The Tummy Tuck
The anterior portion of a lower body lift is generally a standard tummy tuck where the muscles or fascia is tightened in the midline with sutures to help flatten the abdomen. Excess skin is removed from the umbilicus to the pubic bone area and the upper abdominal skin is pulled down to cover the entire abdomen. The only difference is that, rather than tapering the excision to a point on the sides, the resection continues around to the back.
Rather than narrowing the excision on the sides with a standard abdominoplasty, the incisions with a body lift actually separate significantly during the skin removal the tighten the flanks and, in some cases, also result in somewhat of a lateral thigh lift. The scar here is generally kept low enough to stay below and average belt line.
As much of the lower back and upper buttock skin as possible is removed to flatten and tighten that areas as well as to provide a buttock lift. Fat injections can be done at the same time for buttock enhancement, which is known as a Brazilian Butt Lift or BBL. The scar in the back is designed to be as fine as possible and curved on each side as naturally it can be along the interface of the back and buttock.
The majority of patients who are good candidates for a lower body lift are those who have lost a significant amount of weight through either diet and exercise or bariatric surgery. They have a lot of loose skin on their abdomens and flanks as well as some sagging of the buttocks. Best candidates are also active, exercise regularly, have stabilized their weight for many months and are otherwise healthy.
Drains and Garments
After a standard tummy tuck, two drains are usually placed through the incision to eliminate any accumulation of blood or serum under the skin after surgery. Generally one is removed three to four days after surgery with the other being removed a few days after that depending on how much is coming out of the drain. With a lower body lift, two drains are also placed in the back and these are typically taken out in the office at the same time as the drains in front.
A compression garment is worn for a few weeks but can be removed for showering and for washing of the binder.
There are a variety of different types of tummy tucks, which makes for various options with a lower body lift. It can be done with a mini-tummy tuck rather than a standard tuck for those who don’t have a lot of excess skin in front. Those who have a lot of excess skin in a horizontal dimension can also have a fleur-de-lis tummy tuck which removes both a vertical and a horizontal wedge of skin in combination with the buttock lift.