Massive Weight Loss After Lap Band or other Bariatric Surgery
The circumferential body lift is the major, or core, procedure of body contouring after massive weight loss. In a single surgery that takes approximately 4 hours, the "belt" of skin and fat that surrounds the circumference of the lower trunk is removed. This re-contours the abdomen, waist, flanks, buttocks, hips, and outer thighs. Typically, there is one incision that goes all the way around the circumference of the lower body to lift the front, back, and sides in one procedure.
On the front of the body, the incision is made just above the pubic bone and extended toward the back in a curved fashion below the protrusions of the hip bones. The skin and tissue above and below the incision are elevated (raised) as tissue flaps, which are pulled downward or upward into a new position. The excess skin and fat of the flaps are then excised. The deeper tissues that have been elevated and repositioned are tacked down to provide support and prevent them from moving.
If the skin around the navel has been removed, a new navel is created in a procedure called an umbilicoplasty. The skin and underlying tissues around the navel and above the waist are pulled downward to contour the waist and upper part of the tummy. When the skin and tissues below the incision are pulled upward, the front of the thighs and sagging in the groin area are "lifted."
To treat the back, the incision is carried around the hips and across the back below the waist and across the buttocks. This incision is placed slightly lower than what is called the bikini line. When the skin flaps are raised, the tissue above the incision is pulled downward to re-contour and smooth the waist and flank area (roughly that region over the kidneys). The skin and tissue below the incision are pulled upward to lift the outer and posterior thighs and the buttocks into a new position. The excess skin is trimmed off from the upper and lower flaps, and the underlying tissues are secured in the new position.
The skin above and below the incision in front and in back is stitched together and sealed with DermaBond (the medical equivalent of superglue) to keep the wound clean, dry, and secure.