Body Contouring Procedures
Body types vary dramatically between individuals, and many of us find our bodies changing over time more than we expect. There are a number of factors that influence body shapes including diet, exercise, pregnancy, age and genetics. Unfortunately, not all of these changes are reversible even with strict attention to diet and exercise.
All of the options for body contouring are best suited for patients that maintain a stable weight. Options can range from Coolsculpting in the office, to liposuction, abdominoplasty or even body lifts for patients whose excess skin extends on to the back. Because of the number of options available, tailoring the right operation to the right patient is critical for a great result. We will guide you based on both your physical exam and perceived problem areas.
Abdominoplasty (Tummy Tuck)
Most often after pregnancy, or considerable weight loss, people may develop excess lower abdominal skin and/or muscle laxity. Although diet and exercise are great ways to minimize the fat, neither will help once the skin has become loose or the muscles separate or become lax. Although abdominal exercises can strengthen these muscles, all of the crunches in the world can’t repair a diastasis (a separation of rectus muscles). An abdominoplasty will address both the excess skin over the lower abdomen and tighten the rectus abdominis or core muscles. A ‘mini’ version of the abdominoplasty may be an option with a shorter scar for patients that only have lax musculature but with normal skin.
In situations where there are problem areas of excess fat but otherwise normal skin and muscle tone, liposuction can be a great option. These can include abdomen and flank regions, inner and outer thighs, arms, back and bra rolls. A cannula is inserted into the fatty space between the skin and muscle and the fat is removed. This typically requires several small 5mm incisions so that we can contour the area. Most commonly, we utilize the Vaser Ultrasonic Liposuction which applies an ultrasound energy to help emulsify the fat and free it from the surrounding tissue. Ultimately, a significant component of the final result is dependent on how well the skin shrinks around the new contoured areas.
Brachioplasty (Upper Arm Lift)
For patients with some extra fat on the arms, but otherwise no extra skin, Coolsculpting or liposuction may be a reasonable option with a minimum of scarring. For those with a true arm “waddle,” this excess can be removed with excision of a portion of the skin and fat of the upper arm. This will typically result in a scar that extends from just above or below the elbow up to the armpit and, in some cases, the chest wall. Unfortunately, for those patients in between, there are not too many viable options at this time that address significant skin laxity without scarring.
Inner Thigh Lift
Liposuction and Coolsculpting are reasonable options for a reduction of fat on the inner thighs in the setting of excess fat without significant excess of skin. But, for those patients with both excess skin and fat, or those primarily with skin excess after weight loss, a surgical inner thigh lift may be beneficial. This most commonly involves an incision from the groin down the length of the inner thigh ending somewhere above the knee. As always, we go into great detail about caring for scars, and generally the inner thigh scars are hidden even in skirts and dresses.
If you have a couple of small problem areas and are interested in a non-invasive procedure with minimal downtime, Coolsculpting may be a great option. The skin is drawn in between to two cooling plates essentially freezing the fat, triggering pre-programmed cell death. We typically see approximately a 20% reduction in the fat per treatment, but ultimately this can vary substantially. Coolscultping will typically require more than one treatment site for a final sculpted result, and our brand new handpieces can reduce treatment times per site considerably!