A belt lipectomy, or lower body lift, is a procedure that removes excess skin from the abdomen, hips, thighs, and buttocks, commonly following major weight loss like after bariatric surgery. It reshapes the lower body, improving comfort, mobility, and appearance, helping patients reach their desired outcome.
Bariatric procedures are more popular than ever.
Can you believe nearly 16,000 Australians had bariatric operations in 2023? (Ref 2) Our nation is becoming healthier as thousands embark on a massive weight loss journey. While there are countless benefits to losing weight, there is a drawback.
Excess skin tissue is extremely common after rapidly dropping 30+ kilos. Excess skin and fat around the waist often adversely affect the lives of weight-loss patients.
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The good news is there are surgical procedures specifically designed to tighten loose skin after losing a lot of weight. Body lift procedures, in particular, offer some of the most dramatic results. In this article, you’ll learn everything you need to know about belt lipectomy surgery (also called a body lift or circumferential abdominoplasty) and how it can improve the bodies and lives of patients with extra skin after hitting their weight-loss goals.
Common Post-Surgery Challenges
There is a laundry list of problems post-bariatric patients tell me about when they see me for a belt lipectomy consultation. First and foremost, they often say their extra skin has a profound impact on how they view themselves. (Ref 1) Some tell me they’ve experience feelings of shame or embarrassment, which is the last thing anyone wants to feel after they’ve worked so hard to lose weight.
Many patients with extreme saggy skin have sores and rashes in areas where skin folds constantly rub together. Hygiene issues could also come into play. It’s challenging to keep the damp, warm areas between the skin folds clean. (Ref 1)
Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.
Some patients have difficulty finding clothes that look flattering since skin folds often create bumps and rolls where they aren’t wanted. In severe cases of excess skin, a person might feel physically weighed down, possibly limiting their mobility or ability to exercise. Naturally, it’s challenging to maintain a stable weight if exercising is uncomfortable.
The trouble is saggy skin is unlikely to tighten on its own after losing a substantial amount of weight. Once the skin has stretched out during weight gain, it loses elasticity and therefore won’t shrink down once the weight is lost. With thousands of Australians undergoing gastric bypass surgery every year, it’s no surprise that many are turning to body contouring procedures to remove loose skin and fat and achieve a firmer physique.
Belt Lipectomy (Body Lifting) as a Solution
Those who’ve lost over 30 kilos often need a surgical procedure to tighten lax skin. A belt lipectomy is the most comprehensive surgical service offered to massive-weight-loss patients. This surgical procedure is exclusively for those with excess skin on their tummy, love handles, lower back, bum, mons area, and thighs after losing 30+ kilograms.
What is a Belt Lipectomy?
A belt lipectomy targets multiple body areas with excess skin and fat in one or two surgeries. It’s a major operation and the results can be dramatic. Other procedures like an arm lift (brachioplasty) or thigh lift (thighplasty) only correct sagging on one body area at a time.
Definition and Explanation of the Procedure
A belt lipectomy is also known as a 360 body lift or circumferential abdominoplasty. During the operation, I place a circular incision around the waist through which I remove the excess skin and subcutaneous fat. Closing the incision allows me to correct laxity 360 degrees around the waist for a sleeker, firmer body contour.
My technique also incorporates VASER liposuction to melt fat. VASER liposuction is great for eliminating stubborn fat pockets that remain even after a person reaches a healthy weight. Once I liquefy the fat with VASER, it’s sucked out through a cannula.
Areas Targeted by Lower Body Lifting
A belt lipectomy (circumferential abdominoplasty) is perfect for tightening sagging skin on the upper and lower abdomen, upper pubic area, hips, lower back, bum, and thighs. These are some of the most common trouble zones for people who’ve lost weight rapidly. I also frequently repair separated abdominal muscles (diastasis recti) during the procedure, which is a common issue for patients who were significantly overweight or pregnant in the past.
Goals of the Procedure
Anyone with excess skin and fat 360 degrees around their lower torso might benefit from a belt lipectomy. This procedure creates firmer-looking skin on the tummy, bum, lower back, thighs, hips, and mons pubis after reaching a healthy weight. Aside from looking better in the mirror, a belt lipectomy can resolve skin irritation and improve hygiene in areas where excess skin is present.
Planning Your Belt Lipectomy
Ask Your GP for a Referral
Recently, laws changed. Australians seeking body contouring services must now get a GP referral before seeing a specialist surgeon. Your GP will pre-screen you for issues like body dysmorphia and assist you with reaching a healthy weight if needed.
Choosing a Qualified Specialist Surgeon
When researching surgeons, look for someone who is licensed and who has great reviews, specifically for excess skin removal after weight loss surgery. You should ask to view their past work. Before-and-after belt lipectomy photos are often available on surgeons’ websites.
I have performed circumferential body lift operations for 15 years. I am also a FRACS surgeon, which means I have met the requirements of the Fellow of the Royal Australasian College of Surgeons. FRACS-designated surgeons have at least 12 years of medical and surgical education, which includes five years of specialty post-graduate training. My area of expertise is body contouring (including liposuction and extra skin removal) after losing weight and pregnancy.
Your First Consultation
What to Expect
My initial consultations typically last one hour, during which you will have the opportunity to ask questions as we proceed. I also usually offer a follow-up consultation. While you will need to pay for the first consultation, there is a Medicare rebate available for this. Subsequent consultations will be billed directly to Medicare, so you won’t have to pay anything out of pocket for them.
Reviewing Your Aesthetic & Functional Goals
During your first consultation at my office, I will ask what body areas you want to improve and examine your skin elasticity. I will take your pre-operative photos and let you know if services such as a belt lipectomy procedure are suitable for you. We will discuss your goals, lifestyle, how much weight you’ve lost, how long you’ve kept your weight stable, medical history, and more.
Discussing Your Operation and What Comes Next
If you are a good candidate for a belt lipectomy, I will design your custom surgical plan and explain what you can expect before, during, and after your surgery. I will also review the possible risks of belt lipectomy surgery in detail. My staff will follow up with price quotes a few days later.
Deciding if Surgery is Right for You
After leaving your consultation, you’ll have plenty of time to review all of the information and decide whether you’d like to move forward. If you decide to have the belt lipectomy procedure, simply call my office to start scheduling. You’re welcome to see me for additional consultations if you still have questions.
What happens during a belt lipectomy operation?
Anaesthesia & Surgery Duration
You will receive general anaesthesia before your surgery. The total operation time for a belt lipectomy with VASER liposuction is usually six hours, but it can sometimes take a bit longer.
VASER Liposuction
I usually perform VASER liposuction before I start to remove excess skin. The VASER does more than melt unwanted fat so it can be easily extracted with suction. It also helps dissect the tissues, making it easier to free the saggy skin. Additionally, I find VASER helps reduce bleeding and bruising compared to standard liposuction.
To begin, you will lie on your back on the operating table. I’ll start by performing a traditional abdominoplasty (tummy tuck) procedure. This involves creating an incision across your abdomen, extending from hip to hip. I’ll carefully release your belly button, then lift and dissect the tissue to access your abdominal muscles. If there is any muscle separation, I will suture the muscles together to provide a firmer foundation.
Next, I’ll remove the excess skin and tissue from your abdomen, pulling the remaining skin taut to create a smooth, firm appearance across the upper and lower abdomen, mons pubic area, and thighs.
After closing this initial incision, my team and I will gently turn you onto your side. This turning process is done slowly and carefully to ensure your safety and comfort. In this position, I will perform additional liposuction on the flanks, hips, and saddleback areas, followed by precise skin removal.
Finally, we’ll turn you onto the opposite side to complete liposuction and skin removal on the remaining flank and hip area. Each step is designed to ensure a balanced, toned result across the abdomen and surrounding areas.
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The Belt Lipectomy Recovery Process
General Recovery Time
The initial healing process usually lasts two to three weeks, but a full recovery can take months. Individual experiences may vary.
- Hospital Stay: 2-3 days
- Have a Full Shower: 4-7 days
- Resume Driving: 2-3 weeks
- Resume Working: 2-3 weeks unless you have a physically demanding job
- Resume Intense Exercise: 6-8 weeks
- Swelling/Numbness Resolve: 3 months
- Final Results: 12 months
- Scar Matures: 12-18 months
Scarring After Belt Lipectomy
A belt lipectomy leaves a long scar around the waist. The scar will be prominent at first. It may be dark, thick, or bumpy for several months. After six to nine months, the scar should begin fading to a slightly lighter colour and become flatter. However, surgical scars usually take a year or two to mature. Over time, the scar should fade substantially, although scar fading is different for everyone.
Hospital Stay & Early Recovery
Plan to stay in the hospital for approximately two to three days. The first two to three weeks can be uncomfortable. Soreness, significant swelling, and bruising are normal side effects that should resolve in time.
You’ll be able to walk from day one, but you may need to walk leaning forward slightly for the first ten days to avoid straining your incision. The hospital staff will assist you with walking and getting out of bed as needed. Within a week, most patients are cleared to go home. You’ll need to arrange for someone to drive you since you won’t be able to drive until two or three weeks post-op.
Throughout your belt lipectomy recovery, you will see me for routine follow-up appointments. During the first week, I will check in with you at the hospital. After you’re discharged from the hospital, someone will need to drive you to and from my office for your follow-up visits.
Around seven to nine days after your procedure, I will change your PICO wound dressing to medical tape. The medical tape can get wet, at which point you’ll be able to have a full shower. In the meantime, you can take quick bird baths, just be sure to avoid getting your PICO dressing wet.
Getting Back to Life as Usual
Most belt lipectomy patients resume working and driving within two to three weeks. If your job requires physical labour or if you have a complication, your downtime could be longer.
You must avoid vigorous exercise, stress, and heavy lifting during the first six to eight weeks. Otherwise, you might develop a complication. That said, you can and should take short walks every day to keep your blood circulating. Walking is also a great mood booster, which might be especially beneficial as you recover from surgery.
Within two to three weeks, I may clear you to increase your physical activity level day by day. Eventually, you’ll be able to return to the gym. Exercise and a healthy lifestyle will help to maintain your belt lipectomy results, keeping your body fit and firm.
You can expect most of the swelling to resolve within three months, although it can take six months to a full year to appreciate your final surgical outcome.
Belt Lipectomy Risks & Factors to Consider
Risks to Know
Surgical risks are possible when removing skin and tissue. I will review these with you during your consultation. The most common complications are minor or cosmetic. For example, excess tissue removal surgery can sometimes cause excess fluid in the underlying tissues (seroma). Some complications are more dangerous, such as a blood clot that could potentially lead to a pulmonary embolism, infections, deep vein thrombosis, and so on.
Infections and wound healing issues (such as tissue death and wound dehiscence) are possible, though uncommon. Please follow my pre- and post-op instructions carefully; They are designed to lower complication rates.
Surgical complications from general anesthesia are also a possibility. Death, respiratory, or heart problems from general anaesthesia are, thankfully, extremely rare.
If you have pre-existing health issues, it’s important to let me know during your consultation. A belt lipectomy can be a safe procedure, but you must be overall healthy and follow your pre-surgical and post-operative instructions. In the event of a complication, you’ll need to follow up with a healthcare provider.
The Importance of Having Realistic Expectations
If you’re considering a belt lipectomy after losing a lot of weight, you’ll need realistic expectations. The surgery can make your lower torso look firmer and shapely by removing excess skin and subcutaneous fat 360 degrees around your waist, but it’s not a weight-loss procedure. You must to be at or close to a healthy weight first.
You will also have a surgical scar that is permanent. I’ll discuss scarring and incision site placement with you during your consultation.
Belt lipectomy procedures also have a significant recovery period and you won’t see your results overnight. A few weeks off work, driving, and intense exercise are mandatory to enhance healing. You’ll need to wear compression garments to minimise swelling and post-operative pain. Failing to adhere to your aftercare protocols can cause poor wound healing or land you back in the hospital.
Finally, you’ll need to maintain your results with a healthy lifestyle. Regular exercise and a healthy diet are crucial to preventing weight gain after a circumferential lipectomy surgery. If you gain then lose weight after your operation, you could end up with saggy skin once again.
Your Choice of Surgeon Matters
You aren’t obligated to work with the first surgeon you meet for a consultation. Be selective and choose a licensed surgeon with many years of experience performing belt lipectomies. It’s a major surgery and requires a highly skilled surgeon to do correctly. Additionally, each surgeon has their own specific surgical technique. You’ll want a provider who stays abreast of the latest techniques, which tend to be safer and more effective than techniques of the past. Medical technology is always evolving.
Lower Body Lift (Belt Lipectomy) Cost & Insurance
How do I find out how much a belt lipectomy costs?
The only way to get a straight answer is to meet a specialist surgeon for a consultation. After meeting with you, my staff will follow up by email with a detailed price quote.
What factors affect the cost?
Belt lipectomies are customisable. No two patients are exactly alike. The extent of your excess skin removal could be more or less than others. Add-on services and aftercare could also affect your wallet.
My surgeon fee is billed separately from the anaesthetist and hospital charges. Therefore, the hospital you choose, number of nights spent in the hospital, and how much the anaesthetist charges can all affect pricing. Whether you have private insurance or qualify for a belt lipectomy Medicare, rebate can also impact your out-of-pocket spend.
Private Insurance & Medicare Rebates
If you have a belt lipectomy due to a medical necessity after you’ve undergone significant weight loss (defined as losing more than 5 BMI points), you may be able reduce your out-of-pocket expenses by applying for the MBS rebate or turning to a qualifying private health fund.
Not all patients qualify as strict criteria applies. For example, those with no unresolved medical issues directly related to excessive skin usually pay out of pocket. The same goes for those only seeking to achieve a smoother contour. I can tell you more about all this during your consultation.
If you are eligible, keep in mind you will likely still pay some costs out of pocket. The difference between how much private health insurance and/or Medicare covers is known as a ‘gap’, which you will be responsible for paying.
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Preparing You for a Belt Lipectomy (Body Lift) Surgery
Your Pre-Operative Instructions
Before your operation, I will provide detailed instructions to prepare for your operation. You may need to have lab work done as well as avoid nicotine and vitamins, supplements, and medications that increase bleeding.
Tips on Getting Prepared for Major Surgery
You’ll need to schedule at least two to three weeks off of work, possibly longer if your job requires intense physical exertion, to heal from surgery. To make your recovery easier, it’s a good idea to do laundry, buy groceries, and prepare meals in advance. Place loose, comfortable clothing in easily accessible drawers and prepare your bedside table with essentials so you won’t have to get up repeatedly as you heal.
Preparing Your Loved Ones for Surgery
You will need someone to drive you home from the hospital. You won’t be able to drive for two to three weeks so your loved ones will must drive you to your follow-up appointments with me. During your initial recovery period (roughly two to three weeks), your loved ones will need to handle chores, grocery shopping, preparing meals, and driving your children to school and activities if you have kids. If you live alone, have a friend or caretaker stay with you for at least 24 hours after leaving the hospital.
Belt Lipectomy (Lower Body Lift) Results
It might take a year to fully appreciate your surgical results, although you could experience some of the perks of a tighter, toned body within the first six months.
- Aesthetic: This surgical procedure lifts and tightens the skin 360 degrees around the waistline, resulting in firmer abdominal contours, a flatter mons pubis, fewer lower back rolls, trimmer hips, a tighter buttocks, and firmer thighs.
- Physical: Many post-weight-loss patients with skin irritations, rashes, and hygienic issues related to excess skin find these issues resolve after a belt lipectomy.
- Psychological: Excess skin removal has the potential to help some patients feel more comfortable during socialising and intimacy according to a research study, although these secondary benefits are not guaranteed. (Ref 1)
FAQs
What is the main purpose of a belt lipectomy procedure?
A belt lipectomy procedure aims to remove remaining skin and fat around the belt line after a patient has lost a lot of weight. The goal is to improve the body contours and/or alleviate skin irritation from the surplus skin rubbing together. While removing the lax skin and tissue, I can also bring the abdominal muscles back together if they have separated.
Is a tummy tuck and circumferential abdominoplasty the same thing?
No, but there is some overlap. A tummy tuck (traditional abdominoplasty surgery) only operates on the front of the abdomen. A belt lipectomy (also called a circumferential abdominoplasty or body lift) operates on the front, back, and sides of the waistline. These operations are similar in that they remove surplus skin after weight loss surgery. Like a tummy tuck, a belt line lipectomy can also fix abdominal muscle separation.
Dr Beldholm’s Final Thoughts
Losing a substantial amount of weight is the first step toward achieving your ideal body if you’re morbidly overweight. If you have excess skin after losing weight, your next step might be to remove excess skin with a body toning procedure. Belt lipectomies are an excellent way to tighten loose skin 360 degrees around the waistline after reaching a stable weight.
Tightening sagging skin after losing massive weight can have an overwhelming positive effect on a person’s appearance and daily life (Ref 1) This surgical procedure is only for patients who are physically healthy and have realistic goals.
As with any surgery, there are some risks and drawbacks, such as the surgical scar. However, many patients find the rewards of tighter skin and a trimmer-looking physique outweigh the cons.
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References
- Alzahrani, Khalid J, et al. “A Psychosocial Analysis of the Effect of Body-Contouring Surgery on Patients after Weight Loss.” Eplasty, U.S. National Library of Medicine, 28 Mar. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5372753/.
- Bariatric Surgery Registry, www.monash.edu/__data/assets/pdf_file/0004/2582131/2021-Bariatric-Surgery-Registry_8th-Annual-Report_Amended_May.pdf. Accessed 2 Oct. 2024.Belt lipectomy surgery guide
