Two-Stage Body Lift After Major Weight Loss: Less Risk, Better Results

Posted June 22, 2018 in

If you have experienced a major weight loss due to aggressive dieting and exercise or bariatric surgery, congratulations! You have undoubtedly improved your health and you probably look way better — in clothes. Out of clothes, however, you may notice sagging skin along the abdomen, thighs, buttocks, breasts, and arms.

If the excess skin in your midsection is primarily limited to the abdomen and pubic region, then a tummy tuck may be an excellent option. However, if you also notice sagging of the buttocks and outer thighs, you may be better served by a body lift. A body lift (circumferential abdominoplasty, belt lipectomy) entails removing excessive skin and fat along the entire circumference of the midsection (front, sides, and back).

A body lift may be performed in a single stage or in two separate stages spaced several months apart. At first glance, one surgery certainly sounds better than two. However, I believe that dividing a body lift into two stages offers two major advantages:

1. Less risk
   Single-stage body lift is arguably associated with greater risks and a longer recovery than just about any other cosmetic surgical procedure. It is a lengthy procedure that has significant risks of wound healing problems, infection, bleeding (sometimes requiring transfusion), fluid collections, and occasionally fatal blood clots. I am not suggesting that single-stage body lift is an inappropriate procedure; only that it is associated with a high number of complications, some of them quite serious.
   Two-stage body lifts entail an extended tummy tuck in the first stage followed by a buttock and outer thigh lift (whose incision completes the circle started by the tummy tuck) in a second stage. The two-stage procedure entails the same risks as the one-stage. However, the frequency and severity of the complications is lower– and yes, that’s accounting for the risks of both stages. The reason is simple: tummy tuck and buttock/outer thigh lift are big surgeries, but single-stage body lift is a huge surgery.
   Similarly, a single-stage body lift entails postoperative hospitalization, frequently for up to a week. In contrast, each stage of a two-stage procedure requires an overnight stay (i.e. you can go home the next morning).
2. Better results
   Why do people get body lifts?
   To remove sagging skin.
   How much skin should be removed?
   As much as possible.While these answers are self-evident, it may not be so obvious that this is better accomplished in two stages.When a tummy tuck is performed, you must stay bent at the waist for a week or more because there is so much skin removed that you cannot possibly stand up straight or lie down flat. Eventually the skin relaxes, and you can straighten out.When a buttocks and outer thigh lift is performed, you must stay straight at the waist for a week or more because there is so much skin removed that you cannot possibly sit down comfortably. Eventually the skin relaxes, and you can bend.

   Performing a body lift surgery in two stages maximizes the amount of skin removal that can be removed in each stage. Think about it: you’re maximally bent after one stage and you’re maximally straight after the other.

   In contrast, a single-stage procedure inevitably leads to compromise in the amount of skin that can be removed. Since you can’t be simultaneously bent and straight at the waist, you have to choose a middle ground—which means less skin removal and less skin tightening.

   I believe that a two-stage body lift approach simultaneously improves safety and surgical results. Better results with fewer complications? Certainly worth considering.

Stage 1: Tummy Tuck

Stage 2: Buttocks and Outer Thigh Lift

Dr. Friedman specializes in breast and body contouring in Plano, Frisco, McKinney, Allen, Denton, and Irving.