(Also called surgery after gastric bypass or massive weight loss surgery, or lower body lift) 

Surgery after Massive weight Loss:

After massive weight loss, such as that which occurs with bariatric or gastric bypass surgery, there is a large amount of residual skin.  Patients will note that the skin hangs in virtually every area, from the face to the thighs.  In addition to the unsightly appearance, the excess skin can cause irritation, and hamper exercise and sex.  This situation is much different then a patient after pregnancy or with moderate weight loss or the sagging that occurs with aging.  The skin after massive weight loss has no elasticity left and even after skin excision and tightening procedures, there is frequently some relapse in the skin looseness.   We do not see this degree of relapse in other situations.   Each of the procedures described on this website including facelift, breast lift and breast reduction, brachioplasty (arm lift), thigh lift, and abdominoplasty (tummy tuck), can be used in the patient with massive weight loss.  Typically however there are certain modifications that we use in massive weight loss patients and body lifts are usually only preformed on massive weight loss patients.   Many surgeons in the Nevada area and elsewhere will not or cannot perform a body lift.  Dr. Smith performs them frequently.

 

It is important to understand that the commitment to begin corrective surgery after massive weight loss is a very serious, long and somewhat costly one.  However, when a patient is willing to undergo the procedures necessary to bring his or her body back into harmony, the results are frequently quite gratifying.  One patient compared it to buying a car, stating that a car typically becomes old and out of style after only four to five years, while her body is going to be with her for the rest of her life.  It should be noted however that the figure will never be the same as a thin person who never gained or lost weight.  As stated above, it is important for the patient to understand that the goal is improvement and not perfection.

 

What is a body lift:

A body lift is the largest surgery Dr. Smith performs.  It is typically only done on a patient who has lost a massive amount of weight.  The body lift simultaneously lifts the sagging buttocks, outer thighs, abdominal area and pubic area.  In a sense it is four surgeries combined into one; a buttock lift, an outer thigh lift, a tummy tuck and a suprapubic lift (the skin hanging over the genital area).   It is typically the first surgery a massive weight loss patient should have, and it is often combined with either a breast lift or arm lift.

 

How a body lift is performed:

Because of the extent of surgery, a body lift is always performed under general anesthesia.  The patient is put under anesthesia and carefully turned face down.  An incision is made at the top of the buttocks and the excess skin is elevated off the top of the buttocks and excised the lower portion of the buttocks is then pulled upward to the new height, lifting the buttocks.  The incision is carried around to the side and the excess skin is excised from the outer thighs and liposuction is then performed along the leg.  The skin is pulled upward on each side lifting the thighs.   The patient is then turned back facing upwards and the incisions on each side are continued around the front.  The skin is excised over the abdominal area similar to an abdominoplasty (tummy tuck.).  The tummy muscles are tightened which helps to flatten the tummy just as Dr. Smith does when he does a tummy tuck.  The hanging skin over the pubic area is then excised and the two edges are brought together pulling the tummy downward and tight and the suprapubic area upward and tight.  This tightens the tummy and lifts the handing skin over the genitalia.  When the surgery is finished there is a scar going 360 degrees all the way around the patient.  This lifts the buttocks, outer thighs and pubic area and tightens the abdomen.   The changes can be impressive and patients are usually very happy with the surgery.

 

What to expect in terms of recovery and healing:

This surgery takes the longest to recover from.  The patient is usually kept overnight and sent home the next day.  To prevent blood clots, it is important that the patient be up and walking the evening of surgery and every day thereafter.  There are typically three drains placed and these are removed over the next two to three weeks.   A patient should plan on taking at least three weeks off of work.   After about three or four weeks the patient may begin light exercise and by eight weeks most patients can be back to full exercise.  The scar is long, but fades over a two year period and once it has faded most patients do not notice the scar.