In most patients this layer is loose due to pregnancy and or excess weight that has been lost. The fat and skin above the belly button is then stretched down to the pubic area and sutured in place. A new opening is made to allow the belly button to be brought through, in its original position. The wound is then closed. The patient is then turned to the side and the excess skin and fat from the side to the mid back is removed.
Most patients require liposuction of the outer thighs.
This part of the operation reduces the protrusion of the outer thighs but also lifts the skin of the whole leg down to the knee. As the skin and fat is removed from the back area the back rolls are reduced and the buttocks are lifted. Of course each of these maneuvers is done to a different degree depending on the needs of the patient. The wound is then closed. At the University of Iowa it takes an average of five to six hours to perform the operation.