After massive weight loss, it’s normal to have loose skin. Sure, your tummy may have skin folds…but what if you have looseness on your hips, lower back, and buttocks, too?
A belt lipectomy is a 360-degree surgery that tightens loose skin on the abdomen, flanks, and lower back. It also has a buttock, mons, and thigh-lifting effect. After the surgery, your midsection will look tighter. Think of it as a way to put the finishing touch on your body after weight loss.
If you are considering a belt lipectomy after weight loss, you may be curious as to what happens during the surgery. This article shows how Dr. Bernard Beldholm performs the operation step-by-step, so you will know what to expect on surgery day.
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What is a belt lipectomy?
The goal of a 360-degree belt lipectomy is to remove loose skin on your abdomen, sides and back. As the skin on your midsection tightens up, it lifts your buttocks, thighs and mons area as well.
It’s like three operations in one
A belt lipectomy renews your body after weight loss in several ways. It includes an extended tummy tuck, lateral thigh lift, and buttocks lift. Since multiple body parts are involved, the surgery is quite complex. Though your recovery may take a bit longer than a standard tummy tuck, the results are more dramatic.
What is a belt lipectomy for?
Doctor Bernard’s belt lipectomy is excellent for removing loose skin on your:
- Abdomen
- Flanks
- Buttocks
- Outer thighs
- Mons pubis area
During your surgery, he can also fix abdominal muscle separation. This is fairly common among patients after major weight loss or pregnancy.
Operation Guide: What Happens During a Belt Lipectomy?
Dr. Bernard’s lipectomy belt firms and tightens your entire midsection. For a sneak peek inside the operating room, keep reading. This is a step-by-step guide to belt lipectomy surgery with VASER liposuction.
Phase 1: Surgery Prep
1. Pre-operative appointment
On the day of surgery, you enter the hospital, meet with a nurse, and change into a gown. Doctor Bernard meets with you before surgery to answer any last-minute questions or concerns you might have.
2. Surgical markings
Before surgery, Doctor Bernard draws on your skin with a surgical marker. You will be standing up while this happens. That is important because when you lie down on the operating table, your skin and fat shift due to the effects of gravity.
The markings help to plan your operation. Another benefit of drawing the markings while you are awake is that you can see where he plans to put your incisions. Doctor Bernard works with you to make sure your surgical scars are placed in the optimal position. If you have a preferred style of swimsuit or undergarments, you can bring them to your appointment so he can ensure your scars are well-hidden.
3. General anesthesia
Now you’re ready to enter the operating room. A highly trained anaesthetist places an IV into your arm. Sedative drugs are administered to induce sleepiness. As your body relaxes, you will drift off to sleep. You will have no memory or sensation of the surgery.
During your surgery, the anaesthetist watches over you the whole time. They keep an eye on your vitals to ensure you are monitored from the moment you fall asleep until the moment you wake up.
Phase 2: Buttocks & Thigh Lifting
1. Positioning you on the operating table
Once you are sedated, your surgery can begin. The first step to a successful belt lipectomy is positioning your body on the operating table. Doctor Bernard will work on your lower back and buttocks first, so you’ll lie face down. Your head will be cradled in a foam block with an opening.
Doctor Bernard has a special operating table known as a Jackson table. This will make it easier to turn your body over when he is ready to work on your tummy area. Instead of the surgical staff turning you over during surgery, the Jackson table does all the work, turning your body in a controlled manner. This makes turning less risky.
2. VASER liposuction on your lower back and buttocks
Next, Doctor Bernard performs liposuction on your lower back and buttocks. Instead of traditional liposuction, Doctor Bernard uses special equipment called VASER liposuction, a cutting-edge technology that breaks fat cells apart with ultrasound energy. It liquefies fat, making it easier to remove with suction. VASER not only melts fat, but it also helps to define curves and muscles.
VASER is a three-step process
Wetting solution
First, Doctor Bernard injects a wetting solution into your tissues. It consists of a local anesthetic, which has a numbing effect. The wetting solution helps to isolate the fat cells. It also constricts your blood vessels to reduce bleeding. The local anaesthetic provides pain relief for the first night and the next morning after your operation.
In traditional liposuction, the fat is removed manually in an aggressive back-and-forth motion. VASER is much less aggressive, reducing trauma to tissue.
Fat removal
Once the fat is melted, Doctor Bernard removes it with machine-assisted suction. In traditional liposuction, a surgeon would need to remove solid masses of fat through a small cannula. VASER liquefies the fat cells, making suction all that is necessary to remove them. Because there is less tissue damage with this method, VASER provides better results.
3. Tightening loose skin on your lower back, buttocks, and thighs
To make cutting simpler, Doctor Bernard pre-loosens the skin using the VASER tool. By removing just the right amount of skin, Doctor Bernard works on one area at a time, making sure to cut nice, straight lines. This results in a neat, straight scar.
4. Sealing the blood vessels
As he cuts away your excess skin, he seals up each blood vessel as he goes. It is time-consuming to close each individual blood vessel, but it is essential for your health. Doctor Bernard’s goal is to minimise your risk of bleeding after surgery. Sealing the blood vessels may also reduce bruising and post-op complications.
5. Closing the back incision
Now that your loose lower back skin is gone, the next step is closing the incision. As your skin is pulled together and stitched closed, it will tighten and lift your buttocks and outer thighs. The closure should be tight initially, but not so tight that it causes unsightly skin bunching.
Doctor Bernard closes your incision in layers.
He also applies a medical-grade glue as he closes your incision. The glue comes in spray form. It keeps your tissues tightly sealed as they heal. Creating a tight seal with glue also reduces fluid buildup at the wound site. Tissue glue may also reduce bruising as you heal.
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Phase 3: Turning You Over
Now that your backside is complete, it’s time to remove loose skin on your front. To work on your tummy, you need to be turned over on the operating table.
Doctor Bernard and his staff turn you over with help from special equipment known as a Jackson table. Turning must be done very carefully. Even with the Jackson table, it takes a team of people to make sure everything goes smoothly. Your ** is top priority.
Once you are turned over, the operating room staff will prep and re-strap your body.
Phase 4: Extended Tummy Tuck with Liposuction
During this step, Doctor Bernard tightens the loose skin on your abdomen and sides. The technique for the front is similar to the back.
1. VASER liposuction of your abdomen and hips
Doctor Bernard repeats all three steps of VASER liposuction on your tummy and sides. He removes excess fat, shapes your curves, and highlights your existing muscles.
2. Abdominal incision
Next, he makes a horizontal cut on your lower abdomen. The incision may extend up and around your hips, depending on how much loose skin you want to be removed. Doctor Bernard will discuss the incision and what kind of scar to expect at your consultation.
3. Creating the epigastric tunnel
Starting from the incision, Doctor Bernard cuts upward, stopping at your belly button. Older tummy tucks dissect all the way up to the ribs. All that cutting is not necessary today. Instead, he creates a tunnel the rest of the way up to your ribs. This is called an epigastric tunnel. This method makes your recovery easier since fewer nerves and blood vessels are damaged. It also preserves blood flow.
4. Abdominal muscle repair
5. Belly button repositioning
If you have a large amount of loose skin, your belly button may need to be moved. Otherwise, it would be too low on your abdomen once your skin is pulled down to close the incision. If necessary, Doctor Bernard will adjust your belly button to a position that’s not obvious you had a tummy tuck.
He carefully cuts around your belly button to free it. He attaches a small plastic marker to your belly button with a 2/0 silk stitch. The plastic piece allows him to feel where your belly button is located once your skin is pulled down later. Feeling for the hard plastic bit, he can then create a new hole for your belly button.
6. Removing loose skin on your tummy and sides
Doctor Bernard trims off the loose skin on your abdomen and sides. He carefully measures the amount of skin to remove before making any cuts. He may position the operating table on a slight tilt of about 15 degrees.
Dr Beldholm places a few Allis forceps (surgical clamp) at your lower tummy incision. Next, he will pull your upper tummy skin downward so it overlaps your lower belly. He can feel the allis forceps underneath, so he knows exactly where to mark and cut the excess skin. Again, he seals each blood vessel as he goes to reduce bleeding.
7. Belly button repositioning
If necessary, your belly button will be moved. The goal is to move your belly button to a natural position. This prevents your navel from sitting too low on your abdomen now that your belly skin has been pulled downward.
He feels for the plastic bit he attached to your belly button earlier in the surgery. He makes a new hole for your belly button and pulls your original belly button through this hole.
Let’s talk about belly button aesthetics. It may be small, but it makes a big difference to your cosmetic results. An oval or irregular belly button looks more natural than a round shape. A rounded belly button can also cause your skin to bunch and eventually close up. Doctor Bernard finds that creating an oval belly button usually prevents that from happening.
Doctor Bernard has another trick to make your belly button **. He removes a small cylinder of fat beneath your belly button with VASER liposuction. This creates a natural dip in your belly button, similar to the look of a swimsuit model.
He then shapes your belly button and adds a small hood.
8. Closing the incision
Your surgery is almost done. Doctor Bernard closes your abdomen in layers. He uses deep permanent sutures and V-Loc 90 barbed sutures, which are absorbable. He will start at your scarpa’s fascia and work upward to your skin surface.
In addition to sutures, he applies ARTISS tissue glue. The glue creates a tight seal, reduces fluid buildup, and reinforces your stitches. For the first few months of recovery, your abdomen needs that extra support for proper healing.
He also places four dissolving sutures around your new belly button. The stitches are pulled taut and downward. This helps to bury your belly button scar so you won’t see it. The results **.
9. Skin tightening and mons lift
It’s time to close the abdominal incision. As Doctor Bernard sutures the incision closed, it tightens your abdomen and lifts the mons area.
The mons pubis is a common trouble spot. It is located a few inches below your belly button. This fatty pad of tissue covers your pubic bone. You may have a pronounced mons after pregnancy or weight loss. If you have a belt lipectomy, it has a mons lifting effect.
10. Wound dressings
Wound dressings protect your incision as it heals. Bandages keep germs out and cushion your skin, preventing irritation. Basic sterile bandages are fine, but Doctor Bernard prefers something a bit better.
He loves the PICO negative pressure dressings. This high-tech wound dressing is battery-operated. It creates constant pressure on the wound to promote healing. By boosting blood circulation at the wound site, swelling is reduced. Doctor Bernard has seen the results firsthand and has been using the PICO bandages for years. His tummy tuck pricing includes the PICO dressings for no extra charge.
PICO’s advanced inner layer is made of super-absorbent material with AIRLOCKTM technology. It helps to keep bacteria out and keeps your wound dry. Studies from the manufacturer show it prevents up to 99.9% of bacteria from reaching the wound. After your surgery, you’ll wear the soft, ** PICO bandage for seven days. Doctor Bernard will then remove it for you.
11. Compression garments
The final step of surgery is placing a compression garment on your tummy. Compression garments reduce swelling, which is a normal response to surgery. They also reduce tension on your skin as it heals. Compression garments may also lower the risk of seroma, or fluid buildup, after surgery.
Doctor Bernard provides you with a high-quality compression garment, so you won’t have to purchase one separately. You will wake up in the recovery room already wearing the garment.
Your belt lipectomy is now complete.
