3. The 30 to 50 Pounds Overweight Group
The second group is composed of patients with moderate excess of the trunk. These patients have attempted for years to lose the excess 30 to 40 pounds but are unable to. A traditional tummy tuck procedure in this group will often lead to less than ideal results, especially in the hip, flank, and buttocks areas. Their anatomy requires belt lipectomy to attain a striking improvement in their truncal contour (see Figure 19, Figure 20, and Figure 21).
Figure 19. This composite photo is of a patient who belongs to a group of patients who are not able to lose 30-50 pounds despite serious attempts. (The upper three pictures are of the patient prior to surgery and the lower three pictures are of the same patient after surgery.) Note the remarkable improvement in the belly, hips, back, back rolls, and buttocks.
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Figure 20. This composite photo is of a patient who belongs to a group of patients who are not able to lose 30-50 pounds despite serious attempts. (The upper three pictures are of the patient prior to surgery and the lower three pictures are of the same patient after surgery.) Note the remarkable improvement in the belly, hips, back, back rolls, and buttocks.
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Figure 21. This composite photo is of a patient who belongs to a group of patients who are not able to lose 30-50 pounds despite serious attempts. (The upper three pictures are of the patient prior to surgery and the lower three pictures are of the same patient after surgery.) Note the remarkable improvement in the belly, hips, back, back rolls, and buttocks.
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4. The Normal Weight Patients
The fourth group is composed of patients that have a mild amount of excess in the belly, hips, thighs and sagging buttocks. These changes are common in the mid thirty to forty year old group. They are associated with early aging, often secondary to changes that occur after child bearing in women. Although these changes are treatable in many instances with a tummy tuck and liposuction alone, some patients choose to lift their thighs and contour their buttocks, thus requiring a belt lipectomy (see Figure 22).
Figure 22. This composite photo is of a patient who patient belongs to a group of patients that are within the normal weight range, but desire a remarkable improvement in the hip and buttocks area. (The upper three pictures are of the patient prior to surgery and the lower three pictures are of the same patient after surgery.) This extent of improvement in the buttocks region is not attainable with liposuction alone.
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5. Patients Who Have Had Overly Aggressive Liposuction
In this group of patients, liposuction of the trunk in varying degrees has left them with loose skin that is irregular in appearance. A belt lipectomy is not able to fix all that is wrong with these patients, but it can help patients attain an improvement in an otherwise very difficult situation, see Figure 23.
Figure 23. This composite photo is of a patient who had extensive liposuction and a tummy tuck prior to belt lipectomy and was unhappy with the excessive removal of tissues from the buttocks, hips, and outer thighs. This is an extremely difficult problem to fix but the patient is seen after belt lipectomy with an improvement, although not an elimination, of her problems. (The upper three pictures are of the patient prior to belt lipectomy and the lower three pictures are of the same patient after surgery).
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Contraindications (Patients Who Are Not Good Candidates)
If the patient is massively obese he or she is not a candidate for this procedure, because it will not improve contour and they may not heal their wounds. Patients who have medical problems that preclude a general anesthetic are also not considered. Smoking causes a significant decrease in blood supply to all tissues of the body, thus smokers are not candidates for belt lipectomy because of the increased risk of tissue loss associated with the surgical procedure. Patients who are deemed mentally unable to handle an extensive surgical procedure with its concomitant recovery period may not be good candidates and may require counseling and/or psychiatric drug therapy prior to being reconsidered for surgery.
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