No question about it, pregnancy and time do change the human body. If your best efforts at dieting and exercise aren’t working, are you just going to accept it? If the answer is no, read on for a clear understanding of some of your choices. Today’s options in body contouring are best understood as a graduated series of possibilities from the subtle to the dramatic.
Everyone’s heard about liposuction. Simply speaking, pesky areas of fat can be removed through a nearly invisible incision by softening the fat and drawing it out through tiny tubes called cannulas.
Liposuction is not for everyone. The two biggest limitations are in the amount of fat which can be safely removed and the quality of skin over the fat deposits. If the skin is too loose, it may bunch up or show surface irregularities after the fat is evacuated, since loose skin may not be tighten up adequately after the fat is removed. In addition, there is a safe limit to the amount of fat which can be removed at one time. Removing too much fat can cause shifting of body fluid into the empty spaces, which can affect the circulation and blood pressure. Most problems with liposuction surgery are due to trying to remove too much fat at one time or poor patient selection.
The best situations for liposuction are in individuals with good, firm skin and localized bulges. Liposuction works best on localized areas of fat that don’t seem to fit the rest of the body, like inner and outer thigh bulges, hips, and the abdomen. Fat looking knees and arms can be improved too. Men usually do best with the “spare tire” area (love handles and lower abdomen) as well as breast areas, which can be fatty and sometimes look feminine.
The perfect candidate for liposuction alone is near normal body weight with good skin tone and very localized bulges of fat. If expectations are set realistically, liposuction can also be successful if the skin is a little loose or the individual is a little overweight. Liposuctions should not be considered a way to lose weight. I like to use both ultrasonic liposuction and “superwet” liposuction, which is a safer, more predictable variation of the tumescent technique. The results of liposuction are related to proper patient selection and your surgeons skill much more than they are to which device is used.
If the skin is too loose for liposuction, great results can often be obtained with abdominoplasty, also called tummy tuck surgery. Liposuction cannot tighten loose skin or stretched out muscles, which follow pregnancy or obesity. Abdominoplasty can remove and tighten unwanted loose skin, reshape and rejuvenate the belly button and tighten and flatten loose abdominal muscles.
There are actually three types of tummy tucks, depending on the individual situation. The simplest variation, called a mini-abdominoplasty just tightens the muscles below the belly button through a small incision over the pubic hairline. This is perfect for the thin person with a “pot belly” due to the stretching and relaxation of the abdominal muscles that often follows pregnancy. If the muscle is stretched out and there is also loose, rippled skin below the belly button, an extended mini abdominoplasty is ideal. The extended mini abdominoplasty not only tightens lax and bulging lower abdominal muscles but also removes skin and excessive fat below the belly button. If the abdomen also has loose skin or fat rolls above the belly button, a full abdominoplasty works best. Full abdominoplasty removes almost all of the skin between the belly button and the pubic area and tightens the upper abdomen too as well as reshaping and tightening the belly button and skin around it. With each type of tummy tuck, the scar is progressively longer but there is more dramatic improvement. Each individuals scar is slightly different based on their body shape, but we try to get the scar as low as possible. I like to draw the tummy tuck pattern on each patient during the consultation to show approximately where their scar will end up. We have extensive before and after photos of all types of tummy tucks, which help decide if abdominoplasty is right for you.
Although most people have heard of tummy tucks, most don’t know that we can lift and tighten other areas of the body too. The most common areas are the outer thighs, the bottom and the arms. These procedures aren’t for everyone since the scars tend to be more difficult to hide and recovery is often longer and more uncomfortable. Nonetheless, if the skin is really loose and saggy in those areas, body lifting procedures are the best options and dramatic changes are possible.
Putting It All Together
Most of the techniques to reshape the body can be done together. It’s usually possible to analyze all of the trouble spots and develop a plan that allows considerable body reshaping with one procedure and one “down time” for recovery. This has been called “The Mommy Makeover” or Total Body Contouring. It’s especially popular to combine one or more of these options with breast surgery, since the loss of breast volume or tone often goes hand in hand with the other changes of age and pregnancy. There are several different breast implants and different types of breast lifting so that most people have good choices.
Gregory Stagnone, M.D., F.A.C.S., is the owner and director of the Plastic Surgery Center of Dallas.
He is a specialist in cosmetic surgery limiting his practice to cosmetic enhancement and rejuvenation of the face and body. Individuals interested in obtaining specific information regarding cosmetic surgery may call (972) 661-5077 in Dallas.