S. Larry Schlesinger, MD, FACS of the Breast Implant Center of Hawaii performs the first part of a lower body lift which is essentially a buttock lift. Buttocks are lifted, roundness is restored, and dimples are eliminated for a smooth and shapely finish. The next step is a tummy tuck.
So we’ve removed the fat, now we’re going to recheck and see if we can take out more tissue here. [checking for symmetry] Yeah, pretty much the same.
Now we’re going to put some xylocaine with epinephrine in to decrease the bleeding and start cutting. By putting the xylocaine in, even though the patient is nicely asleep, we decrease the memory of the nerve endings that they were injured by temporarily putting them to sleep. Just like athletes say there is muscle memory well there’s also nerve memory. Less trauma to the system, quicker recovery.
Give it a few minutes to have that, have the xylocaine and the epinephrine start working. About 10 minutes is the usual suggestion. And we’re marked our midline. This is so nice because we pull the buttocks up with this back half of the lower body life and all the dimples vanish, see? You get rid of the dimples in your butt by doing a buttocks lift. The loose skin on the outer thigh goes away by pulling here and, because there’s a lot of tension in the middle, any loose skin on the inner thigh will also be improved and/or gotten ride of.
So what we’re doing here is we are cutting through the various layers of fat, not all the way down to the muscle, we’re really near the sacral bone and now we’re moving down away from there onto the ischium. So as you can see, this has depth to it. We’re not just sewing skin to skin, we’re sewing tissue to tissue. And as we bring this down, this will give her more roundness. This is an O braided polyester suture. We go down into the deep fascia and then we come across into the deeper part of what we’re sewing. And same here. We’re sewing this up subcuticularly, under the skin. We’ll do a few more of those, keep on moving down. Table up, please?
Ok, there’s the first layer. Now the second layer is insorb. Insorb is an upside down, dissolvable staple. So that’s probably good. Ok, and then we coap the skin. That means to put together the edges very neatly with 4-0 black nylon. I find it works really well to hold things together and also get a very fine scar.
As you can see, she has no more dimples on her butt. We’ve pulled it up, we’ve liposuctioned all of this. It’s nice and smooth up there, it’s nice and smooth here. Now we’re going to turn her over and go on to the next phase. The front part of a lower body lift, which is known as a tummy tuck.