The following is information regarding lower body lift which is important for you to review, understand and discuss with family and/or friends before choosing to proceed with this surgery.
GOALS OF LOWER BODY LIFT
The purpose of a lower body lift is to improve the contour and tone of the abdomen, inner and outer thighs and buttocks. This technique combines the standard abdominoplasty with inner thigh lift, outer thigh suctioning and surgical tightening of the hips and buttock area. In any given patient, these goals may only be partially met.
LIMITATIONS OF THE PROCEDURE
The primary indication for this procedure is severe skin laxity in the areas affected. When skin tone has been decreased secondary to weight loss, the aging process or other factors, it is impossible to restore. Therefore, the initial results of surgery will relapse to a certain extent in every patient. Skin irregularities, severe cellulite and alterations in skin texture will not be improved by this procedure. Often it is not possible to totally correct the skin laxity due to potential problems with wound healing.
ALTERNATIVES TO THE PROCEDURE
In some patients who wish only to have an improvement in body contour while in clothing, liposuction alone may be possible. However, if there is poor skin tone and loose skin prior to liposuction this will persist and possibly be worsened if liposuction without skin resection is undertaken. Therefore, under those circumstances only selected patients would be c onsidered candidates for liposuction without the lower body lift. In most patients this surgery is totally cosmetic in nature and will not produce significant functional benefit. Without the surgery, the laxity will persist and probably increase with normal aging.
SURGICAL TECHNIQUES / ANESTHESIA / RECOVERY
The lower body lift requires 4-6 hours of surgery, at least one night stay in the hospital and a significant recovery period. During the operation an incision is made just above the pubic hair line in the lower abdomen and extended above the hip bones to the level of the waist. The incision then extends onto the back and approaches the midline. Through this incision the redundant lower abdominal skin is removed and the abdominal muscles are tightened. This necessitates repositioning of the upper abdominal skin with a separate incision around the umbilicus. The lateral hip and buttock tissue are then tightened removing any redundant skin through the incision in the back. A separate inner thigh incision extends along the inner leg crease to lift and tighten the inner thigh. Additional liposuction may be added to the outer thigh where needed. Drains are utilized temporarily for removal of any fluid which may accumulate in the incisions. There are usually two in the abdominal portion of the incision and two in the back. These are easy to care for and remain for five to seven days. A blood transfusion is usually not required. However, for patients who wish to donate their own blood prior to surgery our office staff can assist with these arrangements. A minimum of two weeks off from work is recommended. You may drive when comfortable which is usually 7-10 days after surgery. Most of the stitches are absorbable although there may be some around the umbilicus, the drains and/or other areas of the incision which need to be removed at 7-10 days. You will have a bladder catheter the night of surgery. You will be fully ambulatory within 24 hours of the surgery. Heavy physical activity and exercise need to be restricted for 3-6 weeks. Your physician will advise you at which point you may begin increasing your physical activity.
RISKS / COMPLICATIONS
Potential surgical complications include a collection of blood under the incisions which is not completely evacuated by the drains (hematoma). Should this be a significant amount it might be necessary to return to the operating room for a second procedure to drain the collection. Occasionally, tissue fluid will accumulate under the areas of the incision which needs to be drained in the office. This may reoccur multiple times and require frequent aspirations. The incisions are long with multiple sutures and can be expected to heal with a permanent scar. Generally, the incisions are placed in a location where they will not be obvious in clothing or bathing suits. However, when nude, they will be visible to some extent. In some patients, portions of the scar may spread or become thickened, necessitating secondary treatment or scar revision. Asymmetry is possible, meaning that one side of the body may not be exactly the same as the other depending upon the skin tone, amount of tightening achieved, placement of the incision, etc. Generally, these discrepancies are very minimal and require no treatment. Infrequently, secondary surgical procedures are required to revise or improve these areas.
Wound infection is relatively uncommon, but if it occurs it may require treatment with antibiotics. An infection which does not respond to oral antibiotics may require hospitalization for intravenous treatment. There may be areas of the incision where delayed healing occurs, requiring special dressings, topical antibiotic treatment or minor surgical procedures to correct. Areas of slow wound healing may persist for weeks following surgery.
As with any large operation, phlebitis or, in rare instances, pulmonary embolus may accompany the operation. There may be areas of temporary or permanent numbness due to interruption of superficial nerves in the areas of surgery or suction. There may also be patchy areas of paresthesia (tingling, abnormal sensation). If your weight changes significantly following the surgery you may have reaccumulation of fatty tissue in the areas of the surgery. It is possible that the fat deposition will be uneven causing asymmetry.
Even though the risks and complications cited above occur infrequently, they are the ones that are peculiar to the operation or of greatest concern -- other complications and risks can occur, but are even more uncommon. Any and all of the risks and complications can result in:
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Additional surgery
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Time off work
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Hospitalization
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Expense to you
On occasion, surgical revisions may be indicated following the original surgery. If planned or performed within one year after the original surgery and if insurance does not cover these revisions, there will be no charge by the surgeon, but a facility fee will be charged by the hospital for use of the operating room, as well as a fee from the anesthesiologist.
NO GUARANTEE -- The practice of medicine and surgery is not an exact science. Although good results are expected, there cannot be any guarantee nor warranty expressed or implied by anyone as to the results that may be obtained.
COMMENTS
If a smoker -- must be off cigarettes for 3 weeks before surgery and 3 weeks after surgery. There is a much greater risk for scarring, poor healing, hair loss and skin loss in smokers. Must be off all aspirin containing products for 3 weeks before and after surgery. (Check all medications with us. Some medications, such as Motrin and Advil may also affect clotting.) You must stop all herbal medications two (2) weeks prior to surgery.
If there is any item on this consultation sheet that you do not understand, mark it and call the office. An explanation or additional information will be provided. Share the information that we provide to you with interested family members and/or friends. Our aesthetic coordinator, Connie Chudoff is available for any questions at 856-325-6768.