What is Belt Lipectomy?

Belt lipectomy or extended abdominoplasty is a surgical procedure which corrects loose or sagging skin from the abdomen, the flanks, and the lower back. It is applicable for those patients who have undergone massive weight loss after Bariatric surgery or through dieting. With the above procedure, the redundant skin and stretch marks from weight fluctuations can be excised.

With the belt lipectomy, if the abdominal muscles are found to be weak, they are tightened to make the lower abdomen flatter.

Although the results from the belt lipectomy are expected to be permanent, if one fluctuates in weight the results may not be ideal because the skin can stretch again. We, therefore, recommend that candidates for this procedure are those whose weight has stabilized.

Good candidates for this type of surgery are those who are:

1. Healthy adults with no serious medical illnesses.
2. People who do not smoke or are willing to discontinue smoking (as smoking is recognized to affect healing).
3. Men and women who have lost excessive weight due to dieting, exercising or stomach stapling, banding or bypass (Bariatric surgery) and are medically healthy.
4. Individuals with realistic expectations.

Where do I start?

We recommend an initial consultation in our office. In this consultation the plastic surgeon will learn what really bothers you about your abdomen. You will be educated about the procedure. There will be: 1) a frank discussion about your goals and expectations, 2) an assessment of your abdomen, 3) the options will be discussed with you and the most appropriate technique will be emphasized, 4) the expectations will be discussed as well as the potential complications, and 5) the general course of the treatment plan.

The Evaluation Process

During your evaluation process, you will be asked about your past medical and surgical history. It is important that you honestly disclose to your surgeon the requested information as they may have an impact on the belt lipectomy results as well as the safety of the procedure overall. It is imperative that you disclose truthfully to your plastic surgeon any illnesses and all the prescribed medications you are taking as well as the ones you are taking “off the shelf” ie. non-prescribed medications such as herbal supplements, vitamins, etc. They too have interactions with medications and anesthetics you will be given at the time of the surgery. You will need to disclose alcohol, smoking, and drug consumption as well.

Safety in Belt Lipectomy

Belt lipectomy is generally a safe procedure. It can remain so by following the instructions of your plastic surgeon. Dr. Thoma is a certified plastic surgeon by the Royal College of Physicians and Surgeons of Canada. This certification designates surgeons who have trained in plastic and cosmetic surgery.

My Belt Lipectomy

Your particular problem will be identified during the consultation and examination. The usual problems fall into the following four categories:

• Excessive skin and fat in the lower abdomen
• Loose and wrinkled skin in the lower abdomen
• Loose skin and multiple stretch marks in the lower abdomen
• Loose skin that involves the lower abdomen, the flanks and back
• Any of the above and fat redundancy at the hips

Any of the above can be present and belt lipectomy will take care of them. Stretch marks can be excised if they fall in the area of the redundant skin that is planned for excision. Fortunately, most of the stretch marks are located low in the abdomen, below the belly button which is the area that is excised. The overall intention is to provide a better profile and a firmer abdomen.

Preparation for Belt Lipectomy

Dr. Thoma will explain to you the procedure in detail. You will be told of the expectations of the surgery and the possible risks. You will be given specific details about what you should do the day before and the morning of the surgery. You will be instructed how to apply an abdominal binder over your abdomen which will control some of the discomfort. Before surgery or on discharge from the hospital you will be given prescription for necessary medications. You will have the opportunity to talk to the anesthetist before the surgery as well. You will need to sign a consent form in preparation for the surgery. This will be required well before the surgery.
This operation is usually done under general anesthesia.

After Surgery

After surgery you will have dressings over the abdomen and a compression binder. This binder will control the swelling and support your abdomen while it heals. Drains will be left under the skin and you will be instructed how to care of them. These will be removed on your first post-operative visit in Dr. Thoma’s clinic. Upon discharge, you will be instructed again how to care for the dressings and binder. You will be told when to take the medications and who to call in the unlikely event of a problem. You will be given an appointment to see Dr. Thoma usually within one week.

Recovery Period

Some swelling and discomfort at the incision site are expected. This should improve day by day. The abdominal binder should control both the swelling and pain. It is important that you be up walking the same day as the surgery to avoid developing clots in the legs which can cause serious problems.

During the first post-operative visit the dressings will be removed and you can start having showers. Until then sponge bathing will be recommended. You will be expected to be up walking the same day as the surgery. Return to usual activities improves gradually. Unrestricted activities usually take 4 – 6 weeks.

Expected Result

Although you will notice immediate improvement of the contour of your abdomen, the final result will be appreciated gradually over the next few months as the scars mature.