|Pain Level After Surgery||Severe|
|Duration of Surgery||6 hours|
|Scars||Belt-like scar around the waistline|
|Final Results||12-18 months|
|Return to regular activity||4 weeks|
|Resume Exercise||6 weeks|
|Price Range||Call to inquire about pricing|
One of the biggest advances in plastic surgery in recent years has been the body contouring surgery that we offer to patients who have lost a massive amount of weight. When someone loses a significant amount of weight, the harsh reality is that, in most cases, excess fat is traded for excess skin. Also, several psychological, social, and medical changes occur with the weight loss that a plastic surgeon should acknowledge when deciding what surgery to offer a weight loss patient.
When a patient undergoes dramatic weight-loss, there is usually loose skin in the face, arms, breasts, abdomen, buttocks, and thighs. A lower body lift is an operation that addresses the laxity of skin and excess fat in the abdomen, waist, hips, outer thighs, and buttocks. It can be combined with an inner thigh lift for total lower body rejuvenation. Although it is a big operation with prolonged healing time, the satisfaction a patient gets from this operation and the dramatic improvement is unparalleled.
A lower body lift procedure is more than cosmetic surgery for a bariatric patient. It is part of a “new me” plan. It is an affirmation of a final chapter in a long road towards self-improvement. It is the crowning achievement after taking huge risks, suffering major setbacks, and finally achieving a body that was once felt to be only a dream. It is a plastic surgeons’ privilege to help a patient achieve this dream.
An initial consultation is set-up where we discuss the lower body lift procedure, and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop medications that cause bleeding, such as aspirin, or aspirin-like products (Motrin or Ibuprofen), a week before this procedure. You are asked to stop smoking two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are always welcome to come back for follow-up, even years after your surgery, free of charge.
Patients seeking lower body lift surgery are usually bariatric surgery patients. They need to understand that massive weight loss, especially after a gastric bypass, puts them at a higher risk of complications from any surgery, especially a big one, like a lower body lift. All efforts to optimize nutrition, body weight, muscle tone, psychological, and mental state of mind should be undertaken to ensure the best outcome possible.
This procedure is a big operation. It usually lasts about 6 hours, and the patient has more bleeding when compared to other plastic surgery procedures. The scar extends completely around the body and is more limiting. Therefore, we require our patients to be admitted to the hospital for two days afterwards.
Conceptually, a lower body lift procedure is simple to understand. Imagine removing a 6 inch belt of skin around your waistline and lifting the lower body to fill the gap. This is a simplistic rendition of what a lower body lift accomplishes. This procedure will tighten the abdomen, waist, hips, buttocks, and outer thighs. It will not improve the inner thighs but it can be combined, in the appropriate patient, with an inner thigh lift, to accomplish a complete lower body enhancement.
The scar in this operation is of major concern. The location varies depending on the patient, but it usually resembles a bikini bottom pattern. Because of the high satisfaction that this procedure yields, patients are accepting of the extensive circumferential scar.
“I went to my 30-year high school reunion and everyone was telling me I hadn’t aged a bit.”
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible, anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class hospital with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Bleeding during and after a lower body lift is significant, and a patient may need a blood transfusion. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. Also, at the end of the operation, four-to-six drains are placed under the skin to manage any early post-operative bleeding. In our practice the rate of significant bleeding is about 10%. If there was a collection of blood, the treatment of a hematoma or a blood clot is to open the incision and remove the blood clot. Typically, this is a straightforward procedure.
The most important step in avoiding infections/wounds, in my opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery and during the two day hospital stay. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, our patients are prescribed a two-week course of antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a lower body lift is low. Conservative removal of skin is important for good aesthetic results, while avoiding undue tension on the skin. Small to moderate wounds, due to the nature of this operation, may be as high as 25% in our practice. They usually heal nicely with dressing changes and antibiotic ointment. The key to a good outcome is patience on behalf of the patient, and good communication and follow-up with our office.
By elevating the skin of a large area in the waist region to perform a lower body lift, the nerves that provide sensation to the areas around the waistline are cut, and sensation over most of the abdomen and the buttocks is lost for months. After a year, sensation usually returns, but not completely. This fact is significant for patients to understand so that they will not put heating pads or cold compresses on their waist after surgery because with nerve sensation absence, a burn may occur.
Seromas (Fluid Collections Under the Skin)
When a large area of skin is undermined, fluid collects underneath. Drains are placed to evacuate this fluid. After drains are removed, fluid may reaccumulate. The treatment is to aspirate the fluid, which is usually sterile, with a needle. This may need to be done multiple times over a few weeks. This maneuver is not dangerous, or painful, but it is a nuisance, requiring more frequent office visits than normal. The rate of seromas in our lower body lift patients is about 20%.
Smoking is an absolute contraindication in lower body lift. The carbon monoxide and nicotine in cigarette smoke causes severe reduction in blood supply to the skin and tissue during healing. This results in delayed wound healing, wound separation, death of the skin, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.
Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that you be monitored in the hospital or at a care facility for the first few days after surgery, and an adult drive you to your first several follow-up visits. With most procedures, you will be instructed to limit activity for the first several weeks, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four to six weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure. We also offer scar creams at an additional cost to optimize results.
To promote healing and minimize complications, you will be seen in a series of post-op appointments. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s cell phone number if you need to reach him after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.
At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.
There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.
We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Dr. Bitar is committed to continuing education, honing his skills and introducing new techniques always with the aim of improving safety and surgical results.
We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.
Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar is a distinguished board certified plastic surgeon who stays on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, he is able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.
For more information, call our office at 703-206-0506.
Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.
If you would like further information regarding this procedure, please feel free to contact our office to schedule an appointment by calling (703) 206-0506 or filling out an online request form.