A Belt Lipectomy is an operation designed to remove rolls of excess skin and the associated fat in the lower back, flanks, and abdominal region. It also lifts the buttock and pubic regions. A Belt Lipectomy combines two operations: a Buttock Lift and a Tummy Tuck (Abdominoplasty), which consists of one continuous circumferential scar contained within the belt line.
Men and women who have undergone significant weight loss, will often be left with excess skin, and associated fatty tissue along the buttocks, flanks and abdominal. The primary problem associated with excess skin, is largely functional, with aesthetics being a secondary concern. Therefore, a Belt Lipectomy essentially tailors this area by removing the excess skin creating far more functional and aesthetic contours – helping to create firmer buttocks, scooped in waistline, a lifted pubic region and tighter abdominal wall.
A Belt Lipectomy is a complete reconstruction of the belly and buttocks in one operation
Throughout the field of Plastic Surgery, the ‘Belt Lipectomy’ procedure may also be referred to as a ‘Total Body Lift’, ‘Lower Body Lift’ or a ‘Lower Truncoplasty’. Ultimately, the name is not that important, but the explanation by your surgeon as to what their plan entails is far more important.
After massive weight loss, all parts of the body are affected by excess skin, with some areas more problematic than others. It is uncommon for excess skin problems to be isolated to a single region of the body. Therefore, the reconstructive decision process must be tailored to address everyone’s specific concerns. As such, the surgery and its associated scars is dictated by the issues that need addressing.
Areas of concern that need to be assessed in determining the precise surgical plan include:
Assessing these areas will be establish the best surgery (and associated scars), that will be necessary. Ultimately the scar will be circumferential within a standard “belt line” with some subtle variations depending on precisely what areas need most reconstructing.
Of course, the actual abdominoplasty scar pattern is dictated by what abdominoplasty is necessary for an optimal outcome.
The above points will be discussed within your consultation with Dr Dona and an individualised surgical plan will be created to address your goals.
A Belt Lipectomy procedure, along with any other post-weight loss procedure, require an individualised surgical plan. Individuals that have experienced massive weight loss, will experience excess skin and tissue, in varying degrees and areas of the body, with the most common areas of concern being the arms, breast, back, tummy and thighs – therefore it is not uncommon for these patients to request and require surgery in these areas.
Some operations that are often combined with a Belt Lipectomy include various extended Tummy Tucks, including Fleur-De-Lis or Dr Dona’s custom Open Book Tummy Tuck.
A Belt Lipectomy can also be combined with Breast Reductions and Arm Reductions (Brachioplasty).
Ultimately the patient’s general health, logistics and finances are all considered in determining what is the appropriate surgical pathway to take to address all areas of concern. Typically, more than one operation is required in a staged manner to ensure a safe and effective pathway to address all areas of concern.
A Belt Lipectomy is performed in a private hospital under general anaesthetic.
A Belt Lipectomy can take anywhere from 4 to 6 hours.
It is important to know that everyone has a different experience after surgery from negligible pain to significant discomfort. You may experience pain localized to the incisions but also nerve pain (shooting pains and burning). You will be given pain medication during your hospital stay and for home.
Most patients will spend at least two days in hospital and will be medically fit to return home at this stage, although some may benefit from another day or two in hospital.
You will wake up from surgery in a hospital bed on your back with the head of the bed elevated.
A total of four plastic tubes or drains are usually placed adjacent to your wounds – two on your left and right sides.
Whilst in hospital you will also have a catheter in your bladder, so you don’t have to worry about getting up and trying to go to the toilet.
You have at least one drip in place to give you intravenous fluids and pain control medication and antibiotics.
All your wounds are covered using waterproof dressings. The wounds are stitched using several layers of internal dissolving sutures. You may have some visible sutures – these will be removed at your 1-week post-op appointment.
You will experience different sensations and feelings in the abdomen, buttocks, groin and upper thighs – this includes numbness, pins and needles, shooting pains, tightness or burning sensations – most of these will gradually resolve over the first six weeks.
The nurse or physiotherapist will help you out of bed the day after surgery.
Usually at your second day post-op we will remove all your drains, drips, and catheter.
After everything has been removed, you will be able to have a shower with assistance.
When you leave the hospital, you will be given pain medications and antibiotics – please take them as prescribed.
You should have someone with you at home for at least the first week for general day-to-day care.
When you get home, we encourage you to be up and mobile, however, do not expect too much of yourself. You will be hunched over slightly due to the tightness in your abdominal wall.
You are placed in a garment immediately after surgery to help control the swelling. This needs to be worn for at least 6 weeks. A significant amount of the initial swelling will be gone in the first 1-2 weeks. The amount of swelling can differ slightly from one side to the other.
You cannot have baths or swim until at least three weeks after surgery.
You will wake up from your surgery on your back with the head of the bed slightly elevated. Pillows can be used to provide some gentle hip flexion and minimize tension on your abdominal wall. You will be sleeping on your back for a minimum of four weeks. After this initial time, there is no recommended sleeping position as you can sleep in whatever position you are comfortable in.
As you have had your lower back and buttocks tightened, then it is important that you do not place too much tension on this area and potentially compromise your wounds. Therefore, for the first two weeks you should minimise any hip flexion. Therefore, you should be sitting on a recliner chair or in a very slouched manner utilizing several pillows behind your lower back. Of course, toileting will be those times where significant hip flexion will be unavoidable.
Leave your dressings intact until your first post-operative appointment. Your first appointment will be with one of our excellent and friendly post-operative nurses, who will care for you for the following six weeks after your surgical procedure(s) with Dr Dona.
It is very common after surgery. This is because you have just had surgery, you are less mobile and taking strong pain medication which causes slowing of the bowels. You are encouraged to have plenty of fluids, a high-fiber diet and some gentle laxatives such as Movicol to help restore your normal bowel habits.
You will be given Movicol whilst in hospital and are encouraged to continue with the above measures at home until your normal bowel habits return.
Every hospital patient, especially surgical patients, are at increased risk of developing blood clots in their legs. Therefore, we undertake a number of measures to reduce the risk of these.
You will also have special massage devices on both legs which promote blood flow and is designed to minimize the chance of any clots developing in your leg veins.
Whilst in hospital you are encouraged to do simple foot exercise such as tapping your feet or wriggling your toes. This is designed to activate your calf muscles and encourage blood flow and is another vital measure to help reduce the risk of blood clots.
In addition to this, all patients are given an injection once per day of a blood thinner (clexane). This also serves the same purpose of helping to minimize blood clot issues.
You may be required to give yourself an injection of clexane once per day for the first three weeks after you leave the hospital to further reduce the risk of blood clots.
Mobilising regularly and remaining well hydrated at all times is also recommended.
You should not consider driving for the first two weeks after surgery. After this time, you should only drive if you feel safe doing so.
You will be able to return to a light office or desk work environment at 3 weeks post-op. Light hospitality work may be possible at 4 weeks. Any employment that involves heavy lifting or straining must be avoided for 6 weeks.
At 6 weeks post-surgery you can gradually return to normal training and physical activities. Consider the first 6 weeks after surgery as RECOVERY, and after 6 weeks consider all activities as REHABILITATION. Undertake any physical activities that you wish to do and be guided by your comfort and strength which will slowly improve.
You can return to sexual activity at any stage with the following understanding:
You should avoid any activities that increase your heart rate and blood pressure during the first couple of weeks as this can increase the risk of swelling or bleeding problems.
Your wounds or adjacent surgical area should not be firmly handled or vigorously manipulated for the first six weeks.
If you engage in sexual activity during the first six weeks, you need to take on a very passive role.
Remember that you should not undertake any physical activities where you need to strain, exert, or even stretch your upper body muscles for the first 6 weeks.
It will take at least six months before you are feeling “normal” and able to do all the things you could before surgery. At this stage, we will assess your final surgical results from a contour and form point of view. However, the scars will take at least 12-18 months
Whenever someone is having an anaesthetic, no matter what it’s for, then things can potentially go wrong. That is why no surgery should be considered “minor”. Of course, whilst the chances of the following potential problems occurring are extremely small, you still need to know about then:
All these potential problems are standard for any operation, although some operations and some patients have an increased risk of developing them.
Other specific potential complications may include:
Surgery after massive weight loss is like dress making – the surgeon is the tailor, and they need to tailor your skin to fit your smaller body. With dressmaking, once its “done” you often need to have a second fitting for some minor adjustments to make it fit just right. Surgery after massive weight loss is very similar.
Belt lipectomy surgery is of course many times more complex than dressmaking. The skin and tissues are not static and rigid objects. They swell, they stretch, they shrink, they sag etc. In addition to this, the underlying body is also changing.
So as a surgeon, Dr Dona is crafting, sculpting, and reshaping everything that’s 3D and not static, whilst at the same time making sure that he doesn’t push things too far and make it too tight and increase the risk of wounds not healing and breaking down.
With all this in mind, after everything settles and swelling starts to settle and things “relax” into position, it’s normal for things to be nowhere near as tight as they initially were. Therefore, it’s not uncommon for patients to require further surgery to “fine tune” the results, just like you would for a second fitting of a tailor-made dress. This is especially the case in quite large transformations.
So, you should not undertake any surgery, especially these larger transformations, if you’re not prepared or willing to have further surgery, and the potential time off and costs involved.
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