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Cosmetic Surgery

Body Contouring

What is body contouring?

Surgical body contouring following major weight loss removes excess sagging skin and fat while improving the shape of the underlying support tissue. The result is a better-proportioned appearance with smoother contours.

Dramatic weight loss has many benefits. But after any substantial amount of weight loss due to weight loss surgery and/or lifestyle changes, the skin and tissues often lack the elasticity to conform to the reduced body size.

Blog: Common Body Contouring Questions Answered

Body contouring procedures may include

Body contouring candidates

In general, good body contouring candidates are:

  • Adults whose weight loss has stabilized
  • Healthy individuals without medical conditions that impair healing or increase risk of surgery
  • Nonsmokers
  • Individuals with a positive outlook and realistic goals
  • Individuals that are committed to leading a healthy lifestyle with proper nutrition and fitness

Body contouring recovery

During your recovery from body contouring surgery, dressings or bandages will be applied to your incisions following the procedure.

Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include:

  • How to care for the surgical site(s).
  • Medications to apply or take orally to aid healing.
  • Specific concerns to look for at the surgical site or in your general health.
  • When to follow up with your plastic surgeon.

Be sure to ask your body contouring surgeon specific questions about what you can expect during your individual recovery period:

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? When will they be removed?
  • Are stitched removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

Body contouring recovery at home

You may be instructed to avoid bending, straining or lifting for several days to weeks.

Where tightening of the abdomen or thighs is involved, your plastic surgeon may also instruct you to avoid standing fully upright and stressing any internal sutures as they heal, and to sleep with pillows elevating your knees.

To minimize the risk of DVT (blood clots in the legs) you will need to be up and walking as soon as possible, and drinking plenty of fluid.

Body contouring results

The results of body contouring following significant weight loss are visible almost immediately; however, it can take two years or more to see the final results.

Visible scars are something you must accept to achieve a body contour that matches your new weight and proportion.

The results of body contouring are generally long-lasting, provided that you maintain a stable weight and general fitness. As your body ages, it is natural to lose some firmness. However, most of your initial improvement should remain.

Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician's instructions is critical to the success of your surgery.

It is important that the surgical incisions are not subjected to excessive force, motion, swelling or abrasion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Body contouring procedure steps

The procedures necessary to achieve your goals will be defined along with a plan for the timing of these procedures.

Plastic surgery procedures that may be recommended by your physician include:

  • Lower body lift: to correct sagging of the abdomen, buttocks, groin and outer thighs
  • Breast lift: to correct sagging, flattened breasts
  • Arm lift: to correct sagging of the upper arms
  • Thigh lift: to correct sagging of the inner, outer and mid thigh

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

All body contouring procedures require large incisions to remove excess skin. In many cases, these incisions may be extensive.

Incision length and pattern depend on the amount and location of excess skin to be removed, as well as personal preference and your doctor's surgical judgment. Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing, but this is not always the case.

Body contouring is often performed in stages. Your particular condition and goals, as well as your plastic surgeon's best judgment, will all influence how your doctor defines a surgical plan.

While it may have taken you two years or more to lose all the excess weight, it may take equally as long for the results of your body contouring to be complete.

Body lift

A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one procedure.

Incision patterns vary and may include a circumferential incision around the body to remove the "belt" of excess skin and fat.

Gynecomastia surgery

The incision patterns for lifting a man's sagging breasts will be determined based on the amount of excess skin to be removed. One or a combination of incisions may be used to reduce male breast size, flatten and enhance the chest contours.

Breast lift

The incision patterns for lifting a woman's sagging breasts will be determined based on the amount of excess skin to be removed. These may include one or a combination of incisions in a circular pattern around the areola, in a line extending from the areola to the breast crease, and horizontally along the breast crease. A breast implant also may be recommended to enhance breast shape and size.

 

Arm lift

Sagging skin of the upper arms is treated with an incision from the underarm area extending along the inside or back of the upper arm. Additional incisions on the arms may be necessary if there are other areas of excess skin.

 

Thigh lift

Reshaping of the inner thighs is achieved through incisions in the groin that can extend downward to the knee along the inseam of the thigh.

Improving contours of the outer thigh may require an incision extending from the groin around the hip.

 

Body contouring risks and safety

The decision to have plastic surgery is extremely personal, and you will have to decide if the benefits will achieve your goals and if the risks and potential complications of body contouring surgery are acceptable.

You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.Body contouring risks include:

  • Bleeding
  • Infection
  • Fluid accumulation
  • Poor wound healing
  • Skin loss
  • Blood clots, deep vein thrombosis (DVT) and pulmonary embolism
  • Excessive or widened scars
  • Numbness or other changes in skin sensation
  • Anesthesia risks
  • Unfavorable scarring
  • Residual skin laxity or contour irregularity

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Your body contouring consultation

During your body contouring consultation be prepared to discuss:

  • Your surgical goals
  • Medical conditions, drug allergies and previous medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
  • Previous surgeries

Your plastic surgeon will:

  • Evaluate your general health and any preexisting health conditions or risk factors
  • Examine your body and take detailed measurements
  • Take photographs for your medical record
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of body contouring and any risks or potential complications

The success and safety of your procedure depends on your complete candidness during your consultation. Be sure to ask questions. To help, we have prepared a checklist of  questions to ask your body contouring surgeon  that you can take with you to your consultation.

It's very important to understand all aspects of your body contouring procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing any concerns with your plastic surgeon.

Preparing for body contouring surgery

In preparing for body contouring surgery, you may be asked to:

  • Get cleared for surgery by your bariatric surgeon and/or primary care doctor
  • Get a lab test
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements or other medications that may increase bleeding

Body contouring surgery should be performed in an accredited office-based surgical facility, a licensed ambulatory surgical center or a hospital. If your body contouring is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

 

© 2017 American Society of Plastic Surgeons