The lower body lift for men

The lower body lift treats the following areas:

• Significantly sagging skin and fat after massive weight loss;

• Very significant areas of localised fat around the lower body, while the upper body has no such fatty excess and so cannot be treated by simple liposuction.

The excess and sagging skin fat is spread around the entire circumference of the body and will require a complete circular re-tensioning of all sagging tissues.

A body lift allows excess skin and fat from the tummy area to be removed:

• At the front: the abdomen and pubis

• At the back: the lower back and buttocks

• To the sides: the sides, hips and thighs.

In cases of massive weight loss, the body has undergone a radical change after losing dozens of kilos. Although the satisfaction of slimming is very beneficial for health, this can be tarnished by sagging tissues, which can often lead to significant functional discomfort and aesthetic issues, requiring a change to your body image.

The purpose of the operation is to achieve:

1. At the front:

• A flat stomach through abdominoplasty, tightening the abdominal wall by removing excess skin and fat and, if necessary, also repairing the muscle wall if you have a hernia, eventration or sagging (diastasis).

• Lifting and tensioning the pubis (pubic plastic surgery).

2. At the back:

• Lifting and restoring the shape of the buttocks.

• Removing bulges to the lower back.

3. To the sides:

• Lifting the outsides of the thighs.

• Removing bulges from the sides and hips.

The removal of excess skin allows re-tensioning in different areas and there are two ways to remove excess fat:

• Fat is removed from under the skin in one block;

• The fatty excess is removed by liposuction even outside the area of skin resection.

When this sagging is really significant, it is a source of discomfort in daily life (irritations in skin folds, sweating, mycosis or eczema, difficulty wearing certain clothes, postural discomfort, back pain, problems with sexual function...) and it also causes a feeling of failure when dieting. This is because excess skin persists despite weight loss and makes dieting efforts seem to be in vain, discouraging patients. This means they are exposed to the risk of the yo-yo phenomenon by gaining weight after having lost it.

Conversely, the operation can be motivating because your dieting efforts are rewarded by an overall slimmer figure.

This new sense of harmony is a balancing factor and boosts self-confidence, both when naked or clothed.

Significant skin sagging after massive weight loss is one of the main uses for a lower body lift.

There are two types of procedure according to the sagging skin and fat:

• When sagging is very significant and also affects the central area of the back above the buttocks fold, the scar will be completely circular, ending in the buttock fold.

• If sagging does not affect the central area of the back, a lower body lift can eliminate the excess cutaneous fat on the hips and lower back, with an almost circular scar that stops a few centimetres from the midline of the back.

In addition, after massive weight loss, patients are anxious to regain firmness on sagging tissue. It is, however, better to wait a few months until your weight has stabilised and you are not too far from your ideal weight.

Other cases where a lower body lift can be used is where there is significant localised fat that is resistant to dieting and sits on the lower body, while the upper body has no such excess fat. In these cases, a lower body lift will slim down the local area to achieve a balanced figure shape where simple liposuction without a skin resection would be insufficient

Re-tensioning the tissues tends to flatten the buttocks. Then, it is often useful to use the excess cutaneous fat on the hips to restore the curve to the upper buttock area.

Each person arrives with a request for correction of a particular defect that is particularly troublesome to them. The objective of the operation will be to correct this defect as a priority by assessing whether it may be appropriate to correct other associated defects to have a well-balanced, natural result that meets expectations.

So, depending on the insights gained during the first consultation, the operation could possibly be combined with another procedure, notably liposuction, a thigh lift, an upper body lift, pubic lift or reshaping the buttocks. This can be carried out during the same operation or at another time, depending on the associated operation.

During the first consultation, it is essential that you openly express what bothers you and what you would like to improve. Do not be afraid to ask any questions, including expressing your fears and expectations. Everyone has a different body shape, psychology and expectations. These are not the same and there is no standard to apply.

After you have explained your motivations, I will examine you and offer one or more solutions, taking into account your expectations, your anatomy, respecting your identity and the natural aspect of your appearance.

During the first consultation, I will evaluate the technique to use, the location of the scar to tighten the tissues, areas to treat with liposuction and, if appropriate, lipofilling (injecting your own fatty tissue collected during the body lift).

So you can visualise the desired result, I will show you photos of surgical results from cases similar to yours so you can understand the objective of the procedure.

It is essential that you and I have a good understanding when deciding to operate and to determine the technique to use from among those I can offer.

I will then give you all the information on the techniques proposed along with the information sheets from the Société Française de Chirurgie Plastique Reconstructrice et Esthétique (French Society of Plastic, Reconstructive and Cosmetic Surgery) as well as a detailed estimate of the costs for the options chosen. You will then be able to move your project forward and get ready for a second consultation when you will be able to ask any additional questions to help you make a decision and prepare for the operation.

This operation is long and tiring and the anaesthetist will need to see the patient long enough in advance to prepare for the operation and be able to carry out all the necessary examinations to check for a good state of physical health and no type of deficiency.

If you have a hernia, associated eventration, or simple sagging of the muscle wall (diastasis), an ultrasound of the abdominal wall should also be performed to assess the extent and exact location of the muscle wall defect.

You will need to remove body hair from the areas that will be operated on, if necessary, a few days before the operation.

You will be prescribed a specific abdominal support belt to buy for post-operative support and a lipopanty if you are also having thigh treatment. These must be brought on the day of the operation to be worn at the end of the operation.

No medication containing aspirin or anti-inflammatories can be taken within 10 days of the procedure.

For a general anaesthetic, you will have to fast strictly for 6 hours before the operation (do not eat anything, chew gum, eat sweets, or smoke).

Tobacco consumption should be stopped or reduced as much as possible during the month before and month after the procedure. Tobacco can cause scarring problems.

Your stay in hospital will usually be 2 to 3 days.

The procedure lasts approximately 4.5 hours.

The operation is performed under general anaesthesia.

Before you go to the operating theatre, in your room, I will go over the precise goals with you that we agreed during the consultations. You can then always make recommendations and ask any questions. I will then draw the lines and marks on your skin to guide the operation and the lines of the incisions.

The incision is circular, passing through the lower abdominal fold and the lower back in an area that will be hidden by a bathing suit.

The length of the scar will depend on the excess skin to be removed:

• When sagging is very significant and also affects the central area of the back above the buttocks fold, the scar will be completely circular, ending in the buttocks fold.

• When sagging does not affect the central area of the back, a lower body lift can remove excess cutaneous fat on the hips and lower back, with an almost circular scar that stops a few centimetres from the middle of the back.

In addition to re-tensioning the tissues, special attention will be paid to reshaping the curvature of the pubis and buttocks, which are often seriously affected after such significant sagging.

The position of the pubis and genitals will be corrected and the buttocks will be reshaped and raised.

If you have a hernia, associated eventration, or simple sagging of the muscle wall (diastasis), it may be necessary to repair the muscle wall to restore integrity and tension.

To finish the figure reshaping, liposuction is used to remove any residual fatty excesses, especially laterally on the sides, waist and thighs.

The stitches are placed within the skin’s thickness (inverted and intradermal stitches), which makes them invisible. These stitches are absorbable and therefore do not need to be removed. Staples are sometimes used to complete the internal stitching, if necessary.

For optimal healing and better long-term results, it is important to deeply stitch the fascia superficialis (fibrous structure located in the subcutaneous fat), which should be secured to support the re-tensioning of the tissues. This will prevent excess tension on the skin, which would have an adverse effect on the quality of healing and tissue maintenance.

At the end of the operation, a compression bandage is applied to the scar, a specific abdominal support belt for post-operative support and, if necessary, a lipopanty.

During the night and days following the operation, there may be a painful sensation of tension in the area that was operated on, including aches and pains that may impede your mobility. These pains are moderate in a resting position and may require analgesics that are given through a drip during hospitalisation or are taken as tablets at home. These post-operative pains will diminish and disappear within a few days of the operation.

You can walk the day after the operation.

Swelling (oedema) and bruising are generally moderate and it takes about ten days for them to disappear almost completely.

As the stitches used are absorbable, they do not need to be removed. Placed internally within the skin’s thickness (intradermal stitches), they are invisible. Any staples are removed within a week of the operation to avoid leaving a mark.

You will need to take 3 weeks off work in most cases.

• The abdominal belt should be worn day and night for 1 month, especially if you have had a hernia repair or eventration.

• Scars should be cleaned with an antiseptic after every shower and, if necessary, treated with ointment in the weeks and months following the operation to improve the quality of healing.

You will need to attend a follow-up consultation about a week after the procedure, then after 1 month, 3 months, 6 months, and 1 year.

• You can resume sporting activities as soon as any painful discomfort has subsided.

• Walking is strongly recommended in the days following the operation because the muscular activity promotes the drainage of the tissues that have been operated on and limits the risk of phlebitis.

• You are advised against prolonged standing still.

• The recommended rest position is lying on your back or side with your legs slightly bent.

• Exposure to the sun: No exposure as long as there are traces of bruising, even slight. Then, exposure is allowed using a sunscreen with a maximum sun protection factor.

• Part of the abdominal bloating that distorts the shape of the abdomen is from the digestive organs. For an optimal result, it is important that you follow a good diet, if necessary with the advice of a nutritionist, to control this problem.

The result is particularly spectacular due to the amount of excess skin and fat removed.

The result of reshaping the figure is immediately visible despite post-operative oedema and will continue to improve in the weeks and months following the operation.

In the long term, tissue sagging is permanently corrected and the majority of patients do not need another operation.

The excess fat removed cannot return because the fat cells do not multiply. If you gain weight, this will be harmonious over the whole body.

In addition to the advantage of eliminating and re-tensioning excess skin and fat, the lower body lift also means the pubis, genitals and buttocks can be repositioned, which also contributes greatly to restoring your body image after considerable changes in body shape.

In addition to the aesthetic improvement, this intervention has a beneficial effect on personal well-being and weight control, making physical activity more comfortable.

Read the information from the French Society of Plastic, Reconstructive and Cosmetic Surgery.

The cost of the operation will depend on the procedure to be carried out, the duration of the operation, the type of anaesthetic and any hospital charges.

If the reason for the operation is purely cosmetic, you cannot get any reimbursement through a Social Security claim. On the other hand, if the area of excess cutaneous fat is large enough to cause functional discomfort, you may be covered by Social Security and, if applicable, by your mutual insurance company after prior agreement from the Medical Adviser from the Primary Health Insurance Fund. The same applies if this is for reconstruction after an accident or disease.

A detailed estimate is given to you during the first consultation following the options you have chosen. You then have a minimum legal period of 15 days to consider your options and move your project forward.

The first consultation costs €50. The follow-up consultations before and after the operation are free.