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Surgical Body Contouring:  Common Techniques


Many things can keep us from being the shape we want.  Pregnancies, weight loss, aging and familial patterns of fat deposits can keep our body from being the best that we think it can be.  To some, surgery may be thought of as a quick fix for a problem that should be addressed with exercise and dieting.  Unfortunately, surgery is not a good substitute.  It only compliments diet and exercise.  The best candidates for body contouring surgery are those who are at or near their ideal body weight, who have areas that are diet resistant familial fat deposits, or areas of excess skin and fat distorted permanently by pregnancy or previous obesity.  Some people can be considered for contouring surgery if they have significant disproportions of their body even if they are somewhat overweight.

There may be areas that no matter how much you have dieted or how much exercise you have done, they will not go away or tighten up.  Even one pregnancy or one episode of being overweight may stretch your skin leaving excess skin and stretch marks.  What many people do not know is that the muscles themselves can be stretched out also and no matter how many sit-ups you do, you may not be able to tighten your muscles the direction that they have been stretched.  During pregnancy the bones of your hips usually widen to allow the passage of the baby out of the pelvis and they will not go back after pregnancy.  That same relaxation may stretch your abdominal wall muscles as well, making them spread both in width of the individual muscles and distance between the two main muscles. 

Muscles can get toned, stronger and more defined with exercise, but they cannot move back to where they were.  The skin itself is often stretched out and redundant.  If that should happen there is no amount of exercise that can move them back towards the middle and snug in the waist, and no amount of dieting can shrink the skin back to where it was.

An abdominoplasty will tighten the skin of the abdomen, removing the redundant skin.  It removes only the stretch marks on the skin that is removed.  Most abdominoplasties will tighten the muscle up as well, usually at the midline, and often at the sides.  Depending on how saggy your skin is, sometimes a mini-abdominoplasty can be performed instead, with or without liposuction.  There is usually quite a long incision with the abdominoplasty and a somewhat shorter one with the mini-tummy tuck.  Both scars are concealed by most swimsuits.  Both of these procedures should be performed after your weight has stabilized.  If you should lose over ten or fifteen pounds after the procedure you may lose some of the new tightness of your skin.

Weight gain should be prevented after these procedures.  You may lose the benefit of the procedure and the new fat may be added on at unexpected and undesirable places such as your arms, hips or thighs.

There are other areas that can be surgically contoured.  If there is excess skin and fat of your arms and thighs, both areas can be tightened.  The scars from both of these procedures are significant and may be visible in regular summer clothing so I usually recommend them only for those with a large amount of redundant skin.

Liposuction is another option to contour your body.  It has been performed in the United States for over twenty years with a good safety record.  If you have a problem area and the skin is in good shape, liposuction can smooth out the fat deposit.  You can use it on your abdomen, especially on the abdomen and saddle bags for women, and the "love handle" area for men.  It can be used on almost any area that has excess external fat.  Liposuction permanently removes fat cells by inserting a small tube in the fat of the area treated.  These fat cells will be gone forever.  However, it is important to keep your weight under control after the procedure.  Fat can and will relocate to other areas where there are other fat cells that could hold more fat if you regain any weight.

Liposuction is a popular procedure because diet and exercise has limitations.  It is ideally performed on someone at or near his/her ideal body weight, but is useful in addressing a problem area that is present regardless of weight.  For instance, a woman with a pear shape, a significantly mismatched top and bottom, may find some improvement in proportion even if she does not plan to lose weight.  It is not helpful if you just generally need to lose weight.

Surgery only addresses discrete areas, and if only a few areas are treated when there is general excess fat, it will throw off the harmony of the body.  The recovery from liposuction is much faster than the recovery from an abdominoplasty, and the scars are usually quite small.

There are many ways to improve your appearance.  The best way to look good is to be healthy.  Cosmetic surgery is a useful addition to address areas that you have been unable to affect with an honest effort.  It is not without risks and often requires significant recovery time.  If surgery is part of your plan, plan well, be realistic about where your body is and how much it can be improved.  Do your research on who will do it, where it will be done, how long the recovery will take, as well as what to expect and you will have a happier experience and an enhanced new appearance.  Make sure your surgeon is Board Certified in Plastic Surgery and that the surgery center used is one that is certified by a nationally recognized certification agency.

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