What is a belt lipectomy?

A belt lipectomy is a type of surgery. It’s done to remove the loose skin and fat around your waist or “belt line.” This is also called an abdominal lipectomy, lower body lift, or panniculectomy. You may have this surgery after you lose a great deal of weight. This is often done after weight-loss surgery.

When people gain a lot of weight, their skin slowly stretches over time. If you lose a lot of weight, your skin might not have enough elasticity to spring back into place. This can cause extra skin folds of tissue. You may have a loose “love handle” around your belly and lower back. You may also have extra skin folds on your upper arms, under your chin, and along the inner parts of your thigh. A belt lipectomy and other similar surgeries can help improve how you look.

During a belt lipectomy, a cosmetic surgeon removes extra areas of tissue. Your surgeon will make a cut around your lower back and belly to take out extra skin and fat. Your surgeon then sews the tissue that’s left back together. This makes a smoother contour. This surgery helps flatten your stomach. It also lifts your buttocks and the outside of your thighs. All of this happens while you are asleep under general anesthesia.

A belt lipectomy is a type of body-contouring surgery. This refers to any type of surgery to remove extra skin and tissue to get a smoother body contour. These surgeries are often done after weight-loss surgery.

Why might I need a belt lipectomy?

If you lost a lot of weight after weight-loss surgery, this surgery may be an option for you. You may not like how you look if you have extra folds of skin tissue.

You may not like the appearance of the skin folds, but they can also cause other problems. These can include:

• Discomfort

• Swelling, rash, or ulcers between the skin folds in your groin. This can lead to an infection.

• Problems with hygiene

• Trouble walking

• Trouble urinating

• Trouble with sexual activity

What are the risks of belt lipectomy?

A belt lipectomy is a safe procedure, but it comes with risks.

People who have lost a lot of weight may be at a higher risk for problems than people who are having this surgery for other reasons. Some complications from this surgery include:

• Problems with wound healing

• Infection

• Heavy bleeding

• Blood clots in your legs or a blood clot traveling to your lungs (pulmonary embolism)

• Nerve damage

• Problems from anesthesia

• The issue comes back, especially if you gain back weight

You also may not get the results you want from surgery. Then you may need to have another surgery to fix this.

Your risks depend on your age, the amount of weight you lost, your health conditions, and the amount of tissue you need removed. Ask your surgeon about the risks that apply to you.

How do I get ready for a belt lipectomy?

First ask your healthcare provider if this surgery is right for you. If you have certain health issues, the risks of the surgery might not be worth it.

Your surgeon will want to make sure that you have a realistic idea of what the surgery can do. You will also need to commit to a healthy lifestyle. This includes good nutrition and regular exercise.

Most health insurance plans won't cover this surgery unless you have a major complication from the extra skin that makes the surgery medically necessary. This may include an infection and sore (ulceration) around a skin fold. Talk with your surgeon to find out what the surgery will cost you before you make plans to have it.

Don't have this surgery until you have reached a stable weight. If you lose weight after your surgery, new pockets of sagging skin may form. If you gain a lot of weight after your surgery, it can harm your already weakened skin. This can cause more stretch marks and wide scars.

If you smoke, quit at least several weeks before your surgery. Smoking greatly increases your risk for complications, especially lung issues and poor wound healing. Most surgeons won't do this surgery if you are still smoking.

Ask your surgeon if you need to stop taking any medicines before the surgery, especially blood thinners. These include over-the-counter medicines, such as aspirin. Pay attention to when the medicine should be stopped. Know when it will be safe to start taking it again.

Follow any directions you are given for not eating or drinking before surgery.

Tell your surgeon about any recent health issues, such as a fever, recent infection, changes in medicines, or any recent illnesses.

Your surgeon may do tests before you have surgery. These may include:

• Electrocardiogram (ECG). This is done to check your heart rhythm.

• Pulmonary function tests. These are done to check your lung function.

• Basic blood tests. These are done to check for infection, anemia, and kidney function.

Ask your surgeon how to prepare for your surgery. They may have more instructions for you.

What happens during a belt lipectomy?

Your surgeon will explain the details of your surgery. Your surgeon and a team of nurses will do the surgery. In general, you can expect the following:

• An anesthesiologist will give you general anesthesia. This is done so you will sleep through the procedure and won’t feel any pain. In rare cases, you will get spinal anesthesia and a medicine to relax you. You will be awake in this case.

• The anesthesiologist will carefully watch your heart rate, blood pressure, and other vital signs.

• You will get antibiotics during and after the surgery. This is to help prevent infection.

• The surgeon will make a cut (incision) where your buttocks and lower back come together. This is done to remove extra skin and tissue.

• The surgeon continues the cut on your front lower belly. They also remove the extra skin and tissue from there. You may need to be repositioned on the operating table.

• The surgeon puts your skin back together. This will make a smooth contour.

• Bandages will be applied to your wounds.

What happens after a belt lipectomy?

When you wake up, you may have a small, thin tube underneath your skin to drain fluid from the wound. Your incision will be covered with dressings or bandages. You may have some pain afterward. You can ask for pain medicines. You should be able to eat a normal diet once you are ready.

You may need to stay overnight in the hospital after your surgery. Some people may be able to go home the same day as surgery. But this isn’t common.

Your surgeon will tell you how to care for your wounds. Tell your surgeon if you have a lot of bleeding, severe draining, odor from the wound, redness, or a fever. If you have life-threatening symptoms, call 911. These include sudden shortness of breath or chest pain.

Your surgeon will also tell you how to limit your movements after surgery. You shouldn’t expose your wounds to too much force as they heal. Follow all of your surgeon’s orders carefully. This will improve your chances of a smooth recovery.

You will see the results of your surgery right away. They will often last if you keep a stable weight. If you aren't happy with your surgery results, talk with your surgeon. Some people need another surgery for best results.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure