Lower Body Lift
A lower body lift involves the excision of loose skin and fat from the lower tummy or abdomen, around to the sides and to the back.
- At the front the underlying muscles of the tummy are tightened, and any hernias are repaired. This can produce a beautiful, flat shape to the tummy.
- At the back extra manoeuvres can be performed to augment or increase shape to the buttocks
- Down the sides tissues are lifted to not only excise the skin and fat, but to also lift the lateral thigh tissues.
This procedure is suitable for men and women who have lost a large amount of weight which could be either through diet and exercise or through bariatric surgery. The loose amount of skin and fat often interferes with their daily life, and exacerbates skin rashes and other skin conditions.
Men and women seek lower body lift surgery to:
- Wear clothes that may otherwise reveal the loose skin or excess fat they find embarrassing
- Wear swimwear they want to wear
- Feel confident in social situations
- Restore shape of their tummy, trunk and sides after going through massive weight loss
- Remove skin and fat that cannot be addressed through other means
- Improve skin rashes and conditions that are exacerbated by the loose skin and do not improve through other means
The medical benefits of a body lift can include: improved back pain, improved incontinence and improvement in skin rashes under the skin.
The best candidates for lower body lift are men and women who:
- Have already lost the weight they want to lose
- Have been a stable weight for at least 6 months (ideally 12 months)
- Are physically and mentally healthy
- Have realistic expectations, and are willing to accept the scar of lower body lift
Lower body lift may not be suitable for those who:
- Have not lost the weight they want to lose
- Have significant fluctuations in their weight
- Are very overweight or obese (BMI >35) – ideally your BMI should be less than 30 for best results, but can still be considered for those BMI 30-35
- Have multiple medical problems
- Have multiple scars on their tummy, or have had a gallbladder removal through a large incision (open cholecystectomy)
- Are on blood thinning medication
- Are actively smoking
- Will not accept a long scar of a body lift
Those who can accept the trade-off of large scars for excision of skin and fat, can achieve remarkable outcomes from body lift surgery.
Patients who lose massive amounts of weight may consider other surgeries:
- Women may consider Breast Surgery
- Breast Augmentation
- Breast lift/Reduction
- Augmentation-Mastopexy
- Arm lift
- Thigh lift
- Liposuction
- Upper body lift
- Face and neck lift.
For more information on other procedures please read the other sections of this website.
At MODE, Dr Aggarwal will guide you through the planning of surgery and help decide which procedure is best suited to achieve your goals.
Procedure Snapshot
- Anaesthetic: GA by accredited anaesthetist
- Time: 6 hours
- Duration of stay: 1 week stay in hospital *can be longer
- Hospital: At any of the private hospitals where Dr Aggarwal works – usually Sydney Adventist Hospital or Hunters Hill Private Hospital.
- Medicare/Health fund rebate: Yes for those who meet the following criteria (introduced in 2016):
- Significant loss of weight equal to or greater than 5 BMI points
- Skin condition exacerbated by loose skin and fat
- Skin condition not resolving with 3 months of conservative therapy
- In addition you need to have the appropriate level of health fund cover.
- If not insured, the length of stay in hospital makes this surgery cost prohibitive and you may wish to join a fund prior to having this surgery.
- Recovery: Most people stay in hospital for a week, but there is a chance of more prolonged hospital stay. It is not uncommon for patients to go home with a drain. Patients start walking hunched over and by the end of the first week they are starting to walk almost straight. Heavy lifting or exercise is disallowed for 8 weeks and strenuous exercise for 3 months. For 8 weeks you will be required to wear a binder (which is like a corset) over the tummy. You can shower once down to 1-2 drains but patients have to avoid swimming until all wounds have healed (at least 2-3 weeks but it can be longer).
- Results: Can be a life changing operation and a massive reward for patients who have done well to lose massive amounts of weight. The difference the surgery can make to their lower body can be remarkable.
Cosmetic Concerns
- This is a good mindset to have after undergoing massive weight loss, and it these patients who will do well from lower body lift surgery.
- The scar from a lower body lift involves the scar of a conventional tummy tuck but extended around to the sides and around to the midline at the back. This removes the skin and fat excess in a vertical dimension.
- As the skin and fat expands the body in all dimensions, when weight is lost the extra skin and fat should be thought of as a lamp shade which needs to be reduced in all dimensions. This means that some patients may also require a vertical scar at the front to reduce the skin and fat horizontally.
- This is a common concern for women presenting to Mode Plastic Surgery.
- During pregnancy the belly expands to accommodate the expanding uterus and foetus. Part of this process involves expansion of the abdominal or tummy wall, and therefore the rectus muscles separate.
- It is variable to what extent this separation repairs itself after pregnancy and unfortunately no amount of fitness training or exercise will completely repair the separation.
- During a lower body lift and tummy tuck procedure not only do we excise the excess skin and fat, but underneath we carefully tighten the muscles and correct their separation. This provides a beautiful definition to the waistline and much flatter tummy.
- The muscle repair is part of the reason for restricting activity after a lower body lift tummy tuck and wearing a binder, as they layer on top of the muscles (called the fascia), is slow to heal and scar, and takes at least 8 weeks to strengthen.
- An outie belly button can be due to the presence of an umbilical hernia.
- All umbilical hernias are repaired at the time of lower body lift and tummy tuck surgery and should be able to produce a more normal appearance to the belly button.
- However the larger the hernia, the more the blood supply to the belly button can be at threat when combined with a lower body lift or tummy tuck. In very large umbilical hernias it may be necessary to remove the belly button altogether and come back to reconstruct it in the future after the lower body lift and repair of hernia procedure.
- This is usually not possible at the time of lower body lift surgery.
- This is because a lower body lift and a thigh lift pull tissues in opposite directions, so performing the two together can risk higher chances of wound breakdown and higher complications.
- It is best to stage these operations, however it may be wise to perform aggressive liposuction of the thighs at the time of lower body lift surgery in preparation for future thigh lift.
- This is a common request in patients who have lost massive weight loss
- However upper back rolls will not be corrected with a lower body lift
- The procedure required to correct this is an upper body lift. This usually needs to be performed as a separate stage as an upper and lower body lift pull tissues in opposite directions.
- For more information please refer to the upper body lift section of our website.
Procedure Information
The procedure is performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). The procedure takes 6 hours and most patients will spend at least a week in hospital
- Patients with massive weight loss can have nutritional deficiencies
- This is especially the case in patients who have undergone bariatric surgery and have experienced rapid weight loss
- You are most likely to be sent for preoperative blood tests and sometimes a nutritional assessment before undergoing lower body lift surgery
- If there is any suspicion for hernias in your tummy or you have had multiple previous abdominal operations, you may be sent for an ultrasound or CT scan, but this is not routine.
- A scar has to be placed from hip to hip and all the way around to the midline at the back. The exact position of this scar is changed in different patients depending on the amount of loose skin and fat, how much the waist needs to be defined and how much the buttock needs to be shaped and lifted.
- The operation begins on the back and buttocks – The incisions are made, buttocks are lifted and the measured skin and fat excised. The wounds are closed over drains.
- The front is operated on next and like a traditional tummy tuck the skin and fat are lifted upwards towards the rib cage. The tummy muscles (rectus muscles) are tightened and their separation repaired. At the same time any umbilical hernias are repaired.
- The amount of skin to be removed is then calculated, and after it is removed, the incisions are closed. The belly button takes a new position on the tummy skin although its physical position has not actually changed.
- Some patients, depending on the amount of loose skin and fat, may need an additional scar down the midline at the front.
- In general 4 drains are used for lower body lift surgery.
- Whilst in hospital the drain outputs are recorded, and the drains removed once fluid drainage is minimal.
- It is not uncommon for patients to go home with a drain and see Dr Aggarwal or his staff in rooms to have the drain removed after discharge from hospital.
- Dr Aggarwal will place dressings over the incisions.
- When you come out of surgery you will be in bed with your back and legs up.
- You will be able to walk hunched over (as the tummy will be tight). You may have a catheter in place which will be removed as soon as you are mobile.
- When you walk or move you will need to do so slowly and carefully as both the front and the back will be tight, taking are not to increase in tension in one area.
- You will be able to get all areas wet once you are down to 1 to 2 drains.
- Swimming in a pool or beach is usually deferred for several weeks until all incisions are healed and all the drains are out.
- You will be given a script for antibiotics by Dr Aggarwal which you must continue until all drains are removed. You will also be given appropriate pain relief medications.
- When you go home it is best to have someone look after you as you recover.
- While most sedentary activities can be resumed when you go home, you must lay low and not exert yourself. You will also not be allowed to do any heavy lifting or exercises for the first 8 weeks. During this period you will also be required to wear an abdominal binder (resembles a corset).
- Dr Aggarwal will see regularly after your discharge from hospital.
Risks & Complications
Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.
- Risks of anaesthetic – there are general risks of going under an anaesthetic such as stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of clotting in the legs. These risks are generally higher in patients undergoing lower body lift partially due to prolonged length of surgery.
- Bleeding (2-5%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
- Infection (2-%%) – this is rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
- Seroma (5-10%) – A lower body lift raises large amounts of skin which must then scar to the underlying fascia and muscles. This ‘injury’ causes the body to respond with accumulation of fluid, and there is a large potential space in which it can build up. Drains are inserted during surgery to remove the excess fluid that your body does not absorb. Drains are only removed when the fluid reduces. Keeping a binder on after surgery, as well as reducing movement is also essential to avoiding the risk of a fluid collection. If a fluid collection develops after removal of drains it may need to be removed via a needle through the skin. The fluid is removed as if it accumulates there is a risk of it getting infected
- Poor Wound Healing, wound separation (10-40%) – Risk of wound issues are much more common in a lower body lift due to the extent of scars, but also multiple areas of tension. Some surgeons regard wound issues to be almost universal in lower body lift. These are more common on the back and the sides, and also in patients who are malnourished or have protein or other vitamin and mineral deficiencies. It is for this reason that sometimes Dr Aggarwal will elect to stage this surgery. Usually wound issues resolve with dressings over several weeks.
- Umbilicus (belly button) compromise – this is a rare complication in lower body lift and tummy tuck surgery. By cutting around the belly button, its blood supply is reduced and it gains it nourishment through small blood vessels from inside the belly. However if you have an umbilical hernia that requires repair can reduce its blood supply even more. The umbilicus can also be at threat when you have had multiple previous abdominal procedures. The risk of all of these is higher in patients who smoke or are diabetic. Usually this settles with dressings or worst case may need a belly button reconstruction down the track.
- Skin necrosis – this is also a rare complication. By lifting skin at the front and back, its blood supply is reduced and it gains it nourishment through blood vessels from near the rib cage. However if you have previous scars on the tummy or have had multiple previous abdominal procedures the blood supply may be reduced even more. The risk of skin necrosis is higher in patients who smoke or are diabetic.
- Change in tummy sensation – it is common for the lower tummy to be numb after the procedure especially the skin between the belly button and the scar. This area reduces over months after surgery and there may be a small patch that remains numb forever.
- Widening of the belly button – this occurs in everyone and for this reason Dr Aggarwal will err on the side of making your belly button smaller, as it will stretch over months following surgery.
- Asymmetrical scars – This should be regarded as the norm in lower body lift given that all tissues are lax and floppy. There are natural asymmetries to the body and there can be a difference in how each side of the body behaves to surgery and skin tension, and can produce an asymmetry to the scars, albeit the aim is to get them as symmetrical as possible.
- Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.
Procedure FAQs
- It is best to obtain a referral for tummy tuck as it is possible to claim a Medicare rebate of approximately $73 for the consultation if you have a referral.
- You should have documented in your referral the amount of weight lost, the reduction in your BMI, and skin rashes or other skin conditions that may have been exacerbated by the loose skin and fat. This is because as of 2016 there are strict criteria used by Medicare for this surgery.
- A referral will therefore also allow you to claim a rebate for this procedure from Medicare/health funds, as long as you are appropriately insured.
- You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill or Camperdown.
- Please scroll to the bottom of the page to find out more information about these locations.
- Any of the hospitals where Dr Aggarwal works – usually at Sydney Adventist Hospital, or Hunters Hill Private hospitals.
- Cease fish oil, and other supplements such as Ginkgo, Ginseng.
- Take protein supplements and multivitamins well in advance of your surgery, and any other supplements to correct nutritional deficiencies that may have been picked up before surgery.
- Stop smoking well in advance of surgery – Dr Aggarwal does not offer lower body lift to patients who are actively smoking.
- You will also be required to wear an abdominal binder for 8 weeks.
- You will need to walk hunched over initially but you straighten a little day by day.
- Heavy lifting and exercise will need to be avoided for 8 weeks to allow the abdominal tissues to heal.
- Heavy gym exercise will need to be discontinued for 3 months.
- Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief. The antibiotics need to be continued until when the drains are out.
- Not usually for the lower trunk.
- However patients who undergo massive weight loss return for other surgeries such as arm lift, thigh lift, upper body lift, and facial cosmetic surgery.
- It may be possible to undertake scar revision at any of the future surgeries
- Yes
- However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise
- It is also unwise to undertake long haul flight after long operations as this significantly increases your risk of clots in the legs (DVT) and clots in the lungs (PE).
- You may do gentle swimming in a pool or beach after 2-3 weeks once all wounds have healed and all the drains are out.
- However it can be much later than this as it is common for small areas of the wound to take weeks to heal after a lower body lift, and you cannot swim until all the wound has totally healed.
- Heavier swimming (like doing laps) will need to be deferred for 3 months.
- It is best to not drive for the first 4 weeks after lower body lift surgery.
- Yes.
- Initially a lot of the skin between the belly button and the incision or scar line will be numb.
- This gradually recovers over month following surgery and can take up to 12 months.
- There may always be a patch of numb skin just above the incision and below the belly button.
- Yes
- In general the buttock is lifted as part of the lower body lift procedure.
- Dr Aggarwal will judge before the operation as to how much bulk will be left in this area once the loose skin and fat is excised.
- If you have significant deflation, meaning a lot of your buttock tissue lacks volume, then it is possible at the time of surgery to use some of the loose tissues to augment the buttock.
- No.
- Patients who have lost significant amounts of weight need the loose skin and fat cut out.
- However in some patients Dr Aggarwal will elect to stage the front and back parts of the body lift operation to reduce wound complications.
Procedure Pricing
- Lower body lift surgery attracts a Medicare/health insurance rebate for those who meet the following criteria (the rules changed in 2016):
- Significant loss of weight equal to or greater than 5 BMI points
- Skin condition exacerbated by loose skin and fat
- Skin condition not resolving with 3 months of conservative therapy
- In addition to this you need to have the appropriate level of health fund cover.
- If not insured, the length of stay in hospital makes this surgery cost prohibitive and you may wish to join a fund prior to having this surgery.
- The out of pocket cost of surgery is approximately $20000 – 25000. This includes
- Surgical fees
- Hospital fees
- Anaesthetist fees
- Follow up
- Please note that the above prices do not include
- Preoperative consultation fees – which are $280 for the initial consult and $140 for additional preoperative consultations
- Fees for other procedures such as liposuction, breast or face surgery.
Meet Dr Aggarwal
Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.
What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at two of Sydney’s most prestigious public hospital campuses (RPA and POWH/RHW), and operates privately on the North Shore.
Why Choose Us
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New Consulting Locations
In addition to our Hornsby and Camperdown locations, in 2018 we bring you:
- Hunters Hill (Lower North Shore) – conventiently located near one of Dr Aggarwal’s operative locations at Hunters Hill Private Hospital, Hunters Hill offers the convenience of accessing Dr Aggarwal in the lower north shore.
- Gordon (North Shore) – set to be our primary practice, our flagship rooms will be open for trading in August 2018. Follow our blog to see an update on progress.
Consulting Locations
Phone:
info@modeplasticsurgery.com.au
Suite 13, 924 Pacific Highway
Gordon NSW 2072, Australia
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