MIAMI, FL, UNITED STATES, April 14, 2023/ — An aging population whose skin has lost its youthful elasticity and increased numbers of patients undergoing bariatric surgery to shed significant weight have prompted greater demand for a procedure that removes, tones, and contours sagging skin around a person’s middle, says plastic surgeon Dr. Alexander Zuriarrain1, founder of Zuri Plastic Surgery2 in Florida.“It is called a lower body lift3 – or belt lipectomy. It calls for the surgeon to make an incision around a person’s entire torso – at the ‘bikini line’ — in order to eliminate excess skin from the abdomen, thighs, flanks, and buttocks; tighten muscles; and create a firmer, more contoured appearance by lifting and repositioning remaining tissue,” Dr. Zuriarrain explains.

Skin stretched by excessive weight for an extended period of time does not automatically retract. That is because components underlying skin’s structure – like collagen and elastin – have been damaged, explains Dr. Zuriarrain. Approximately 80 percent of skin structure is composed of collagen, which provides foundational strength. Elastin helps keep skin tight.

“Aging, which generally causes skin to lose volume; genetics; and overexposure to the sun can further complicate efforts to return skin to its former appearance and tone, especially after weight loss,” Dr. Zuriarrain says.

Although exercise, such as resistance training and Pilates; laser therapy; and laser resurfacing help firm up minor or moderate skin laxity, surgery is the most likely recommendation when skin redundancy is extensive, Dr. Zuriarrain adds.

The lower body lift actually is a combination of procedures that can include an abdominoplasty (tummy tuck), butt lift, a panniculectomy to excise loose skin around the abdomen, an outer thigh lift, and a tightening of tissue between the pubic bone and genitals – what surgeons call a monsplasty. Depending on what the patient requires, the lower body lift, normally performed on an outpatient basis, may take several hours to complete under general anesthesia.

“Like any surgery, the lower body lift has its pros and cons,” Dr. Zuriarrain says. “On the pro side, this menu of procedures eliminates a significant amount of sagging, loose skin quickly, and results are almost immediate. The patient looks trimmer, more toned, healthier; clothes fit better. Most importantly, the surgical approach returns a patient’s self-esteem and self-confidence.

On the con side, surgery can create permanent scars, which, of course, will lighten over time; requires a rather extensive recovery period; and has a relatively higher rate of post-operative complications for some patients, although the majority of the issues, such as wound healing failure, infection, and abnormal accumulation of serous fluid, tend to be minor.

“Complications can be minimized in the hands of an experienced, board-certified plastic or cosmetic surgeon and with proper selection of patients,” Dr. Zuriarrain says.

In a study published in Plastic Reconstructive Surgery (PRS) Global Open, authors indicate that age and the “percentage of excess weight loss before lower body lift surgery are also predictors for postoperative complications. The closer the patient is to the ideal weight, the lower the complication rate (”

Dr. Zuriarrain cites two studies, one in the journal Surgery for Obesity and Related Diseases and another in the Annals of Plastic Surgery ( and ( In both articles, scientists contend the lower body lift restores patient satisfaction, an enhanced body image, and quality of life. Authors of the study in Surgery for Obesity and Related Diseases refer to the lower body lift as an “an essential component in the treatment of patients who have experienced massive weight loss.” And add, “Body contouring surgery…remains a fast-growing field due to the rising number of post-bariatric surgery patients.”

But the loss of a sagging torso is not simply a mental and emotional boost. Excessively loose skin can interfere with physical activity, cause physical discomfort, or lead to skin-related disorders and skin breakdown, including development of ulcers and infections, Dr. Zuriarrain states.

Preponderance of patients who opt for lower body lifts are women. In fact, according to the American Society of Plastic Surgeons, of the 8,433 lower body lifts reported in 2020, 7,713 – 91 percent – involved females.

To anyone considering a lower body lift, Dr. Zuriarrain offers this advice:

• Have realistic expectations regarding outcomes.
• Know you should be a non-smoker and free of other conditions like cardiovascular disorders or diabetes before undergoing a lower body lift.
• Be committed to maintaining a stable weight after the procedure. Continuous weight gain and loss cycles and yo-yo dieting cause skin to become even more loose and floppy.
• Take action to build and strengthen muscle, especially core muscles, following recovery. Work with an exercise physiologist or fitness trainer if possible.
• If surgery frightens you, consider available alternative strategies. Cosmetic procedures that do not involve an operation can prove effective if your skin is only moderately loose.

“And should significant weight loss necessitate a lower body lift, celebrate yourself. Shedding weight is an achievement. Do not let loose skin be a source of depression. The problem is common and can be corrected. Talk to a board-certified plastic surgeon about options,” Dr. Zuriarrain advises.

Bio: Alexander Zuriarrain MD is a quadruple-board-certified plastic surgeon who specializes in aesthetic procedures of the face and body. He is the founder of Zuri Plastic Surgery in Miami, FL.