PST 038: All about Belt Lift
May 2, 2019
This week, Dr. Stephen Mulholland discusses the Emsella technology and SUI
Welcome to Plastic Surgery Talk with Dr. Stephen Mulholland brought to you by SpaMedica.
Hello, Dr. Stephen Mulholland here in Toronto, Canada on Plastic Surgery Talk on our podcast series. Today’s podcast is on the belt lift, a specific, modified tummy tuck for guys that fits into the aesthetic and outcome and recovery and scar profile that guys want.
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Who’s a candidate for a belt lift? Male candidates for belt lifts are those males that have lost some weight or substantial amount of weight and they’ve got skin laxity, loose skin, usually around the belly button and below. No matter how much diet and exercise they do, that loose skin that was stretched when they were overweight becomes an aesthetic problem. When they bend over, the skin’s loosey-goosey, and there’s no amount of tightening technology out there that can lead to the kind of results that most guys want. So a belt lift is best offered to those guys who have loose skin around the belly button and below, that have good muscle tone. They may or may not have excess fat on the abdomen and love handles and it can be combined with liposuction in those cases.
So the best candidates have extra skin from weight loss or age with or without extra fat that might be sub to liposuction or have good medical condition. They don’t have any heart disease or any uncontrolled medical diseases, and their expectations are realistic. They want a nice, firm tummy. But we can’t give them back a six pack with the belt lift. It’s really just a skin pinch of the lower abdomen to improve skin tone. And they should have realistic expectations. They should allot some time for recovery, usually about two weeks. And they have to be accepting of the scar. Those are the best candidates for a belt lift procedure.
How is the belt lift performed? Belt lifts are generally performed under a local aesthesia and sedation. Most patients don’t need a full general aesthetic. It maybe in combination with other treatments like liposuction. But the specific belt lift is a well designed low pubic, groin crease incision. The extra skin of the lower abdomen is elevated, pulled down, and the excess cut away. The incision is tailored, tapped and trimmed within the pubic hair and the groin crease. So any underwear or belt or pant can cover the scar. And the goal of the belt lift is to achieve a flatter, tighter tummy with less loose skin.
Can other procedures be combined with a belt lift? Absolutely. The belt lift is best combined with liposuction, modern liposuction. Body type lipo, smart lipo, laser lipo. Liposuction of the love handles, very common in mean. Occasionally love handle of the abdomen itself, especially upper tummy, can be performed at the same time. So synchronous liposuction of the love handle, the flanks, and the upper tummy of the time of the belt lift is a very common combination, and occasionally loose skin of other areas, such as the inner thigh and inner thigh lift or an arm lift maybe combined at the same time. If there’s been massive weight loss, not uncommon to perform a belt lift in combination with a guy lift or a neck lift as well. So anywhere where there’s loose skin or excess fat can be part of the combination treatment that can be performed at the same time as a super pubic, below the belt, skin removal belt lift procedure.
What kind of results can you expect from a belt lift in general? Guys who have loose, lower abdominal skin can expect flatting of that lower abdominal skin to have less laxity, less extra hanging skin, and feel more confident when they’re bending over or working out or exercising. It’s hard to exercise loose skin away. You can’t diet and exercise loose skin away. Often it’s the diet and exercise that led to the loose skin. So you should expect a much flatter abdominal contour. You should have much tighter appearing abdominal skin in bent over positions or positions where otherwise you might’ve had a self conscious awareness of that extra skin. And the only exchange you need to make in order to achieve this outcome is a scar.
Is the belt lift scar acceptable and is it hidden? This a very, very common question because guys don’t want to have a great big tummy tuck scar that often women will put up with. And so the answer to the question is there’s always going to be some visible component to the scar. As a plastic surgeon, of course, we take the time to get the best possible scars with delicate and careful closure. Part of that is selecting an extremely well hidden and inconspicuous location, and an incision that goes right through the pubic mound or the pubic hair and out to the groin creases is extremely low down, below the belt line. In any given male scenario, is generally very well accepted, very well tolerated. Once the hair and the pubic hair grows out in the area, it often camouflages the visibility of the scar, and the scar could be treated to ensure it doesn’t go through adverse keloid or hypertrophic scar condition. So a low-lining scar below the belt, below the underwear line, very acceptable and most gentlemen who undergo this have no problem with that kind of scar once an exchange for a much tighter skin.
What’s the recovery like? Is there any pain and discomfort? The answer to that question is absolutely. We’re doing some surgery. However, I would say that a male belt lift is way less painful than a female tummy tuck. Female tummy tuck is often following child bearing and the abdominal muscles, rectus abdominis muscles are spread apart leading to bulging. And so a classic tummy tuck for a woman involves sewing their muscles together again, making a new belly button, and removing loose skin. It’s that sewing of the muscles that gives that very sore, like ran through the house, have a charlie horse because I hit my thigh on a coffee table type of pain, that very sore rectus abdominis muscle pain that women experience following a tummy tuck is not a characteristic of a belt lift.
Remember, a belt lift is removing the extra skin below the belly button on gentlemen that have lost weight or become old and lax that involves no muscle tightening, no plication. You don’t have that agonizing soreness of a tummy tuck and this muscle repair. There’s no belly button incision. So although we guys are not generally as tough as the women in recovery, a belt lift has far less pain or discomfort than liposuction, far less pain and discomfort than guys who do a nose job or a neck lift. So it’s one of the least painful things we offer, and it’s easily hidden and camouflaged in clothes.
Do I need to wear a garment after my belt lift? The answer to that is absolutely. We use a garment, which is like a Lycra spandex, Lululemon, super strong compression garment with some foam underneath it to compress the skin to its new shape on the rectus abdominis. If you’ve done some adjunctive liposuction of the love handle or the upper abdomen, we also use foam to compress those areas. And the goal is to have the skin lie down flat and smooth to the underlying muscle, and that takes about six weeks of garmenting. 20-22 hours a day to ensure that contraction occurs.
Is there any maintenance following a belt lift? And the answer to that is often there is because if you’ve done this for reasons of laxity, if you’ve got loose tummy skin and we pull and tighten it, with age and time, your tummy skin will become lax again. Maybe never as lax as it was to begin with before the belt lift, but nevertheless, there’s some recurrence of laxity. So we recommend all our female and male patients that have lifting, tightening procedures, they begin pulsating radio frequency energy treatments, like the Venus Freeze, the Xles, the Forma Plus. At about eight to 10 weeks, and we start doing treatments once a month for several treatments. And then we hand that off to the patient to come back for a paid maintenance program once every three months for the rest of their life. These are noninvasive, very comfortable, bulky new radio frequency treatments that are great at maintaining and holding the tightening we get with any of these lifts, such as a belt lift.
What do you do if you don’t like your scar following a belt lift? At SpaMedica and generally most clinics, they’re going to offer some scar treatments, and if it’s a thick, raised scar, injection of triamcinolone or Kenalog will soften that scar. The application of silicone gel strips at home will help with that scar. You can see your surgeon for specific injections of other agents that can soften the scar. Then of course we use lasers. We use pulsed eye lasers if it’s red. PCO, second pulsation lasers if it’s brown. And in general, I can make a commitment to my belt lift guys that we will do what it takes to make your scar lie light and flat and inconspicuous as possible by the use of laser and injection therapies in your post-op program, and that comes with a surgeon’s no additional cost.
Will my tummy have normal sensation after a belt lift? That’s a common question, and the answer is not initially. When you lift the skin up and pull it and lay it back down and suture it back down, the skin that was elevated is quite numb and the anesthesia will last 12-18 months but almost always restores itself to near normal levels. Now there may be some additional numbness just above the scar that never comes back, which is often the case around a scar. But 95% of the sensation comes back in 95% of belt lift patients by one year.
So what’s the cost of a belt lift? And that’s depending upon the practice, the city that your physician lives in, and market conditions at the time in those cities. But in general across Canada and the United States, a straight up skin only belt lift without any liposuction will cost anywhere from $7-, $8,000 to $15-, $16,000, depending on the practice, the city, the size of the patient, and the amount of loose skin. If you add additional procedures to that, such as liposuction of the love handles, of the abdomen, of the double chin or a blepharoplasty or a nose job, the price of course will go up. But generally you’re going to get favorable pricing for second and third procedure bundle discounting than you will for individual procedures done three times.
So thank you for joining me again, Dr. Steven Mulholland here on Plastic Surgery Talk in Toronto, Canada. This podcast was on the belt lift, the male belt lift. And if you find this podcast entertaining, enjoyable, informative, please share on your social networks, subscribe, and comment. See you next time.