled downwards towards the patient’s feet and the redundant skin and fat removed. Strong sutures are placed deeply within the strengthening fascia layer. The sutures take all of the tension of the closure of the wound so that there is minimal pull at the skin surface. This means that the scar is unlikely to broaden and will remain thin and pleasing. Finally a small hole is made in the abdominal skin and the tummy button is returned to the surface and stitched in place.
The tissues involved in the operation tend to ooze fluid afterwards, for this reason drains are placed in the wound at the time of closure to prevent a fluid build up under the surface.
Depending on the patient’s needs, liposuction may also be performed as part of the procedure and/or to other areas.
Post-operative Recovery
A hospital stay of 2 -3 nights is required. The drains will remain in for 10 -15 days, and you will be thoroughly instructed on how to care for them prior to going home. Most patients require a minimum of 2 weeks to recover sufficiently from the surgery to return to work, but allowing 3 is better. There are usually no sutures to be removed following the procedure. You will wear a post-operative garment for approximately 3 weeks. This garment helps to reduce swelling and offers support to the tissues which makes you feel more comfortable. A series of follow up appointments will ensure you have no problems during this vital post-operative phase.
Initially, you will feel that you are unable to stand straight and will feel significantly stooped over. This feeling disappears as your natural posture returns over the first week to ten days post-operatively. Initially you will notice diminished or patchy skin sensation over the abdomen, buttocks and upper legs. Usually this sensation makes a full and complete recovery; however, occasionally you are left with permanent numb spots in these areas.
Dr Masters encourages patients to resume gentle cardiovascular exercise as soon as they feel able. You should not contemplate higher impact exercise (eg running, aerobics classes, etc) for at least six weeks. Swimming may be recommenced as soon as your wound is fully healed (usually around 3 weeks). If you have a membership at a gymnasium, it is recommended that you suspend the membership for 6 weeks to allow sufficient time for adequate healing. Should you be ready to return to the gymnasium prior to this, you will be able to reinstate your membership sooner.
Results
Once you have fully recovered from your lower body lift procedure, you can expect a smoother, flatter and firmer abdomen and narrower waist line with firmer, smoother and elevated buttocks and thighs. The umbilicus (tummy button) changes shape and is left in a more vertically orientated shape resembling that of a youthful abdomen. Dr Masters aims to have the scar from your tummy tuck located low on the abdomen, so that it is easily covered by your underwear or a bathing suit.
Risks and Complications
A lower body lift is a significant operation. Although every precaution is taken to help avoid complications, surgery by its very nature has inherent risks. Some of the complications that can occur are detailed below: -
Numbness - as described above. .
- Seroma (fluid accumulation under the skin) – this can develop occasionally after the drains have been removed. It will need to be drained on a regular basis or even require an insertion of a new drainage tube, but it will resolve with time.
- Unfavourable scarring – occasionally scars may widen despite the surgical manoeuvres performed to avoid this. Similarly, the location of the scar can sometimes be visible beyond the confines of underwear. .
- Lumpiness - usually in the lower abdomen and resolves with time. .
- Bleeding - it is unusual to require a blood transfusion for this surgery. .
- Bruising – particularly if there has been liposuction performed. This resolves with time. .
- Blood clots - you will need to wear compressive stockings on your legs until you are fully mobilising. These clots, which are not common, can be very serious if they move to your lungs, occasionally fatal. .
Approximate Costs
Including the theatre charges, consumable items used, post-operative garment, anaesthetist and surgeon's fees, the cost of a lower body lift starts from $29,000. This price can change depending on your medical history, the complexity of the case and whether additional procedures such as liposuction are done at the same time.
Back to Top
|
Printer Friendly