Lower Body Lift

The lower body lift is becoming more common. Even though age, pregnancy and aging can lead to loose skin around the body, massive weight loss is the main reason for performing a body lift.

Whether due to diet alone or surgery (bypass, sleeve, gastric ring), significant and/or fast weight loss very often results in excess and sagging skin. As bariatric surgery is gaining popularity, the number of surgical procedures performed to repair the after-effects of weight loss is also increasing.

In these cases following dramatic weight loss, the lower body lift may qualify for corrective surgery as long as it meets the following condition: “major deterioration of the anterior abdominal wall with an overhanging apron that partially covers the pubic area, justified with a pre-operative photograph”.

The surgeon can sign off for prior approval, and if the case is accepted by the medical advisor from France’s national health care system, medical insurance may partially cover the procedure. However, coverage is minimal, given the significantly limited reimbursement from complementary health insurance plans since January 2017.

This plastic surgery procedure has relatively dramatic after-effects. Patients should plan for a recovery period of four to six weeks.

If the procedure is covered by France’s national health insurance, the doctor may prescribe sick leave from work. If the lower body lift is not covered, patients must take paid time off for their recovery.

Patients must stop smoking at least one month before surgery to limit the risks of phlebitis and pulmonary embolism and to promote healing.
Iron supplements are automatically prescribed one month before the procedure to limit the risks of anemia after surgery.

The lower body lift procedure has been completely redesigned by Doctors Claude Le Louarn and Jean-François Pascal and now follows a clearly defined protocol to optimize results and minimize operative and post-operative risks.

The key point is to perform the pre-operative marking accurately while the patient is awake in a standing position and lying down.

As surgery lasts between five and six hours, the patient must be kept warm during the procedure using heated blankets and be wearing intermittent compression tights.

The lower body lift procedure is divided into two phases:

• The first phase with the patient lying on the stomach, to treat the entire posterior side and the thighs. During the buttock lift, if the volume of the buttocks is inadequate, the excess fatty tissue will be used to increase the size of the buttocks by performing a subcutaneous fat graft.
• The second phase with the patient lying on the back, to perform the abdominoplasty on the anterior side of the body.

The weight of the fat and skin removed can range from one to several kilograms.

No drains are used, and a compression undergarment is placed on the patient at the end of surgery. A urinary catheter may be left in place for the first 24 hours but will be removed quickly.

The compression garment placed on the patient after surgery must be worn night and day for one and a half to two months.
An anticoagulant, low molecular weight heparin, is commonly used for the eight days following surgery. This involves daily injections in the thigh to avoid any phlebitis or pulmonary embolism.

Showers can be taken starting the day after surgery. Showering the scar improves healing and prevents infections.

No particular bandages are needed. The sterile strips left in place after surgery are changed with the bandages at the doctor’s office.
The stitches are dissolvable and do not need to be removed.

The patient must start walking again the day after surgery, gradually increasing the amount of time spent walking.
Despite all efforts to avoid blood loss, the lower body lift is a long procedure, and the patient may feel severe fatigue after surgery. Movement is difficult at first but becomes easier after a few days.
Patients can gradually resume exercise after two months. It is important to maintain physical activity.

Complications

Apart from potential complications after any surgical procedure, the specific risks of a lower body lift include thromboembolic events (phlebitis and pulmonary embolism) and poor healing due to the significant length of the scars.
If healing is slow, bandages may need to be changed daily.
If necessary, a cosmetic procedure to address the scars may be performed later.