What is body lift?
I am glad you asked that question. A body lift is a very unique operation and tends to be combination of several other operations. In essence a body lift is a combination of a tummy tuck, a thigh lift, arm lifts and breast lifts. This is an operation popularized in the recent show “The Swan” and “Extreme Makeover.” In these operations, the whole body is effectively changed. This is an operation that also is often offered patients with massive weight loss following gastric bypass surgery.
The actual body lift procedure tends to be a combination of many operations that are completed in staged fashion. We evaluate the patient and see which of the operations would benefit them most. In post gastric bypass patients for example a circumferential lift or lipectomy is first entertained. In this operation, similar to an abdominoplasty an incision is made around the excess skin of the abdomen. However, unlike an abdominoplasty, the incision in this case is taken all the way around the body. This helps us get rid of all the excess skin both in front and in the back. For these patients, this is the better operation as opposed to a standard abdominoplasty. Once this first stage is performed, the patient is allowed to heal for about 6 weeks.
The next stage usually considered is the medial thigh lift is which the excess skin of the medial thighs is removed. We take care to place
the incisions in the medial aspect of the thighs so that patients cannot see them when they look in the mirror. This helps to hide the incisions best.
Another stage that is considered is when the excess skin of the arms is resected. This is called a brachioplasty. This stage is usually combined with the breast lift or breast contouring operation. In this stage the excess skin of the arms are measured and the excess skin is resected. Like the medial thigh lift, the incisions are placed medially so that they can hidden and not seen when a patient is in a standing relaxed position. As for the breast lift operation, a standard breast lift is done. This can be complemented with an augmentation as most patients complain that their breasts feel hollow after their weight loss. A mastopexy and augmentation is routinely done for these patients and can be done with the brachioplasty procedure. The specifics of the mastopexy augmentation operation are discussed in the mastopexy/breast lift section.
How painful is the procedure?
Like any surgical procedure, there is pain involved. Most patients comment that they have a moderate amount of pain. To help with the pain, we regularly give patients oral pain medicine upon their discharge from the hospital. In an attempt to also help with the more immediate post-operative pain, we place indwelling pain pump catheters. These are placed during surgery and enable a self-contained system to dispense local numbing medicine (marcaine) into the area of the incision and help with anesthetizing the incision and wound area for the first 48 to 72 hours. The pain pump is heat activated so as long as it is taped to the body it will work. It is a continuous pump and does not need to be activated or regulated by you, the patient.
How long do I have to take off from work?
Great question. Most often I suggest to patients that they consider taking about 2 to 3 weeks off from work. Each patient is different but in my experience I have seen most patients be active and up to most of their usual tasks by 3 weeks after surgery. Again each person and each body is different. One thing I need to mention is that I would require as most plastic surgeons do that you wear an abdominal binder, a corset of types, to give you additional support during your recovery period. I would recommend you wear this binder for approximately 6 weeks time.
What are the possible complications of a body lift?
There are many possible complications of a body lift. Most often these complications include infection, bleeding, seroma formation, dehiscence, contour irregularity, asymmetric result and numbness. One by one we will discuss these. Infection is an issue here because most of these operations leave the patient with large incisions. We do our best to hide the incisions but we cannot make them smaller. Therefore, we do our best to give the patient the best coverage and anti-bacterial support with preoperative, intra-operative and postoperative antibiotics. This helps to reduce the chances of getting an infection. The patient also helps with this by being diligent with the care of the incision. Bleeding is a possibility. However, this tends to be easily managed in the operating room. We are diligent in stopping all bleeding points that we can see. As for bleeding however, the patient plays the most important role. Bleeding can best be prevented by the patient. Patients need to be off of any type of blood thinners such as coumadin, aspirin, plavix, and must also be off of vitamins and additives for at least three weeks. It may sound strange but many of the bleeding complications seen are due to the use of vitamins. So again the patient by being diligent and thoughtful can be the best asset.
Seroma is a fluid collection and its formation is understandable when there are so many long incisions on the body. A seroma tends to accumulate in an area with an open space. In patients undergoing body lifts procedures this can be a definite problem. To help with this we tend to keep drains in place for several weeks. These drains help to evacuate any excess fluid and keep the underlying tissues as dry as possible allowing for maximal healing. The abdominal area is also usually helped with the use of an abdominal binder that can help tighten tissue spaces and hinder the formation of a fluid collection. So again patient compliance can help reduce the chance of this complication.
Dehiscence is the breakdown of a wound following surgery. This can occur when two areas are tightly forced together. To prevent this we do exact measurements of the patient’s body contour and mark our incisions carefully. This gives the patient a certain amount of leeway and ensures that stress and movement do not cause breakdown in the incisions.
Asymmetries and contour irregularities are often seen with these operations. Since there is a significant amount of tissue resected,
most often small irregularities are noted. This is not to say that they are accepted. However, they are common. As the patients swelling dissipates, these areas are better assessed and they are individually tailored and repaired to give the patient the overall result that
Last but not least, numbness. Numbness is common in and around the incision areas. This again is not unexpected. When incisions are made and tissues are moved, nerves can in some cases be cut and in other cases stretched. Because of this numbness is an expected complication. Most often the nerve sensation returns in time. Unfortunately, when exactly the function returns is unknown. Most often nerve sensation returns within 6 months to a year.
Can I combine this procedure with any other procedure?
Yes and no. Like any surgical procedure, there are limits to what can be done and what is safe. As for the yes, it can be combined with some other procedures. Usually the belt lipectomy operation takes about 5 hours by itself so no other procedures are combined with it. However, the smaller or less intensive operations like the medial thigh lifts or the breast lifts allow for a significant amount of time excess. During these cases other procedures are routinely performed. Please not that any procedure that may be too long or too arduous and place the patient at risk for significant bleeding or significant anesthetic exposure would have to be deferred and done in two stages. Please understand I say this without knowing exactly what you, the patient, may have in mind. I can only speak from my experience.
Am I a good candidate?
Plastic surgery is not for everyone. It involves certain risks like any operative procedure. As long as you are aware of this fact, you can be considered for the procedure. However, in every case, the patient is best served by a thorough evaluation of their history, their body and
their overall expectations. You as the patient have to be realistic and cognizant of what is possible and what is reasonable. Trust me I am from Beverly Hills and I have had the privilege of working with many of the famous groups of plastic surgeons in LA. I can simply tell you there is no magic. We offer an opportunity to help you with surgical procedures in correcting what you may think is abnormal about your body. Also please understand that for many patients no surgery is needed; just a friendly word of encouragement and confidence from the local plastic surgeon.