Body contouring

Lower Body Lift

Abdominoplasty and Body Lifts in Leesburg, VA

Lower Body Lift

The lower body lift  procedure is designed to lift and tighten a sagging buttock and outer thighs.

This procedure is not designed to tighten the abdomen or inner thighs.

The most common patient is a patient who is either overweight or who has lost a tremendous amount of weight.  

These patients will have sagging skin and fat in the buttock and lateral thighs.

 

The lower body lift procedure is designed to lift and tighten a sagging buttock and outer thighs.

This procedure is not designed to tighten the abdomen or medial thighs.  Tightening the abdomen requires an abdominoplasty where as lifting and tightening of the medial thigh requires a medial thigh lift.  

A lower body lift combined with an abdominoplasty is typically referred to as a circumferential body lift or a total body lift.


An abdominoplasty addresses just the abdomen.  A lower body lift addresses the buttock and lateral thighs.  A circumferential body lift combines the two procedures to address the sagging skin of the abdomen, buttocks and lateral thighs.


I limit all of my cosmetic procedures to approximately 6 hours for safety reasons.  A lower body lift takes approximately 2 to 3 hours.  This leaves about 2 to 3 hours for the addition of another procedure.  Common additional procedures include an abdominoplasty, breast augmentation or lift, an arm lift, or labiaplasty.

All scars take approximately 12-18 months to fade to their optimal ability

  • application of a protective surgical tape on your incision for the first 1-2 weeks after your procedure.  The surgical tape protects the incision from the outside environment while also maintaining a lubricating environment for your scar.
  • Apply a lubricating scar ointment ( we use biocorneum) for the next 1-3 months.  Ideally the ointment contains vitamin E, silicates, sunblock, and a gentle steroid.  Our preference is biocorneum because it contains all of these elements in an easy to use pump applicator.
  • Apply a silicone sheet for the 1-3 after surgery.  Many patients will just use the sheet at night and use the ointment during the day.
  • Steroid injection into the scar if it remains raised after 6 months
  • Profractional laser remodeling if it remains raised or conspicuous after 6 months.
  • All patients will wear a compression garment for about 4 weeks.  
  • Final results should not be expected for at least 6 months to a year.  Over that time, your tissue will change dramatically so you will have to be extremely patient; swelling will decrease dramatically
  • Scars will not be at their best appearance for over a year
  • Sutures if any are removed in 10 to 14 days
  • Strenuous exercise should also be avoided for 4 weeks to help in the recovery process.
  • Apply aquaphor ointment to exposed sutures and incisions should be applied twice a day until the sutures are removed
  • Most patients will take 10-14  days off of work
  • Pain can initially be moderate to severe
  • As with any surgery, there are associated risks. Only you can decide whether the procedure can achieve your goals and whether the recovery and risk profile are acceptable to you. 

    The most common and significant problems associated with a thigh lifts are widening and visibility of the scars, delayed wound healing or tissue necrosis, and some recurrence.  This is because of the thin quality of the skin of the medial thigh as well as the constant pull of gravity on the scar.  

    Other complications are rare but can include:

    Local bleeding or bruising

    • Infection particularly from the absorbable sutures
    • Loss of sensation although rare
    • Widened or thickened scar
    • Asymmetry (unevenness between two sides)
    • Delayed wound healing with skin or tissue necrosis
    • Extra skin at the ends of the incisions
    • Under-correction
    • Over-correction

    Unsatisfactory results that may require additional procedures. Patients will generally be responsible for any associated facility fees.

Losing weight can almost immediately reduce your medical risk factors.  Patients report that they immediately feel better. 

The consequence, however, is an abrupt change in their physical appearance. In particular, the skin that was stretched by the weight gain has lost much of its elasticity and will not shrink down to properly envelope the body again. The skin of the breast, abdomen, arms, thighs, buttocks, and even face will sag.  

Treatment of tremendous weight loss patients is directed at re-tailoring the skin to fit the new body frame. 

Some potential procedures include:

  • Breast lift, breast augmentation, breast reduction, or combination
  • Abdominoplasty
  • Total body lift (also known as a circumferential body lift)
  • Thigh lift
  • Arm lift
  • Face and/or neck lift

Insurance will often pay for bariatric surgeries such as gastric bypass, gastric stapling, or gastric banding. This is because obesity is known to be responsible for highly expensive medical problems including diabetes, hypertension, congestive heart failure, and obesity-related infections.  

On the other hand,  medical insurance is very reluctant to pay for cosmetic procedures after tremendous weight loss; it is their stance that the excess skin that results after the fat is removed is not a “medical necessity” that they should be responsible for. This is not to say that they would refuse to do so.  It always depends upon your policy. 

Limitations to how many procedures you can have at the same time revolve completely around being able to perform the cosmetic surgeries safely. Factors that contribute to safety include the duration of the procedure and the potential for blood loss.

According to recommendations from the American Board of Plastic Surgeons, procedures should be limited to about 6 hours. The longer the procedure, the greater the degree of fluid shift, and the higher potential for blood pressure and clotting disorders.

In addition, surgical removal of tissue obviously increases blood loss. Blood loss in turn also increases the degree of fluid shifts and a higher potential for blood pressure problems during the surgery.  

For safety reasons, cosmetic procedures for tremendous weight loss should be limited to about 6 hours and about 2-3 body areas (which is about how much can be completed in the 6 hour time frame).

It is very important to improve your health before any kind of surgery. It is even more relevant, however, when considering elective cosmetic surgery. 

Some thoughts to consider:

Optimizing your weight loss:

Most patients will not complete and stabilize their weight loss for 6 months to a year after their weight loss surgery. You will want to be stable on your weight loss before undergoing a cosmetic reconstruction in order to optimize the amount of tissue that can be removed and tailored.

Optimize your nutrition:

Many patients will have problems with vitamin and nutrients absorption after weight loss surgery. You will also want to improve protein intake. Vitamins and and adequate protein are necessary to help you heal your incisions and fight infection after surgery. Some important labs to check include…

  • Vitamin levels including B, C, and D
  • Protein and albumin
  • Iron
  • Hemoglobin

Optimize your strength and endurance:

Patients will not be able to exercise for about 3-4 weeks after surgery.  Optimizing strength and endurance will give you a cushion to tolerate the surgery. 

While several vitamins, minerals and amino acids are used during healing, there are specific ones that are known to specifically support the normal response to healing, and to support the immune system’s response to infection.

Herbal supplements, in general, are to be avoided prior to surgery because they can cause bleeding or other operative complications. A few commonly taken herbal supplements to avoid are: Ginko Biloba, Garlic, Ginseng, Ginger, Dong Quai, Ephedra, Feverfew, St. John’s Wort, and/or Omega 3 fatty acids.

Vitamin E and surgery do not mix because Vitamin E is associated with increased bleeding, and this can lead to collection of blood (called a hematoma) which could result in serious complications. Most surgeons will instruct you to avoid Vitamin E before surgery, so it is important to check your dietary supplements/multivitamin carefully. After the surgery, your health care professional will likely indicate that Vitamin E is again acceptable.

  • Surgery is not a one time deal.
  • Delayed healing.
  • Wound necrosis.
  • Extra skin and dog ears.

Patients with:

  • multiple medical problems,
  • cardiac problems,
  • a poor understanding of the risks involved,
  • poor nutrition,
  • or, continued obesity. 
  • Hematoma
  • Seroma
  • Blood loss
  • Infection
  • Nerve damage
  • Blood clots
  • Organ damage
  • Scarring
  • Dissatisfaction with appearance
  • Anesthesia complications

The easiest way to reduce your weight before surgery is to engage in exercise such as walking, jogging or even cycling. You will also need to be willing to change your dietary habits to include fresh, whole foods and less processed foods and sugars. If you are not sure how to compile a healthy eating plan, your surgeon will either provide you with a basic plan or refer you to a dietician who will be able to assist you. Once you have followed the plan and engaged in exercise for a few weeks, your surgeon will reassess your current weight along with your surgery requirements and then operate accordingly.

If you have pre-existing health conditions, you will need to inform your plastic surgeon beforehand. Failure to do so could not only affect the outcome of your surgery; it could put your health at risk, especially if you suffer from bleeding or bruising disorders. It’s important to be wary of surgeons who claim to be able to perform ‘miracle’ surgery on you if you are heavily overweight, as there is no substitute for a healthy diet and exercise plan.

Obesity is an epidemic in the United States. It is fueled by the encouragement of overly processed carbohydrates by large companies (with government assistance) as well as taking in foods and drinks with high sugar content such as sodas, wine, and deserts regularly.  The medical consequences of being overweight can be catastrophic, including: diabetes, high blood pressure, and a limited life expectancy.  

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Dr. Phillip Chang is a leading plastic surgeon in Loudoun County who specializes in surgical and nonsurgical cosmetic procedures for the breast, body, face, and skin. He is board certified in plastic surgery by the American Board of Plastic Surgery and is the founder of Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA. Dr. Chang is dedicated to providing high-quality service that concentrates on the unique needs and concerns of his patients. He believes combining attentive care and minimally invasive techniques is the best avenue for achieving beautiful, natural-looking results. Dr. Chang is thrilled to be serving the greater northwest area of Washington, D.C. with top cosmetic care that is dependable and trustworthy.

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