Body Lift Following Massive Weight Loss

Speaker1 (00:02): You're listening to Behind the Double Doors, bringing you behind the scenes to learn about cosmetic surgery procedures and the latest non-surgical aesthetic treatments with Houston board-certified plastic and reconstructive surgeon, Dr. Bob Basu.

Dr. Bob Basu (00:19): Today on Behind the Double Doors, we're talking about body lift surgery and on this podcast, we take questions from our audience.

Kayla (00:26): Hi, there, Dr. Basu. My name is Kayla, and I have lost 115 pounds over the last five years. I am 5'5" and now weigh 133 pounds, and I've decided it's time. I know I'm not going to gain weight again, I'd like to finally leave the old me behind and get this extra skin taken care of.

Kayla (00:45): In my research, I can see that most people who look like me are having body lifts. Can you help me understand what a body lift is exactly and what kind of results I might expect?

Dr. Bob Basu (00:55): Well, Kayla, first, congratulations on your weight loss. That's a huge achievement, and you've kept the weight loss and remain healthy.

Dr. Bob Basu (01:03): You remind me of patients that I see on a weekly basis. They've lost the weight, whether they've lost the weight through diet and exercise, lifestyle changes, or whether they've had medical weight loss therapies, or whether they've undergone bariatric surgery.

Dr. Bob Basu (01:18): When patients have lost more than 40, 50, 100, 150 pounds of weight or more, they're healthier, but they now encounter the next challenge. Which is loose skin, the loss of elasticity that can really not just hinder confidence, but also impact function and activity levels.

Dr. Bob Basu (01:39): Regardless of how someone has lost weight, the challenges nonetheless stay the same. So whether a patient's lost weight after pregnancy, I see moms that have lost 30, 60, even 100 pounds of weight after having kids. Or they're a patient has lost weight with lifestyle changes, diet modification and adjustment of nutrition, more active lifestyle. Or that they've undergone medical weight loss through medical treatments or surgical weight loss.

Dr. Bob Basu (02:04): Surgical weight loss means bariatric surgical procedures. One of the very common procedures today that are quite effective is a laparoscopic gastric sleeve procedure.

Dr. Bob Basu (02:14): When we talk about body lifts, one patient comes to mind. She had lost about 150 pounds from a laparoscopic gastric sleeve procedure. Her weight loss had stabilized. She was very active. She was actually a ballroom dancer; that was her passion.

Dr. Bob Basu (02:31): She found that the loose skin around her torso really got in the way of her really maximizing her ballroom dancing. She also had concerns about loose skin hanging from her arms because she felt really insecure. When you're wearing these ballroom dancing dresses, she wants to wear sleeveless dresses, and she has, in her own words, she says, "I can't wear them. I have these bat wings on my arms."

Dr. Bob Basu (02:56): So we examined her, and we developed a treatment plan for her to undergo a circumferential body lift. She also opted for an arm lift at the same time. The procedure took in total about seven hours for us to do.

Dr. Bob Basu (03:10): She did very well after surgery, healed beautifully. In fact, she's one of our arm lift results and her body lift results on our Instagram page. She gave us permission to share her results. She looked gorgeous within a matter of weeks. I mean, her scars were barely noticeable. Her story comes to mind.

Dr. Bob Basu (03:30): As a surgeon, it's really inspiring for me because when she came back all healed, she brought pictures of her actually competing in a ballroom dance competition where she was finally for the first time wearing the outfit she wanted to do and she was able to do the dances she's always wanted to do.

Dr. Bob Basu (03:49): When we removed all that tissue, skin and fat around her waist, and we gave her toned-up, tight svelte arms, I mean, it just really transformed her life. Her passion was ballroom dancing, and it really motivated her to live life to the fullest.

Dr. Bob Basu (04:03): She's not only an incredible success story for weight loss through bariatric surgery; she's an incredible testimonial for us of how plastic surgery after weight loss can truly transform lives.

Dr. Bob Basu (04:18): Regardless of how a patient has lost weight, their challenges nonetheless stay the same. Which is typically loose skin, laxity, loss of elasticity. Oftentimes that loose skin is getting in the way for patients to lead a more active lifestyle. The loose skin is also hindering their confidence in terms of what they can wear and how active they can be.

Dr. Bob Basu (04:40): So that's where plastic surgery after weight loss comes into play, where we can help contour multiple areas of the body to help restore not just their confidence in how they feel, how they look, but also to restore their activity level. So these procedures are quite transformational.

Dr. Bob Basu (04:56): But weight loss affects different patients in different ways, and it really has to do with where they carry their weight. Some patients have more significant laxity in their tummy area. Some people have that laxity, a loose skin extending all the way around to their waist, their back, their thighs. It can impact their face. That can impact our breasts or arms. Essentially weight loss can impact any body part.

Dr. Bob Basu (05:18): Now, I usually try to guide patients to try to triage or prioritize their areas of concern. Look, I see patients every week that want to transform their body head to toe. But it's important to prioritize goals so we can set up the most efficient surgical plan where we can transform multiple areas safely in one setting.

Dr. Bob Basu (05:39): Not always, but usually the number one line of attack for patients who have lost significant weight is a procedure called a body lift or a circumferential body lift. A circumferential body lift includes multiple procedures in one. It transforms your entire lower torso.

Dr. Bob Basu (05:56): What that means is everything from your rib cage down to your upper thighs, 360 degrees. It includes multiple procedures in just one procedure. So for the front portion of your torso, it includes an extended tummy tuck that transforms your entire front.

Dr. Bob Basu (06:13): Part of that extended tummy tuck, we also often include what's called a mons or pubic area lift because for patients who've lost weight, the pubic area sometimes still retains fat or it sagged down significantly. So we want to lift and tighten and reduce the mons pubis area so it is laying nice and flat with a nice flat tummy above.

Dr. Bob Basu (06:33): The second portion of a body lift includes treatment of the waist and the lateral thighs, and I call that a waist reduction with a lateral thigh lift. So it's pulling up the loose skin on the lateral thighs. And for women, it's helping to create a nice hourglass-shape contour or what people now say the "snatched waist." For men it's getting rid of love handles where you have loose skin in the waist.

Dr. Bob Basu (06:57): The third portion of the circumferential body lift includes treating the lower back and the flanks as well as treating the buttock area with a buttock lift. Now what's become very popular these days is everyone's into curves and everyone's into the booty.

Dr. Bob Basu (07:11): Patients who've lost weight are concerned that they've lost volume in their buttock. A common complaint that I hear is "I've lost all my butt. I look so flat where I'm wearing form-fitting jeans or a skirt."

Dr. Bob Basu (07:22): To restore volume, we have some options for our patients with buttock auto augmentation. Buttock auto augmentation can be done with two different techniques, which we'll discuss later on this podcast.

Dr. Bob Basu (07:35): I see patients for weight loss contouring plastic surgery on a weekly basis. And one of the basic principles I like to go over with all of my patients, one of the basic principle that applies to any body contouring after weight loss, or, quite frankly, any contouring procedures that we do in plastic surgery, is that we have to accept some degree of scar for a much better form.

Dr. Bob Basu (08:00): So scar for better form is really a universal principle of what we do in plastic surgery. Now, of course, we don't want our patients riddled with bad scars. We try to hide the scars, for instance, in the bikini line or the beltline, or we try to do limited scar techniques whenever possible. But scar for better form is really a universal principle.

Dr. Bob Basu (08:21): Now, I see patients that want head-to-toe transformations every week, and I try to guide my patients to try to prioritize their concerns in areas. So I always ask them, "What's your number one area of concern, what's your number two area of concern, and what's your number three area of concern?"

Dr. Bob Basu (08:37): The answer can't be "Everything," so you have to pick and prioritize what you want to get transformed. Based on those answers, I try to develop a plan to treat as many areas as we can safely in one setting.

Dr. Bob Basu (08:50): So timing. When do you opt for plastic surgery procedures after weight loss? Number one, you want to make sure that you've slowed down or settled down to your ideal body weight.

Dr. Bob Basu (09:02): Now, ideal body weight is a concept that some people cannot achieve. But basically how do you know when you're ready when you've stopped losing weight?

Dr. Bob Basu (09:12): If you're losing a pound here and there, that's okay. But if you're still losing each month 10, 15, 20 pounds of weight, that's not the time to proceed with plastic surgery procedures.

Dr. Bob Basu (09:23): Because what you don't want to do is to do, let's say, a body lift procedure; you've gone through this longer surgery and you look great. And then you lose another 40 pounds after the procedure, you can get some recurrence of sagging.

Dr. Bob Basu (09:33): So the ideal time for you to consider these procedures is when you've kind of stabilized from your weight loss. You've kind of settled out to where your body wants to be.

Dr. Bob Basu (09:43): The second thing that we have to look at for patients who've lost weight is we want to make sure that you're medically safe to proceed with the procedures. Some patients who've had significant weight before, they had medical issues such as sleep apnea, high blood pressure, or poorly controlled diabetes. We want to make sure you're medically stabilized.

Dr. Bob Basu (10:01): Oftentimes with the weight, the diabetes gets better, your blood pressure's better controlled and your sleep apnea goes away. But again, we want to make sure that you're medically optimized to do well with the next transformational procedures that you may undergo.

Dr. Bob Basu (10:14): The third thing is nutrition. So, so important. Fortunately, I work with a lot of bariatric surgeons who have nutritionists in-house. They make sure their patients are in a good nutritional program so they're getting enough protein and nutrition to make sure they're optimized to heal well.

Dr. Bob Basu (10:30): When I, unfortunately, do see some patients who've had bariatric surgery or weight loss at St. Elsewhere, and they're really not followed by a nutritionist, they're nutritionally depleted. That's a problem.

Dr. Bob Basu (10:42): Because if, nutritionally, you're not doing well, you're going to heal slower from plastic surgery procedures, and it increases your risk for complications. So we want to make sure that you're doing very well from a nutritional standpoint. That's so, so important to make sure you heal well from any surgical procedure.

Dr. Bob Basu (10:59): So things that would prevent people from moving forward are number one, they've got significant medical issues that we're concerned about. We want you to be safe after plastic surgery, and so making sure that you're healthy enough for a plastic surgery procedure is super important.

Dr. Bob Basu (11:13): Number two, if you're still active, you're losing a lot of weight per month, this is not the right time to proceed with a plastic surgery procedure. You ideally want to opt for a plastic surgery after weight loss procedure once you have stabilized from your weight loss.

Dr. Bob Basu (11:28): Thirdly, you want to make sure that you have people around you that can support you through your recovery from plastic surgery procedures. The worst thing that you can do is nobody knows you're having this procedure; you have nobody there to help you, and that's a recipe for a disaster. So it's very important that you either have a friend or family member there with you to make sure and help you through your healing journey.

Dr. Bob Basu (11:52): Now, I did mention that a body lift is a 360 transformational procedure, but it doesn't treat every area. For instance, a body lift will not treat your arms. A body lift will not treat your bra line. A body lift will not impact your breasts.

Dr. Bob Basu (12:08): The body lift will improve your anterior and lateral thigh, for sure, but it's not going to treat any loose skin in your medial thigh area or the area in between your thighs or your knees. So there are some limitations of what a body lift can do.

Dr. Bob Basu (12:20): But I tell patients that a circumferential body lift is really the biggest bang for your buck in terms of it's transforming multiple areas in one procedure to really transform everything from your rib cage down to just below your pubic area.

Dr. Bob Basu (12:35): What I mean by anterior and lateral, lateral means the sides. Medial thighs means the area in between the thighs, and anterior is the front portion of your thighs.

Dr. Bob Basu (12:48): The common question that I get is "What BMI is the cutoff?" and every surgeon has a different answer to that. I will tell you that amongst the community of board-certified plastic surgeons, most feel that if your body mass index is above 30, 31, 32, that's an elevated BMI, and lot of surgeons will not actually recommend any surgery if your body mass index is above 31 or 32.

Dr. Bob Basu (13:13): They're not being mean. The reason why they say no is because there's ample data out there to show that with patients with elevated body mass index, even though you've lost weight, you are at increased risk for healing issues. And what does that mean?

Dr. Bob Basu (13:28): That means incisions could open up, skin necrosis, fluid collections, infections, and the list goes on and on. Now, given my extensive experience over 16, 17 years of helping weight loss patients, I've treated patients with a higher BMI, body mass index, and I prepare them that they are at higher risk.

Dr. Bob Basu (13:47): But with my experience levels, we've been able to get all of these patients to a much better place. Some do have some slow healing, and we help them through it. But it's a more complex procedure when the BMI, body mass index, is higher.

Dr. Bob Basu (13:59): Do I have a cutoff? Yes, I do. I rarely see a patient with a body mass index above 39 who is a good candidate for a circumferential body lift procedure. They may have some other procedural options.

Dr. Bob Basu (14:12): But usually a circumferential body lift is for someone who has lost significant amounts of weight, whether that be 50 pounds, 100 pounds or more. They want to transform not just the front of their tummy, but also their waist and their backside, so a circumferential body lift is truly a very powerful procedure.

Dr. Bob Basu (14:32): We talked about scar for better form, but where do we place the scars in a circumferential body lift? This is where surgical technique and experience really becomes important.

Dr. Bob Basu (14:43): Experienced body lift surgeons, in other words, surgeons that have extensive experience with post-weight loss contouring have honed their technique where we can hide their scars as close or exactly to a patient's thong bikini line circumferentially. For men, it would be their swim trunk line.

Dr. Bob Basu (15:01): So it's really important to plan out your surgical procedure. I do a lot of markings on my patients. I measure multiple times before surgery. I mark them out.

Dr. Bob Basu (15:11): That allows me to make the scars very predictable in terms of where I'm going to place them so that once patients are healed and they have their new contour, they can be confident wearing what they want to wear. That includes a two-piece bikini where they can hide that scar.

Dr. Bob Basu (15:26): Of course, that scar will fade over time, but it can take 12, up to 18 months for scars to mature and fade. But we want to place those incisions ideally in areas that can be easily hidden, such as with a bikini bottom. So those scars are hidden.

Dr. Bob Basu (15:41): It depends on the procedure or procedures that we're performing. If we're talking about a circumferential body lift without buttock augmentation, that procedure typically takes me anywhere between four and a half to six hours.

Dr. Bob Basu (15:56): Again, it depends on how much tissue we're removing, how much fat the patient have. If we do a circumferential body lift with buttock augmentation, that procedure can take me anywhere from five to five and a half hours to up to seven and a half hours. Again, it really depends on many variables and what exactly we're doing.

Dr. Bob Basu (16:15): The body lift surgery typically takes anywhere between five to seven hours on average. There's a variance in terms of the time because it depends on how much tissue we need to remove, how much fat the patient has. It depends on many variables.

Dr. Bob Basu (16:31): It also depends on whether we're adding on buttock auto augmentation with some form of fat transfer or what's called a BBL or Brazilian buttock augmentation procedure.

Dr. Bob Basu (16:42): Some surgeons will keep patients overnight, and I think that's fine. I have a very experienced team with a board-certified MD anesthesiologist who has extensive experience helping patients with higher BMI or with post-weight loss contouring.

Dr. Bob Basu (16:56): I also utilize long-acting numbing medicine. So my patients are of course asleep during surgery, this is a general anesthesia, but I inject long-acting numbing medicine or a local all throughout my incisions. I inject that numbing medicine into the muscles that I'm tightening as part of their tummy tuck, as part of their body lift, so patients wake up with absolutely no pain.

Dr. Bob Basu (17:18): The medicine that I'm using is called Exparel. Exparel is FDA-approved, and the numbing effects can last up to three to four days, which makes a huge difference in terms of the recovery for my patients.

Dr. Bob Basu (17:28): My patients, after a six, seven hour surgery, are walking in 30 minutes to an hour right after surgery. They're walking in our recovery room because they're comfortable because of the advanced pain control techniques that we're doing.

Dr. Bob Basu (17:41): I would say most of my body lift patients are comfortable to go home the same day, especially with the advanced pain control techniques. Of course, they need to have someone with them; we train their family member or friend to help them. But I expect my patients to be ambulating immediately after surgery.

Dr. Bob Basu (17:58): Remember, this is not a weight reduction procedure. This is a body contouring procedure. But the skin and fat that's hanging circumferentially or in the front does have weight.

Dr. Bob Basu (18:10): I would say when we do circumferential body lift surgery, and again, it depends on the patient, I will remove anywhere from five to up to the record of removed is almost 40 pounds of skin.

Dr. Bob Basu (18:24): Now, of course the 40 pounds of skin was an extreme case. But typically, I'm removing eight to 15 pounds of skin on a circumferential body lift procedure on a patient that's lost significant amount of weight. Now, there's some patients that they have excess skin, but it doesn't weigh that much, and times some cases, it only may weigh three or four pounds.

Dr. Bob Basu (18:44): But the average numbers that I share with you, we are removing weight and patients do lose some weight from this. But again, this is not a procedure designed for you to lose weight. This is really a body contouring procedure.

Dr. Bob Basu (18:56): Patients see the result at their first follow-up visit, which occurs several days after their surgery. That's almost the reveal. We take down their dressings and their garments, and the impact is immediate. I mean, they see their transformation right away.

Dr. Bob Basu (19:12): I love taking intraoperative photos of their end result because obviously there's no swelling in the operating room. Remember, swelling and bruising starts several hours after the surgery has been completed. So I like to take the end result photo in the operating room, because that really is the light at the end of the tunnel for my patients.

Dr. Bob Basu (19:31): In other words, that's what they'll see six to eight weeks after their surgery because once their swelling goes away, they're going to see their end results. So that way, that photo that I show them in the first follow-up visit, that's a real experience for patients because they see how great they looked on table, and that's what they'll see once all their swelling and bruising is gone.

Dr. Bob Basu (19:50): I always tell patients when they come back for their first visit, "If you're happy now, you're going to be ecstatic and over the moon in six to eight weeks when your swelling and bruising goes away." So the transformations that patients see from body lift surgery are immediate. Of course, the results get better with time as their swelling goes away.

Dr. Bob Basu (20:09): We call it a doctor-patient relationship because, obviously, I'm doing the surgery and my team is helping me to achieve a great result. But it also takes the patient to cooperate with the healing process and participate as a team member to make sure they heal as well. So following your postoperative care instructions is paramount. It is so, so important.

Dr. Bob Basu (20:32): I tell patients that, "Look, you're making this large investment in a fairly involved surgery. You also want to make that equal investment and commitment to take time off, to make sure your nutrition's good, to make sure you're following your postoperative instructions."

Dr. Bob Basu (20:47): The worst thing that you can do is to go through a large surgery, whether it be a body lift or any surgery, and you don't listen to your surgical team and you decide to do whatever you want to do. That's where you're opening up Pandora's box to complications, fluid collections, seromas, infections, incisions not healing well, and the list goes on and on and on.

Dr. Bob Basu (21:07): So it is really, really important to make sure patients understand what they need to do to make sure they heal well. Because just like I'm responsible to do a great surgery, patients are also responsible to listen to their post op instruction. That's why it's a doctor-patient relationship. We're working together on the same team to make sure you get a great outcome.

Dr. Bob Basu (21:30): One of the risks of post-weight loss contouring are fluid collections. The medical term for this is called a seroma, fancy word for saying it's a fluid collection. So when we're doing a tummy tuck or a body lift, we're removing a lot of tissue. We're undermining or elevating tissue up, and we're pulling things down and rearranging tissue.

Dr. Bob Basu (21:50): Well, underneath the skin and fat where we're doing all this rearrangement, there's an empty space that needs to heal down. Well, remember as human beings, we're all made up of two-thirds salt water, saline. So if there's an empty space, your body will want to deposit your own natural body fluid in there underneath your skin.

Dr. Bob Basu (22:10): But we don't want that fluid to sit there because that becomes a fluid collection, also known as a seroma. And seromas are a nuisance because you get very swollen. For instance, in your tummy area, it can feel like a waterbed effect.

Dr. Bob Basu (22:24): Now we have to do procedures in the office, and it can be office procedures where we can drain fluid, but that's not a good thing. So the way we prevent fluid collections are with drains. Drains are plastic tubes that are essentially placed in pockets where we've done surgical maneuvering.

Dr. Bob Basu (22:40): Drains come through the skin, and they create a suction effect that suck out that fluid, that accelerate that internal healing. So in body lift surgery, I typically place drains, and drains help to minimize the risk for fluid collections.

Dr. Bob Basu (22:55): Now, nobody likes the drains because they tug at you and they're kind of a nuisance. But I tell patients that it's a temporary nuisance to make sure you don't get that fluid collection also known as a seroma.

Dr. Bob Basu (23:05): Now, a lot of people are advertising drainless techniques, and drainless tummy tucks have been around for decades. It's nothing new. I do them from time to time as well too, and they're great options too.

Dr. Bob Basu (23:18): But in my experience for patients who've lost significant amounts of weight, I think with drainless techniques, you can do them, but I think they're at a higher risk for fluid collections, also known as seromas. Therefore, I advocate for drains.

Dr. Bob Basu (23:31): There are two good options. But based on my experience of over 17 years, for the post-weight loss contouring patient, I advocate for drains because it reduces my seroma rate as compared to drain-free techniques.

Dr. Bob Basu (23:45): Every surgeon has a different approach in terms of incision management. Well, I can show you my approach. The good news is there's very little to do for the first couple of weeks after surgery.

Dr. Bob Basu (23:54): Because I do a cosmetic closure, there's no stitches to remove. Sutures are dissolvable and underneath the skin. So you're autopilot. I typically put what's called a Steri-Strip, which is basically paper tape, to seal the incision. Those paper tapes either peel off by themselves, or we remove that paper tape at your first follow-up visit, which typically occurs between five to seven days after surgery.

Dr. Bob Basu (24:17): After that, there's nothing to do. We don't initiate scar massage therapy. You don't necessarily need to put any antibiotic ointment. If you want to, it's okay. But really patients are autopilot in our practice, and with their incisions, we initiate scar management protocols around week six to week eight after surgery.

Dr. Bob Basu (24:35): What's more important than doing things to your incision is wearing your compression garments. That's super important. We guide our patients either with an abdominal binder or custom garments, depending on their body type and what procedures were done.

Dr. Bob Basu (24:48): Compression is important because it helps to keep your swelling down. Remember, we talked about after any surgery, a few hours later, you're going to start swelling, and that's normal. That's nothing abnormal. But we want to keep your swelling checked, and the way we keep your swelling down are with compression garments.

Dr. Bob Basu (25:07): Everyone asks about, "Well, what's the best compression garment?" I tell patients, "It's not a one-size-fits-all. It's finding a garment for your body type that you're okay that you'll enjoy wearing. If we give you a garment and it irritates you and you don't want to wear it, then that's not a good garment for you."

Dr. Bob Basu (25:25): For some patients an abdominal binder works great with foam pads. For other patients, we have to get special compression garments that kind of look like waist trainers or spandex garments.

Dr. Bob Basu (25:35): Everyone's different, and that's where expertise comes into play. We look at the patient's frame and figure, and we figure out what works best for them.

Dr. Bob Basu (25:44): So the recovery for circumferential body lift, I tell patients that you're going to be walking right away in our recovery room, but you're not running up and down the halls. You're walking kind of hunched over in that skier's posture.

Dr. Bob Basu (25:57): For women who've had a C-section, they're very familiar with this. They're walking kind of in that skier's posture, and each day you're straightening more and more up. It should take you between seven to 10 days for you to walk straight.

Dr. Bob Basu (26:10): I tell patients that you should feel at your baseline after a body lift 10 to 14 days after surgery, so you're feeling pretty darn good two weeks after surgery. In fact, most men and women feel very comfortable going back to a desk job at their offices two weeks after surgery.

Dr. Bob Basu (26:28): I generally recommend after a larger procedure, like a circumferential body lift, to take two weeks off from work. The good news is with virtual work and people Zooming from home, people can be back at work in three to five days after surgery.

Dr. Bob Basu (26:41): If you can just be at home with a laptop open, there's no reason why you can't re-engage with work. But I think to be able to drive to the office, to sit in an office, I would give yourself two weeks off.

Dr. Bob Basu (26:53): Now, even though you're feeling pretty good 14 days after your body lift surgery, there are restrictions. I tell patients no heavy lifting or strenuous activity for about five to six weeks. What does that mean?

Dr. Bob Basu (27:05): It means no going to the gym, no running, no heavy lifting beyond 15 pounds, and you want to be very careful with intimate activity. Got to give time for everything to heal for about six weeks. Typically once you get to six weeks, you're cleared. We will clear you to gradually resume activity as tolerated.

Dr. Bob Basu (27:24): Body lift results can be life-lasting, but there are some things that can challenge that statement. Number one, if you gain significant amounts of weight, 10, 20, 30, 40 pounds or more, that can definitely undo some of the benefits of body lift surgery.

Dr. Bob Basu (27:40): If you lose significant amounts of weight, that can create laxity. You may experience some recurrence of laxity in the areas we've done body lift surgery. Now, it's not going to go back to what you had before, but you may see some recurrence of laxity.

Dr. Bob Basu (27:54): Remember, if you've lost a significant amount of weight, you've lost elasticity or tone to your tissue. Any surgeon, whether it's me or another board-certified plastic surgeon, we can only tighten the tissue that you have.

Dr. Bob Basu (28:08): So you may see a little recurrence of sagging or recurrence of laxity in some areas which might require a secondary procedure. That has to do with the fact that your tissue has lost elasticity, and we can only work with the tissue that you have.

Dr. Bob Basu (28:22): But if you maintain your weight, and again, it's okay to gain a little bit of holiday weight. We're not talking about plus/minus five pounds for the holidays. But if you're maintaining your weight and you maintain a healthy lifestyle, you're watching your nutrition, these are long-lasting results that patients can enjoy for a lifetime.

Dr. Bob Basu (28:40): I think it's inaccurate to say a circumferential body lift is a skin removal procedure. I think a skin removal procedure is an amputation procedure called a panniculectomy. In a panniculectomy, you're just amputating loose skin that's hanging from places, but there's not a contouring aspect to that.

Dr. Bob Basu (29:02): What I'm talking about is a circumferential body lift that, A, will remove excess skin as well as excess fat. But we're also contouring the tummy to give you a flat washboard belly, to establish nice curves, to get an hourglass-shaped waist or to remove love handles, and to restore the shape of the buttock.

Dr. Bob Basu (29:22): So what I'm talking about is very, very different than just a skin removal/amputation procedure. Body contouring after weight loss, if you're looking for those finesse results through a body lift, it's considered cosmetic surgery. This is not covered by insurance. Amputation procedures of loose skin hanging, that might be covered by insurance, but less and less these days.

Dr. Bob Basu (29:44): The price range of a circumferential body lift depends on many variables. Number one, the level of experience of your surgeon clearly has an impact. Number two, it needs to include the operating facility fees.

Dr. Bob Basu (29:55): We have a state-licensed ambulatory surgery center. It needs to include the anesthesiologist fees. We have a board-certified MD anesthesiologist with us. And it also has to include any garments or any postoperative care that's involved. The price range varies depending on what exactly needs to be done.

Dr. Bob Basu (30:13): As we talked earlier, some body lifts only take four and a half, five hours. Others take seven and a half hours. Others need to include a buttock augmentation with a separate procedure, such as a fat transfer procedure or Brazilian buttock lift. So it really depends on what's being done.

Dr. Bob Basu (30:29): The costs can be as high as $35,000 and as low as $22,000. It really depends on what needs to be done. But I think the first starting point is to call our experienced and friendly patient consultants who can walk you through what the options are and what the price ranges may be.

Dr. Bob Basu (30:45): But we get it. This is a significant investment. So there are many financing options that all make these procedures very accessible to patients and break down the cost into manageable monthly payments. I encourage you to contact our experienced patient consultants who can walk you through some financing options.

Dr. Bob Basu (31:06): We see out-of-state patients all the time, and then before COVID we were seeing many international patients. We practice in Houston, Texas. Houston is a global destination. It's the energy capital of the world, so it's a very popular destination for international patients as well. So we're hoping, as COVID settles down in the world, we'll see our international patients back too, once they're free to travel, once they're vaccinated.

Dr. Bob Basu (31:27): But we continue to see out-of-state patients, and the first step is really to connect with our patient care consultants. They're very experienced at setting up resources for you, to give you options for local Airbnbs where you can stay for one to two weeks so that we can take care of you after surgery.

Dr. Bob Basu (31:43): The worst thing that you can do if you're out-of-state patients, is not plan for your postoperative care. You do not want to fly somewhere, have surgery, then head home a couple of days later. A, that's dangerous because of risk for blood clots. And, B, who's taking care of you after the surgery?

Dr. Bob Basu (31:59): I actually would not take on a patient for a body lift if I knew they were not staying close to my office for at least 10 to 14 days. I think that's irresponsible, to be blunt. I think responsible care is if you're going to treat out-of-state patients, we need to be involved intimately with your postoperative care.

Dr. Bob Basu (32:16): For me, that means you need to stay in our area for at least 10 to 14 days. That way, then you're safer to fly home, you're already walking. We've been able to remove your drains. We're making sure you're doing okay. So I feel much more comfortable with that.

Dr. Bob Basu (32:30): So planning your postoperative care is super important if you're an out-of-state patient. But the first step, talk to our friendly patient care consultants. They can walk you through logistics and make things happen.

Dr. Bob Basu (32:40): We have tons of photos to see on our website, which is basuplasticsurgery.com. That's B as in boy, A-S-U plastic surgery.com. Or you can find us on Instagram at @basuplasticsurgery.

Speaker1 (32:54): Basu Aesthetics + Plastic Surgery is located in northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basuplasticsurgery.com/podcast. On Instagram, follow Dr. Basu and the team @basuplasticsurgery. That's B-A-S-U plastic surgery.

Speaker1 (33:18): Behind the Double Doors is a production of The Axis. T-H-E-A-X-I-S.io.