Many people notice stubborn fat, loose skin, or “pouching” of the abdomen after life events such as pregnancy or weight loss. In addition to loose skin or stubborn fat in the abdomen, the hips and lower back may also be affected. In some individuals, the rectus abdominis (“six-pack”) muscles may need to be tightened if they have become separated (rectus diastasis) over time. Some people also have small hernias in the abdominal wall that must be repaired. Unfortunately, if you have loose skin or significant separation of your rectus abdominis muscles, no amount of diet and exercise can get you a fully toned tummy and lower back. A lower body lift is a surgical procedure that can address these concerns by removing excess abdominal skin and fatty tissue from the abdomen, hips, waist, and back. It also tightens loose abdominal muscles and lifts the buttocks and outer thighs.

The combined effects of aging, gravity, pregnancy, weight changes, and loss of skin elasticity all contribute to loss of tone in the abdomen, buttocks, and thighs. A lower body lift can markedly improve the appearance of all these areas. The benefits of a lower body lift are unique to each individual. A lower body lift can:

• Remove loose skin of the abdomen, hips, waist, and lower back
• Remove extra fat from the abdomen, hips, waist, and lower back
• Tighten loose rectus abdominis muscles
• Boost your self-esteem
• Improve your self-confidence in and out of clothing
• Add balance to your figure

A lower body lift might be suitable if you want body contouring but have loose skin or extra fat around your hips, lower back, and abdomen. People who have done the work to lose a large amount of weight often find that a lower body lift completes the process, allowing them to fully enjoy the results of their hard work to reshape their bodies.

In addition to deciding whether a lower body lift can meet your personal goals, several factors must be considered in determining whether you are a good candidate for this procedure. Good candidates for a lower body lift include those who:

• Want to improve their midsection shape
• Want to improve loose skin of the abdomen and lower back
• Want to improve the contour of their abdomen, hips, waist, and lower back
• Want to achieve optimal proportions for their figure
• Have generally good physical and mental health
• Are nonsmokers, or are willing to stop smoking before surgery
• Have realistic expectations from abdominoplasty surgery

While a lower body lift can address various concerns, it has limitations. Knowing these limitations and understanding when you may be a candidate for a different type of surgery is essential. A lower body lift cannot:

• Address intraabdominal fat (fat on the inside of your abdomen near your internal organs)
• Be used as a weight loss treatment
• Prevent accumulation of fat or loose skin with future pregnancy or weight gain
• Smoke
• Plan to continue making significant weight changes

Because of the complex nature of this surgery, touch-ups aren’t uncommon after lower body lifts (especially when combined with other procedures). Such revisions might include corrections of mild asymmetry or repair of unfavorable scarring. Our plastic surgeons will see you in our office within the first week after surgery, which is when your tapes will be removed and possibly one or more of your drains. We will see you a few weeks later or more often as needed. You can expect regular appointments (once the initial healing is done) about six months after surgery and again about 12 months after surgery.

Managing pain effectively is a large focus of our recovery plan. In addition to a multimodal pain medication regimen, our plastic surgeons use an On-Q pain pump to deliver numbing medicine for postoperative pain relief. The medicine is delivered automatically—you don’t need to do anything. We have found that our patients using the On-Q pain pump need fewer narcotics and have a generally quicker recovery than those who don’t.

Generally, a lower body lift is an outpatient procedure, meaning you can go home shortly after the surgery. In some cases, though, particularly if you have other procedures done simultaneously, you may need to stay overnight and go home the next day. After your surgery, you will be placed in dressings and a supportive compression garment. You will spend a short time in the recovery room before a friend or family member takes you home, where you should plan to rest for the remainder of the day. Be sure to arrange for someone to drive you home after surgery and to stay with you for at least the first night. We will advise you on pain medication to ease any discomfort, give you detailed post-operative instructions, and schedule a follow-up appointment to check your progress.

It would be best if you planned to take it easy following your surgery. It would help if you were up and walking the day following surgery, although you will be sore for several weeks. You should be able to resume your normal daily activities within two to three weeks following surgery. No strenuous activities, heavy lifting (over 20 pounds), aerobic exercises, swimming, contact sports, tennis, or golf should be planned for the first three weeks. As we monitor your recovery, we will advise you when it is safe to resume specific activities. You should be able to resume all of your physical activities within six to eight weeks of surgery, depending on the particular needs of your procedure. It would help if you planned to wear the compression garment for about six weeks following surgery.

You may notice less sensation in the abdominal and lower back area. This is usually temporary. It may, however, take weeks, months, or even more than a year before the sensation returns to normal. Incisions will initially be red or pink. They should fade and soften over time (up to 18 months after surgery). You will notice an improvement in your midsection contour immediately. However, your shape will continue to improve in the following weeks as the swelling subsides. Final results are usually seen at six months to a year after surgery.

Every patient’s recovery is different. Your recovery may be quicker or take more time than average.

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