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Body Lift Surgery
in Dallas, TX

What Is a Body Lift?

“Belt lipectomy,” “body lift,” “lower body lift,” and “360 body lift” are terms used interchangeably. They describe a surgical procedure that eliminates sagging skin and excess fat from the lower aspects of the tummy, flanks, and buttocks.

The removed tissue is in the shape of a boxing championship belt, with more tissue eliminated from the front than the back.

What Does a Full Body Lift Include?

Body lift surgery addresses the areas from just underneath the chest or breast spanning down to the pubic area, flanks, and buttocks, with benefits to the hips and thighs as well.

What Can a Lower Body Lift Treat?

  • A protruding belly
  • A hanging belly apron (called a panniculus)
  • A droopy pubic area
  • 360-degree excess skin and fat of the belly, flanks, and buttocks
  • Droopy thighs
  • Lack of shape and/or waist definition
  • Droopy buttocks

Who Are Candidates for Belt Lipectomy Surgery in Dallas?

Massive Weight Loss Patients (After Bariatric Surgery or Diet and Exercise)

The most common body lift candidates have lost a massive amount of weight (known as a massive weight loss patient). The majority of these patients started out as obese and lost weight through bariatric surgery. There is a smaller subset of people who lost weight through diet and exercise.

Mildly Overweight Patients With 360-Degree Excess Tissue

Less frequently, a belt lipectomy/360 body lift is utilized on patients who are mildly overweight and present with excess tissue around their midsection, including their abdomen, flanks, and buttocks.

Patients of Average Weight Who Want More Improvement Than a Tummy Tuck

A third group of body lift candidates are at a healthy weight but want more than the usual correction attained by a tummy tuck (abdominoplasty). A tummy tuck’s effects are limited to the belly. Patients in this weight group desire a remarkable improvement in the definition of their waist, thighs, and buttocks.

Ideal Body Lift Candidates Should:

  • Be mentally stable
  • Be non-smokers
  • Have maintained a stable weight for at least 3 months, preferably longer
    • Weight must be stable to consider surgery; patients should not be gaining or losing weight
  • Have lost enough weight to allow the surgeon to flatten out the belly
    • Fat around the internal organs, if excessive enough, can prevent the abdomen from being flattened surgically.  Unfortunately this fat cannot be surgically removed.  It  can only be reduced through weight loss
  • Not be significantly obese
  • Have no active medical problems such as diabetes, uncontrolled high blood pressure, heart disease, etc.
  • Have no auto-immune diseases such as rheumatoid arthritis or lupus that require steroid use
    • If the patient is not on steroids, they may be able undergo a belt lipectomy

Can I Get a Lower Body Lift With a High BMI?

Belt lipectomy results, like all other aspects of massive weight loss body contouring, tend to be better if you are at a lower weight. Dr. Aly has found that the lower the BMI of the patient, the less likely they are to experience a complication.

Our gallery of before and after body lift photos includes a range of patients who started at high BMIs and reached varying weight levels prior to surgery.

If you look at the patients who present at a BMI above 35, you will notice that they attain remarkable improvements, but their results are not as remarkable as those of patients who present in the 30 to 35 BMI range. If you compare patients who present at a BMI of 27 and below, their improvements are more outstanding, sometimes leading to almost ideal body contours.

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How Is Body Lift Surgery Performed?

The Mannequin and Dress Analogy

One can think of excessive skin and fat as a loose dress on a mannequin, and the mannequin is the underlying muscles and bones. A body lift can be compared to cutting out parts of the loose dress to better fit the underlying muscles and bones.
It is important to understand that the mannequin has a cavity inside it, deep beneath the muscles, which contains all of the internal organs like the intestines, kidneys, liver, etc. that all lie in fat. The outer cover of this cavity is the “six-pack muscles” connected to a set of muscles that go all the way around the body. This internal cavity can be thought of as an internal balloon that is often loosened by the overgrowth of fat or during pregnancy.

Taylor measuring a waistline on a mannequin

Once weight loss takes place, the internal balloon becomes loose, leading to bulging of the belly. This is manifested by a separation between the “six-pack muscles.” To flatten out the belly, those muscle edges must be brought back together.

This figure shows the separation between the muscles and how it is eliminated surgically.

It is important to note that different patients present with different problems. What is described here is the typical procedure but there are variations.

An animation of what occurs with a body lift is shown here. It is helpful in conceptually understanding what is to be accomplished with this type of surgery.

A belt lipectomy is performed on people with circumferential (360-degree) excess skin and fat. This means the patient must be turned 1 to 2 times during the procedure to allow the surgeon to remove all of the necessary tissue.

After the patient is anesthetized, Dr. Aly prefers to begin operating on the front side in the majority of cases. This is done in a similar, but not identical, fashion to a tummy tuck.

Addressing the Front of the Body

  1. Prior to surgery, Dr. Aly marks both the front and back to delineate the excess skin and underlying fat to be removed.
    These are the typical markings that are placed by Dr. Aly, 1 to 2 days prior to surgery.  Note that both skin and fat are removed from the top line to the bottom line from the front, sides and back.
  2. At surgery, Dr. Aly cuts around the natural belly button and leaves it in place.
  3. Subsequently, the skin and fat of the belly are lifted up from the pubic area up to the rib cage, similar to lifting a sheet off of a bed.
  4.   At this point the six pack muscles of the belly are exposed and are brought together to flatten out the inner balloon.
  5. The skin and fat that were lifted up to the rib cage are then stretched down, similar to pulling a wrinkled bed sheet over the bottom edge of the bed, and the excess  is eliminated.
  6. At this point a new belly button is created.

Addressing the Sides and Back of the Body

  1. Next, the patient is turned on one of their sides, and the excess tissue from the sides to the midline of the back is removed.
  2. The patient is then turned over to the other side, and excess tissue from the other side is removed.
  3. At this point, the patient is placed on their back on their hospital bed, and a light compression garment is applied with foam underneath it. 

It is important to note that this sequence is the most common method utilized by Dr. Aly in females, especially in patients who desire as much waist definition as possible.

Is a Body Lift for Men Performed Differently?

In some patients, the sequence is different, which will depend on their particular anatomy at presentation. For example, in males who present near their ideal weight and do not have a very large amount of hanging skin and fat, the sequence is to have the patient lie on their tummy first to remove their back excess and then position them on their back to remove the tissue on their sides and belly, thus utilizing only a single position change.

Will Body Lift Surgery Help Me Lose a Significant Amount of Weight?

Body contouring surgery after massive weight loss should not be thought of as a way to lose weight. Although a large amount of tissue is removed that may be considerable in weight, the actual change in weight after you have healed and stabilized is often less than you would think.

Body contouring after weight loss, and belt lipectomy in particular, should be thought of as surgery that alters body contour rather than weight loss surgery.


What Is Dr. Aly’s Experience With Body Lift Surgery?

Dr. Al Aly is a board-certified plastic surgeon who has been performing belt lipectomy surgery for over 23 years, and he probably has been doing it longer than anybody alive. He published the first major scientific article on belt lipectomy treatment in the massive weight loss population. He published the first textbook on massive weight loss body contouring, which extensively covers belt lipectomy.

Dr. Aly is recognized worldwide as the pioneer plastic surgeon of this type of surgery. He received the prestigious Lockwood Award in 2008 from the Aesthetic Society (formerly known as the American Society for Aesthetic Plastic Surgery) for his contributions to the field of body contouring.

Can You Combine a Body Lift With Other Surgeries?

Although some surgeons will combine belt lipectomy with other procedures, Dr. Aly prefers not to, with very few exceptions because:

  1. Prolonging surgery increases the risk of complications to an unacceptable level. This is elective surgery, and Dr. Aly feels that it is prudent to minimize the risks as much as possible.
  2. It is best to control scar position as much as possible. If you combine your lower body lift with an upper body lift, arm lift surgery, and/or thigh surgery, the tissues are pulled in opposing directions, which will prevent your plastic surgeon from controlling scar position.

Will Body Lift Surgery Help Me Lose a Significant Amount of Weight?

Body contouring surgery after massive weight loss should not be thought of as a way to lose weight. Although a large amount of tissue is removed that may be considerable in weight, the actual change in weight after you have healed and stabilized is often less than you would think.

Body contouring after weight loss, and belt lipectomy in particular, should be thought of as surgery that alters body contour rather than weight loss surgery.

What Is Dr. Aly’s Experience With Body Lift Surgery?

Dr. Al Aly is a board-certified plastic surgeon who has been performing belt lipectomy surgery for over 23 years, and he probably has been doing it longer than anybody alive. He published the first major scientific article on belt lipectomy treatment in the massive weight loss population. He published the first textbook on massive weight loss body contouring, which extensively covers belt lipectomy.

Dr. Aly is recognized worldwide as the pioneer plastic surgeon of this type of surgery. He received the prestigious Lockwood Award in 2008 from the Aesthetic Society (formerly known as the American Society for Aesthetic Plastic Surgery) for his contributions to the field of body contouring.

Can You Combine a Body Lift With Other Surgeries?

Although some surgeons will combine belt lipectomy with other procedures, Dr. Aly prefers not to, with very few exceptions because:

  1. Prolonging surgery increases the risk of complications to an unacceptable level. This is elective surgery, and Dr. Aly feels that it is prudent to minimize the risks as much as possible.
  2. It is best to control scar position as much as possible. If you combine your lower body lift with an upper body lift, arm lift surgery, and/or thigh surgery, the tissues are pulled in opposing directions, which will prevent your plastic surgeon from controlling scar position.

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Body Lift Procedure Timeline

What Should I Expect Before Belt Lipectomy Surgery?

  1. During your initial visit with Dr. Aly, he will perform a complete history and physical. He will determine if you need to see any other physicians to “tune you up” prior to surgery.
  2. You will have a set of photographs taken, which will allow Dr. Aly to make the correct diagnoses and plan for the upcoming surgery/surgeries.
  3. Dr. Aly will then discuss the potential surgical procedures you may require and show you before and after pictures of patients who have undergone similar procedures.
  4. Dr. Aly will have a discussion with you about the potential benefits and risks associated with a belt lipectomy.
  5. A set of laboratory exams are performed to determine if you have any abnormalities that need to be adjusted prior to surgery.
  6. It is standard for patients who are going to undergo a body lift to be psychiatrically cleared to undergo surgery.
  7. Many patients will require multiple operations to eliminate all of their massive weight loss excess. Dr. Aly will sit down with you to create a course of action to accomplish your needs.
  8. You will have markings placed on your body 1 or 2 days before your operation in preparation for surgery.

What Happens on the Day of My Body Lift Surgery?

  1. On the day of surgery, you are admitted to an area where you are prepared for surgery.
  2. You will meet the anesthesiologist, and they will discuss your anesthesia plan.
  3. Dr. Aly will come in to say hello and make sure the markings are still in place and, if need be, adjust them.
  4. You will then be taken to the operating room, and the anesthesiologist will put you under general anesthesia.
  5. Surgery is then performed, which requires somewhere between 3 and 6 hours depending on your particular anatomy.

What Happens Immediately After Surgery?

  1. When surgery is completed, a light compression garment will be placed on and around your belly and back with foam underneath it.
  2. Dr. Aly does not use post-operative drains, so you will not have to worry about that.
  3. You are then admitted overnight.
  4. You are expected to get up and walk a few hours after surgery, at least a few steps, after you are awake and alert. This is very important because it reduces the risk of blood clots.
  5. The next day after surgery, you are encouraged to mostly sit in a chair or walk, with as little time as possible spent in bed. Most patients go home the next day after surgery.

What Is Body Lift Recovery Like?

The First Few Weeks After Surgery:

  1. Patients will usually come back to see Dr. Aly within a few days after discharge for a check on their wounds and overall well-being.
  2. During the first week after surgery, you are expected to walk at least 6 times a day and stay out of bed as much as possible.
  3. You are instructed to remove your compression garment and underlying foam, shower, and re-apply the foam and garment daily. Foam is usually discontinued after 7 to 10 days.
  4. Initially, patients are most comfortable walking with a slight bend at the waist. After 5 to 7 days, you are encouraged to straighten up slowly, which greatly enhances your level of comfort.
  5. Within the first 3 weeks after surgery, you will usually visit Dr. Aly’s office once a week, unless you live far away and you are not experiencing any problems.
  6. During the first few weeks after surgery, Dr. Aly sees you to make sure you are doing well and not experiencing any problems such as wound separations or fluid collections, which are called seromas.

After the First Few Weeks:

  1. Most patients are able to get back to their normal life in 4 to 6 weeks after surgery.
  2. You will be seen approximately once a month for 3 to 4 months depending on how you are progressing.
  3. Seromas can occur after the first few weeks. Dr. Aly will look for these fluid collections and, if found, treat them.
  4. Occasionally, some of the deep sutures will come through the skin, and they can be taken care of during these longer-term visits.
  5. Dr. Aly will usually see local patients every 2 to 3 months from the 6-month to the 12-month mark. If you live far away, the time between visits can be extended depending on how you are doing.
  6. Most patients will stabilize their results at the 1-year mark, so Dr. Aly prefers to see most patients up to that time. If you are able and willing, he will continue to see you yearly after that.

When do I Expect The Final Results of Body Lift Surgery?

In most patients there is a dramatic change in the appearance of their body immediately after belt lipectomy surgery.  However the final contour of the body will not mature to its final level till a full year has passed.

There are significant changes and improvements noted on postoperative photographs when comparing the immediate postoperative period to photographs taken 3 months after surgery.  There is another dramatic change that occurs from 3 to 6 months.  There is still improvement from 6 to 12 months, but usually not as dramatic as the previous periods.

Scars mature, as far as thickness and width, in 12 to 18 months, but color will continue to improve for up to 5 years in some patients.

Want to Learn More About Body Lift?

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