Body Contouring

Body contouring can reduce body fat or resolve excess skin issues caused by fluctuations in your body weight. After significant weight loss, a person can often benefit from one of these surgical procedures to enhance body contour in multiple areas.

Arm lift surgery contours the arms so they are slimmer and more proportional with the rest of the patient’s body.  Also known as brachioplasty, this procedure removes excess skin and fatty tissue from the upper arm and sometimes part of the chest / underarm.

As you get older and your body weight fluctuates, the tissue of your arms can become loose and persistent fat can gradually accumulate, causing an unsightly condition of hanging tissue on the upper arms.  This condition, which is often described as a bat-wing, can make a person self-conscious about his or her appearance.  Many women in particular choose not to wear sleeveless clothing in order to hide their upper arms.  After brachioplasty, your upper arms will exhibit smoother, tighter contour that is proportional to your body.

ARE YOU A CANDIDATE FOR BRACHIOPLASTY?

Candidates for arm lift surgery have, as described above, excess skin and persistent fat on the upper arms.  Also, the right candidate must be willing to accept the permanent scars that result from arm lift surgery.  The surgical incisions will be placed in areas that can be easily hidden, and the scars will fade and flatten out over time.  Nonetheless, the surgery scars will always be somewhat evident.

Patients should also be:

  • Non smokers (to prevent complications of delayed healing)
  • At a stable and healthy body weight
  • Capable of understanding risks/benefits and realistic about results

During a consultation with your provider, you can ask specific questions about your individual case and provide details about arm lift risks, benefits, and costs. Your provider will inquire about your medical history and general health to determine if you can safely undergo arm lift surgery.

ARM LIFT SURGERY TECHNIQUES AND PROCEDURES

When performed as a single outpatient procedure, your arm lift will require about 1 to 2 hours under local or general anesthesia.  For some patients, your provider may recommend liposuction of the arm area, without removal of skin.  However, to achieve the best results in most cases, excision of redundant skin is necessary. Your provider makes an incision in the inner part of your arm, traveling from your armpit (axilla) area toward the elbow.  Fat and excess skin is removed to contour the arms.  Sutures are placed to close the incisions and maintain the new shape.

WHAT HAPPENS AFTER ARM LIFT SURGERY

Recovery time is about 2 to 4 weeks. Your provider will send you home with specific post-operative instructions, which you should follow closely.  You may need to keep your arms elevated and limit movement for a time.  Swelling and bruising is normal and should subside in about 2 weeks.  Compression garments on each arm will minimize swelling and promote optimal skin contraction.

A body lift is a series of surgical techniques that remove excess skin from the lower body after massive weight loss. This rather extensive set of operations is typically performed for patients who have lost about 50 percent of their body weight.

Body lift techniques may include torsoplasty, belt lipectomy, buttock plasty, and others. The body lift may also be combined with abdominoplasty, thigh plasty and breast lift surgery.

ARE YOU A CANDIDATE FOR BODY LIFT SURGERY?

If you have lost a significant amount of weight and now exhibit loose, sagging skin in multiple body areas, a body lift may be right for you. Redundant skin can be a hygienic problem, cosmetic problem and a source of discomfort. To truly enjoy the rewards of significant weight loss, a procedure such as the body lift may be necessary.

Good candidates should also be:

  • Motivated to improve their body shape
  • Non-smokers or prepared to quit long before surgery
  • At a stable body weight (not losing or gaining weight)
  • Bothered by excess skin on the abdomen, thighs, buttocks, hips, etc.

During a consultation with your provider, you can ask specific questions and discuss the benefits, risks, costs and other details of your body lift. The doctor will inquire about your medical history and general health to determine if you can safely undergo this surgical procedure.

HOW A BODY LIFT WORKS

The body lift will be tailored to meet your individual goals and circumstances. Sometimes the surgery will be divided into separate stages to address each issue.

In general, surgery requires about 2 to 5 hours of operating time. The doctor will mark areas of your body for incisions, taking extra care to place them in locations that can be hidden if possible. General and local anesthesia is administered and incisions are placed in natural creases of skin. In a circumferential fashion, your provider removes and lifts the excess skin. Meanwhile, liposuction is utilized to remove persistent areas of fatty tissue. Incisions are then closed with sutures.

AFTER YOUR BODY LIFT SURGERY

After surgery, you will likely be on bed rest for about 24 hours. Antibiotics will be prescribed and narcotic pain medications will help manage discomfort during your recovery. On day two, you will be advised to ambulate (walk around) with assistance. Elastic compression garments will need to be worn to minimize swelling and promote optimal skin contraction. For the first week, surgical drains will be in place to address fluid accumulation.

POSSIBLE COMPLICATIONS

Because the body lift is such an extensive and varied procedure, it is not prudent to attempt to list all possible complications. The rate of complications is believed to increase with body mass index, so it’s important to reach a healthy weight before considering this procedure.  Some of the documented risks include seroma, infection, delayed healing, scarring, DVT, and pulmonary embolism. Ask your provider for more information if you are concerned about these adverse events.

Calf Augmentation is a procedure that can enhance the shape and size of your lower legs using special silicone rubber implants. Your provider can surgically place implants on the inner calf or outer calf in order to correct a patient’s shrunken or disproportionate lower legs.

Calf augmentation is a relatively uncommon surgical procedure in the United States.  While it may be considered a cosmetic procedure by some surgeons, for others this surgery is purely reconstructive because it works to restore a normal appearance.

WHO CAN BENEFIT FROM CALF AUGMENTATION?

You may be a good candidate for calf implant surgery / calf augmentation if you have small and disproportionate lower legs that do not grow larger with exercise and/or weight lifting.  In many cases, candidates for this surgery:

  • Exhibit lower legs that are naturally thin
  • Desire enhanced contour for bodybuilding
  • Have suffered a disease or injury that contributes to leg-body disproportion

Those with unrealistic expectations or serious medical problems are not considered good candidates for calf augmentation.

During a surgical consultation, your provider will discuss the risks, benefits, costs and other aspects of calf augmentation.  Your provider will also answer your questions and determine if you are a suitable candidate for surgery.  To approximate the expected results of your surgery, your provider may help you simulate the expected results with special sizers wrapped within a long stocking.

HOW CALF AUGMENTATION WORKS

Before surgery, your legs will be cleansed with antibacterial and shaved if necessary.  Calf augmentation is performed under general anesthesia in most cases, with local anesthesia as an alternative option.

Your provider makes a small incision (about 4 cm) in the crease of the knee-pit.  The provider then creates a pocket for the implant on top of the calf muscle.  The silicone rubber implant is carefully inserted below the tissue to effectively enhance the shape of your calf.  In some cases, calf augmentation will require gradual tissue expansion.

WHAT TO EXPECT AFTER CALF AUGMENTATION

After surgery, your provider will typically advise bed rest for about 12 hours, during which time you may be advised to keep your legs elevated.  Gauze and tape will be loosely wrapped around the incision site for approximately 1 week.  Medications such as antibiotics and narcotic pain medications will be administered as necessary.

After the first week, you will be provided a special compression garment that will need to be worn on the implant area for 1 month or longer.  This garment is designed to minimize swelling and promote skin contraction for a satisfactory aesthetic result.  Recovery time is about 2 to 3 weeks and normal exercise of the legs can be resumed after about 8 weeks.

POSSIBLE COMPLICATIONS

Your provider takes precautions to minimize your risk of surgical complications.  Nonetheless, you should be aware of the risks involved with cosmetic surgery and calf augmentation.  Documented complications include hematoma, seroma, edema, scarring, changes in skin sensation, visibility of the implant, tightening of scar tissue, compartment syndrome, skin loss, and skin necrosis.  Ask your provider for more information if you are concerned about surgery risks.

Labiaplasty is a procedure performed to correct disproportion of the labia minora in relation to the labia majora. With this procedure, your provider can improve the natural aesthetic appearance of the labia without affecting sensation.

Since its introduction in the early 80’s, this surgical procedure has also been called labia reduction, labia rejuvenation and vaginal lip reduction. It’s a procedure that seems to be on the rise as surgical techniques become more refined.

ARE YOU A CANDIDATE FOR LABIAPLASTY?

Labiaplasty is designed to treat a condition called labial hypertrophy, identified by large or irregular labia minora. Physicians have linked the condition to genetic causes as well as lifestyle factors.  Pregnancy, intercourse, and genital piercing are all possible causes that may contribute to asymmetry or irregularity of the labia.

Doctors Davison and West have proposed a simple grading system for measuring hypertrophy of the labia minora:

  • None: labia minora are concealed within or extend to free edge of labia majora
  • Mild or Moderate: labia minora extend 1 to 3 cm beyond the free edge of labia majora
  • Severe: labia minora extend over 3 cm beyond free edge of the labia majora

Women may find this condition unacceptable for cosmetic reasons or for reasons related to hygiene and comfort.  If you are dissatisfied by this condition, you may want to consider labiaplasty.

HOW LABIAPLASTY WORKS

This outpatient surgery is typically performed under local anesthesia and sedation, while general anesthesia is an alternative option. There are multiple techniques that your provider can choose to employ with labiaplasty.  In general, the surgery involves a reduction of the excess tissue present on one or both sides of the labia minora. The goal is to provide a natural, symmetrical shape with no visible scarring. Total operating time is approximately 1 to 1.5 hours. After the reduction of the labia minora is complete, your provider uses dissolvable sutures to close the incisions.

WHAT TO EXPECT AFTER LABIAPLASTY

Your provider will send you home with special instructions and medications after surgery. Follow these instructions carefully to minimize your risk of complications and achieve a satisfactory aesthetic result.  Exercise and sexual intercourse will need to be postponed for approximately 4 weeks. You may experience some swelling and discomfort, which should be fully resolved in about 2 weeks. The sutures are usually dissolvable, so you will not have to return to have stitches removed.

POSSIBLE LABIAPLASTY COMPLICATIONS

As with any surgical procedure, labiaplasty carries a risk of complications and adverse events. These include but are not limited to infection, swelling, bleeding, scarring, prolonged swelling, asymmetry and a need for revision surgery. Ask your provider for more information if you are concerned about these risks.

Liposuction, also known as suction-assisted lipectomy, is a procedure that removes persistent deposits of body fat. By selectively removing areas of fat that don’t go away after diet and exercise, your provider can slim down certain areas and improve your body shape. Although liposuction can be performed almost anywhere on a person’s body, the procedure is not intended for overall weight loss.

Many other cosmetic procedures will involve liposuction. For example, breast reduction, abdominoplasty, neck contouring, and arm lift surgery typically utilize some form of liposuction.

ARE YOU A CANDIDATE FOR LIPOSUCTION?

Good candidates for liposuction are healthy and have a stable body weight; they just need a little “extra help” to reduce fat in problematic areas. Obese patients are not good candidates as they have an increased risk for complications and generally realize unsatisfactory aesthetic results.

You may be a good candidate for liposuction if you meet the following criteria:

  • Bothered by persistent areas of body fat
  • Good or adequate skin elasticity
  • In good health and physical condition
  • Stable body weight
  • Realistic expectations and able to understand surgery risks

To determine if you are a good candidate, your provider can evaluate your goals and answer your questions during a consultation. To achieve satisfactory results with liposuction, patients need to have a certain level of quality in their skin tone. Liposuction removes fat but does nothing to address loose skin. If your skin tone is good, it will contract after surgery and exhibit a smooth contour.

HOW LIPOSUCTION REMOVES BODY FAT

Tumescent liposuction is currently the gold standard for plastic surgeons performing liposuction. There are many variations involving lasers, ultrasound and water-assisted methods, but the operator is always the most important factor for achieving great results.

During liposuction, your provider saturates the areas of body fat with a tumescent fluid, which contains lidocaine anesthetic for improved comfort. Through small incisions, the doctor inserts a small tube (cannula) to vacuum out the targeted fat. This process can be applied to the abdomen, buttocks, thighs, arms, chest, neck, back and elsewhere.

WHAT HAPPENS AFTER LIPOSUCTION

Recovery time with liposuction varies. Small or moderate fat removal procedures will require a shorter recovery time than a large volume procedure. Ask your provider for specific details about your liposuction recovery time.

After surgery, you will be discharged with special post-operative instructions. A small drainage tube may be placed to remove fluid that accumulates after liposuction. An elastic compression garment may also be worn to minimize post-operative swelling and promote optimal skin contraction. To control discomfort, your provider can prescribe a pain medication. Some numbness, swelling and changes in skin sensation commonly occur with patients recovering from liposuction.

After healing is complete and swelling subsides, the areas treated will be slimmer and fat will not return to these areas. To further improve your liposuction results, we recommend that you maintain a healthy lifestyle with proper nutrition and regular exercise.

POSSIBLE SIDE EFFECTS OR COMPLICATIONS

The risk of complications is thought to increase with large volume liposuction procedures, so there is a limit to the amount of fat that can be safely removed. Risks include infection, lidocaine toxicity, poor aesthetic results, delayed healing, clots, excessive fluid loss, trauma to surrounding tissues and unfavorable reactions to anesthesia. Ask your provider for more information if you are concerned about risks involved with liposuction.

Male breast reduction can correct excess, feminine-like breast tissue on a man. Your provider uses liposuction and surgical excision techniques to remove the fat and glandular tissue that reside on the patient’s chest. In many cases, male breast reduction is performed to correct a bothersome condition called gynecomastia.

ARE YOU A CANDIDATE FOR MALE BREAST REDUCTION?

Excess breast tissue can be an embarrassing problem for males, and it can affect adolescents as well as adults.  Men and boys who suffer from this condition will often attempt to hide it or ignore it rather than seek treatment.

Surgery is not the only option. In fact, your provider will often instruct patients to see their physician first to investigate possible causes of gynecomastia. While the cause of the condition will vary, physicians have linked gynecomastia to factors such as:

  • Impaired liver function
  • Testosterone deficiency
  • Use of certain medications and illicit drugs

Good candidates for male breast reduction will have completed a thorough investigation of possible causes and adjusted their lifestyles accordingly. If you are considering this procedure, you should first reach a stable and healthy body weight and quit smoking.

WHAT TO EXPECT DURING YOUR MALE BREAST REDUCTION

Your provider may recommend and MRI or mammogram to determine the composition of your excess chest tissue. The surgical technique your provider chooses will partly depend on this evaluation, as well as the condition of your skin. If you are relatively young and have adequate skin elasticity, liposuction alone may be a viable treatment option. In most cases, a combination of liposuction and surgical excision is necessary.

Male breast reduction requires about 1 hour of operating time. Local anesthesia can often be used, while general anesthesia is an alternative in cases of large volume tissue removal. Your provider makes an incision around the pigmented area of the nipple.  Fat is then dislodged and removed with suction.  Glandular tissue is removed with a scalpel. The incisions are closed with stitches and your chest is then wrapped in gauze and tape.

WHAT HAPPENS AFTER MALE BREAST REDUCTION / GYNECOMASTIA CORRECTION

You should be back to work or your normal routine in about 1 week and back to exercise in about 3 weeks. Your provider prescribes pain medications to control discomfort. Swelling and bruising is normal, but will gradually resolve during your recovery.

The stitches, if not dissolvable, will be removed after the first week. Scars from male breast reduction are typically hidden in the pigmented area of the nipple, but they are permanent. To ensure a lasting result and prevent recurrence, it is recommended that patients initiate lifestyle changes such as diet and exercise.

POSSIBLE COMPLICATIONS

As with any surgical procedure, male breast reduction has risks. Adverse events that can occur with this procedure include but are not limited to scarring, changes in pigmentation, asymmetry, infection, skin injury, bleeding, fluid accumulation and adverse reaction to anesthesia. Ask your provider for more information if you are concerned about these risks.

Thigh plasty removes excess fat and sagging, redundant skin on a person’s inner or outer thighs.  Because it involves a lifting and tightening of skin in the thigh region, people have called this procedure a thigh lift.

The contour of your thighs can become lumpy or disproportional after massive weight loss or during the aging process as skin quality decreases. With a thigh lift, your provider can tuck and contour this area to exhibit a more appealing proportion and tone.

ARE YOU A CANDIDATE FOR THIGH LIFT SURGERY?

If you are experiencing problems with excess, sagging skin in your inner or outer thighs, this procedure may be right for you. If excess fat has accumulated in your inner thigh area or elsewhere, your provider may recommend thigh lift surgery combined with liposuction.

Each patient will be evaluated on an individual basis. Body contouring procedures such as thigh plasty are often combined with other body contouring surgeries to address sagging skin in different areas.  This comprehensive approach can help a patient enjoy the rewards of weight loss as they exhibit a tighter and smoother body contour.

Candidates should be:

  • Non-smokers
  • With realistic expectations
  • At a stable body weight
  • Motivated to improve body shape

During a consultation with your provider, you will discuss the benefits, risks, costs and other details of the procedure. Your provider will inquire about your medical history and general health to determine if you can safely undergo a surgical procedure.

HOW THIGH PLASTY WORKS

Thigh lift surgery is an outpatient procedure normally performed under general anesthesia. Operating time is roughly 2 to 3 hours, which will vary depending on concurrent procedures.

The medial thigh lift is the most common technique, which involves removal of excess skin and fat residing on the innermost portion of your thigh. Your provider will mark your thighs before surgery.  After anesthesia is administered, your provider will make an incision in the inner crease of the leg in order to remove excess skin. Liposuction may also be performed to remove persistent fat. The skin is then redraped and sutured to exhibit a smoother appearance.

WHAT HAPPENS AFTER THIGH PLASTY

You will be sent home with gauze and tape covering the incision sites, and (possibly) surgical drains to remove any fluid that accumulates. Your provider will provide specific post-operative instructions to be followed during your recovery from thigh lift surgery. Your provider will probably advise you to walk around the day after surgery, but light exercise will need to be postponed for at least 2 weeks. A special elastic garment will be worn to promote skin contraction and minimize swelling, which may need to be worn for as long as 1 month after surgery. Thigh plasty is a relatively extensive procedure, so recovery takes time. It may be 4 to 6 weeks before you can return to your normal routine.

The tummy tuck, or abdominoplasty, slims down the abdomen and narrows the waist by tightening the abdominal muscles.  Women in particular, who have stretched abdominal tissues caused by previous pregnancies, can benefit from abdominoplasty. Both women and men can benefit from this procedure after significant weight loss.

If you are in generally good physical shape but are concerned about abdominal fat deposits or loose skin that does not respond to diet and exercise, a tummy tuck can help. However, the procedure will produce a permanent scar that can possibly extend to both sides of your hips, although the scar will likely be designed to hide below the bikini or bathing suit line.

modified abdominoplasty or short-scar tummy tuck can sometimes be performed when the full procedure is not required, resulting in a shorter, less visible scar.

ARE YOU A CANDIDATE FOR ABDOMINOPLASTY?

As stated, abdominoplasty is for men and women who exhibit loose skin, stretched abdominal muscles, and a protruding abdomen. If you’re considering a tummy tuck / abdominoplasty, you should also meet conditions such as the following:

  • Stable and healthy body weight (not obese)
  • Not planning a future pregnancy
  • Non-smoker or willing to quit well in advance

During a tummy tuck consultation with your provider, you will discuss the benefits, risks, costs, and other details of the procedure. Your provider will inquire about your medical history and general health to determine if you can safely undergo abdominoplasty surgery.

HOW TUMMY TUCK SURGERY WORKS

Abdominoplasty requires about 2 to 5 hours of operating time, typically under general anesthesia. In some cases where muscle repair is performed, a muscle relaxing medication is also administered.

Before surgery, your provider marks the areas of your midsection where incisions and liposuction will be performed. A horizontal incision is made above the pubic hairline, where excess skin is trimmed and pulled down. The doctor repairs the muscles of your abdominal wall using sutures. If necessary, liposuction is performed on the lower abdomen and flanks to improve your aesthetic results.  Before the incisions are closed, the umbilicus is often remodeled or relocated. Dissolvable sutures are then placed in layers to close the surgical incisions.

WHAT HAPPENS AFTER ABDOMINOPLASTY

Immediately after your tummy tuck, you will be wrapped in gauze and a loose-fitting elastic garment. Your provider will probably advise you to ambulate (walk around) within 12 to 18 hours of your surgery.  For discomfort, your provider will prescribe a pain medication. Surgical drains if used will be removed within 24 hours and sutures will typically be removed within 7 days.

Your provider will monitor your results during follow-up appointments. You may be instructed to wear a compression garment for about 6 weeks to help control swelling and promote optimal skin contraction.  Total recovery time is approximately 1 to 3 weeks.

POSSIBLE ADVERSE EVENTS / COMPLICATIONS

Like all surgical procedures, abdominoplasty carries a risk of complications and adverse events.  Possible complications include but are not limited to the following (in order of frequency): hematoma, seroma, scarring infection, tissue loss, bleeding, intra abdominal hypertension (rare), DVT, and pulmonary embolus. Ask your provider for more details if you are concerned about these events.

YOUR TUMMY TUCK RESULTS

Each patient presents aesthetic goals and considerations that are somewhat unique. However, there are general goals a plastic surgeon will aim to achieve with every abdominoplasty. With a successful procedure, you may achieve a flatter abdomen with fewer stretch marks or scars, a more youthful lower abdomen and mons, a navel without hooding, and enhanced abdominal muscle contours.