Body Contouring
Body contouring encompasses a variety of surgical procedures. These techniques may be desirable if you have excess fat beneath the skin that is resistant to dieting and exercise. Body contouring is also helpful for those that have excess fat and sagging skin following multiple pregnancies or after a major weight loss. Common areas are the neck beneath the chin, the upper arms, chest, breast, trunk, abdomen, hips, waist, thighs, inner knees, calves and ankles.
The primary goal of these procedures is to improve the body contour and to enhance body proportion. These procedures are ot intended as a weight loss alternative. deally, patients are healthy and near
a normal weight.
In the 2,000 plus body contouring procedures that I have performed, the majority of my patients have been extremely happy with their new body contour. I attribute these positive results to:
- An individualized approach to each patient
- Careful patient selection process in an attempt to avoid unnecessary complications
- A motivated candidate with realistic goals for his or her contouring program
Treatment options are determined by the elasticity of the patient’s skin. If the skin elasticity is good, as in the younger patient, liposuction alone is often the procedure of choice. If however, skin elasticity is weak, as in the older patient or after major weight loss, liposuction alone can cause dimpling, requiring the additional procedure of skin tightening.
The most common body contouring procedures are:
Breast Lift/Breast Reduction
After multiple pregnancies or with natural aging, the breast mound can sag. Both of these procedures will raise and reshape the breast, however they differ in two ways:
- Breast Lift is a cosmetic procedure, not usually covered by insurance. The procedure does not reduce the size of the breast.
- Breast Reduction is often covered by insurance and does reduce the size of the breast. In both procedures, the nipple is not detached in an attempt to avoid a loss of sensation to the nipple area. Incisions are usually placed around the areola and beneath the breast. The skin envelope is redraped around the newly formed breast mound to give a more rounded appearance. These procedures may also be helpful in the male patient after a major weight loss. The operative time for either of these procedures is approximately two hours and can often be done on an outpatient basis.
Liposuction (Liposculpture)
In the 1,500 cases I have performed, my preference is the tumescent technique, where I inject a large volume of fluid into the area to be treated to avoid excessive blood loss. With the assistance of ultrasound and vacuum, the unwanted tissue is removed through a hollow tube. In (fig 1) the procedure is done to remove excess fat from the flank area commonly referred to as “love handles.” For small areas this is an in-office procedure, for larger areas, a general anesthetic on an outpatient basis is required. The operative time is to 2 hours and the result is a permanent improvement in contour and body proportion.
Tummy Tuck (Abdominoplasty)
A pregnancy or a major weight loss can result in loose, sagging or projecting lower abdominal wall tissue. This procedure restores the abdominal wall appearance by removing the excess tissue and tightening the waist and abdomen (fig 2). Any scars are hidden beneath the panty line (fig 3). Mini-Tummy Tucks are done
in the office, however, the more extended procedure requires a general anesthetic
in a surgical facility.
Thigh Lift, Arm Lift
Both of these procedures are usually done following a major weight loss, but may be appropriate in the older patient with excess skin laxity. The inner thigh skin can be treated by placing the incisions along the inner groin crease. The upper arm lift is one of the most requested procedures after excessive weight loss. The scar in smaller cases can be hidden inside the arm pit, but for larger cases, the scar is hidden on the inner side of the upper arm. The thigh lift requires an overnight stay in a surgical facility, but the arm lift is an outpatient procedure.
