Surgical Procedure:

The operation will be performed in an outpatient facility under very deep sedation or light general anesthesia, supplemented by local anesthetics.

An incision is made clear around the lower body (thus the term “body lift” or “belt lipectomy”), beginning above the buttocks and extending, in a curved line over the hip areas and across the lower abdominal wall above the pubic area.  The posterior skin is excised as a big wedge, with little undermining unless flaps are desired to enhance the buttocks area.   The skin and fat of the abdominal wall are elevated to the rib margins. The navel remains attached to the abdominal wall, but is released from the surrounding skin and fat through a diamond shaped incision around the navel. The abdominal muscles are tightened by suturing them together in the midline. These internal sutures are permanent but all of the remaining sutures used for the skin closure are absorbable. The excess skin and fat from the lower abdomen are trimmed.   A tighter abdominal wall can be obtained by excising a vertical wedge as well, resulting in an inverted “T” scar, with the vertical component extending up the abdominal midline from the pubic area to the rib cage – this scar tends to spread and is avoided unless absolutely necessary.    On occasion, it may be appropriate to suction some of the excess fat that can not be resected, but there is a limit to how much can be removed without jeopardizing the viability of the skin flaps. A new opening is created in the skin of the abdominal wall to reinsert the navel.   Drains and pain pump catheters are inserted prior to suturing the wound closed.   The pain pump catheters are connected to a reservoir that contains local anesthetic solution that will automatically infuse into the surgical site for the first few days to minimize your discomfort.  The pain pump catheters are optional (strongly recommended) but all patients will have drainage tubes inserted anteriorly (not require from the back side).   The drains remove excess blood and serous fluid and will be removed after the drainage has decreased to less than 25-30 cc. (about an ounce) of fluid per day. This usually takes about a week to ten days but can take up to a month.