All your options for removing fat, tightening skin And creating sexy curves – with no sweat involved.
LIPOSUCTION
What is it?
Liposuction is a surgical procedure performed under anaesthetic to remove deposits of fat from speci c areas of the body. It can be performed almost anywhere on the body where there are pockets of fat, including the neck, arms, stomach, back, chest, buttocks, thighs and ankles.
It is usually performed as day surgery, although some cases may warrant an overnight hospital stay.
Generally, the area to be treated with liposuction is infiltrated with a tumescent fluid containing local anaesthetic and a vaso-constrictor before small cannulas are used to vacuum out the fat. Alternatively, a syringe can be used to withdraw the fat.
Power-assisted liposuction, where radiofrequency, ultrasound or laser technology is used to improve liposuction results, can help increase skin contracture and tone and tighten the skin’s surface. These types of techniques are also typically less aggressive.
Ideal candidate?
The ideal liposuction patient is at or near their ideal body weight (within 30 per cent), has good skin elasticity and is seeking reduction of diet-resistant localised pockets of fat. They also need to understand the risks of surgery and have realistic expectations that liposuction is not a way of losing masses of weight or a cure for obesity.
Results?
Bruising can last for a few weeks and swelling for around one to two months. A compression garment is usually worn for about four to six weeks in most cases. Patients can usually return to work after around three to seven days. Final results – a trimmer-looking, more proportionate and shapely form – can be seen from six months to a year as swelling subsides. Results are long lasting provided the patient maintains a similar weight.
TUMMY TUCK
What is it?
A tummy tuck (abdominoplasty) is surgery performed under general anaesthetic. An incision is made across the lower abdomen, the excess skin and fat are removed and the stomach muscles tightened. The navel is repositioned as the skin is re-stretched over the stomach.
Ideal candidate?
Abdominoplasty is best suited to patients who have lost a considerable amount of weight and have loose skin and fat deposits that don’t respond to diet or exercise, or who are looking to restore their pre-baby bodies. Like all surgery, patients should understand the risks involved and have realistic expectations of what the procedure can do for them.
Results?
A firm strap and drain is usually worn for the first 24 hours, followed by a compression garment for several weeks. Patients usually take around three weeks off work. Results are
a atter stomach with repaired abdominal muscles and removal of excess skin. A scar is created across the lower abdomen, which can be hidden within the bikini line, and minimised with various scar therapies.
What is fat?
The human body contains two types of fat: white fat and brown fat. White fat is important in heat insulation, energy metabolism and mechanical cushioning. Brown fat actively burns calories for heat, but has been thought only to exist in childhood.
Fat tissue is made up of cells that hold the fat. When food that contains fat is ingested it goes through the stomach into the intestines, where the fat droplets get mixed with bile salts from the gall bladder. The mixture breaks up the large droplets into several small droplets, which increases the fat’s surface area.
The pancreas then secretes enzymes that attack the surface of each small droplet of fat and break them down into fatty acids and glycerol, which are then absorbed into cells lining the intestine.
In the cells lining the intestine, the parts are reassembled into packages of fat molecules with a protein coating, called chylomicrons. These are then released into the lymphatic system, which eventually merges with the veins so they pass into the blood stream.
NON-SURGICAL BODY CONTOURING
What is it?
Non-surgical body contouring procedures use medical-grade energy- based devices to dissolve fat and/or tighten skin. The energy is emitted via an applicator through the skin without damaging the outer layers, only targeting the underlying fat and tissues. The most popular energy systems are radiofrequency (RF) body contouring devices and cryolipolysis.
RF treatments. With RF body contouring treatment, the heat generated from the RF energy dissolves fat cells and causes microscopic changes to tissues and collagen bres, with further collagen remodelling occurring over the subsequent months following the procedure. The broken down fat cells are drained via the lymphatic system and then excreted as urine. A reduction in the appearance of cellulite is also commonly reported.
Cryolipolysis. This method uses almost-freezing temperatures to kill fat cells without traumatising the surrounding tissues or harming the skin. A gel drape is placed onto the target area to protect the skin before the applicator head is placed onto the fat pocket, where it remains for approximately one hour. The applicator acts like a vacuum to
suck the area into position and direct the cold temperature to the target fat cells under the skin, which are then destroyed and eliminated naturally by the body.
Ideal candidate?
Patients with small to medium localised pockets of fat on the abdomen, hips and thighs are most suited.
While no non-surgical device can achieve the level of fat removal possible with liposuction, it offers patients a good option to remove fatty areas resistant to diet and exercise without the associated risks and recovery time of surgery.
Results?
Treatment results in a circumferential reduction of the treated area and a more streamlined shape. Most non- surgical devices require a minimum of three treatments in order to achieve optimal results, and often it can take longer before those results are seen, as the fat cells take time to be metabolised through the body’s usual processes. There is no downtime but temporary redness or swelling may be present.
In conjunction with a healthy diet and exercise regime, results should be long lasting because, just as with liposuction, when fat cells are permanently destroyed they will not return.
ARM LIFT
What is it?
Also known as brachioplasty, an arm lift reshapes the underside of the upper arm from the armpit to the elbow, and involves the removal of excess loose skin and fat from saggy underarm areas, sometimes referred to as “bingo wings”.
As well as the surgical excision of loose skin, the procedure may also incorporate liposuction to remove excess fat. Performed under general anaesthetic, the procedure may require an overnight stay in hospital but patients are often allowed to go home on the same day.
Ideal candidate?
People who have saggy, excess skin on the underside of their arms, particularly after signi cant weight loss.
Results?
Improved appearance of the upper arm, with more de nition and no apping skin. Most people can resume normal activities around two weeks after surgery. A scar will be visible, typically running along the inside of the arm from the armpit to the elbow; however scar management techniques and products can help minimise the appearance.
THIGH LIFT
What is it?
A thigh lift is a surgical procedure performed under general anaesthetic to remove excess skin and fatty tissue, typically in patients who’ve lost considerable amounts of weight. A thigh lift can be combined with liposuction for a smoother result. During the procedure, an incision is made in the upper inner thigh – in some cases this may extend to the groin line or buttock fold – and excess fat and tissue is removed via this incision.
Ideal candidate?
Patients with significant drooping skin on the upper leg that does not respond to diet or exercise.
Results?
Improved contour of the upper leg, with tauter skin and more de ned musculature. Normal daily activities can usually be resumed, and are encouraged for circulation, within several days following surgery.
Surgery after massive weight loss
As bariatric, or weight loss, surgery becomes more popular, so too has the need for body contouring procedures such as tummy tucks, breast lifts, thigh lifts and upper arm lifts, which are usually associated with signi cant weight loss, according to new data from the American Society of Plastic Surgery.
Bariatric surgery has become much more common over the past decade. As these patients lose weight they may have excess ’loose’ skin and need plastic surgery procedures to remove it a year or two later.
Roughly one in five people who have weight loss surgery will need body contouring as well.
It is usually recommended that doctors wait until weight loss is complete before assessing whether a patient is a good candidate for skin removal procedures, and then only performing one at a time.
In addition to abdominoplasty, other common cosmetic surgeries following massive weight loss include an arm lift, thigh lift and breast lift.
BREAST LIFT
What is it?
For a small lift, the peri-areola mastopexy is commonly used, with an incision made around the nipple. The nipple is elevated and the skin envelope is moved so the nipple sits higher on the breast mound.
For a larger lift, the anchor-incision technique may be used. It involves an incision being made around the nipple and vertically down, with another incision horizontally under the breast. Another common breast lift method is the shorter scar LeJour technique. In both cases, the excess skin is removed and the nipple placed higher.
Ideal candidate?
A breast augmentation can return shape to a attened, sagging breast, but it is commonly combined with mastopexy (breast lift surgery) to raise the breasts to a more aesthetically pleasing position. In other patients, a breast reduction may be more suitable following weight loss, and again this is usually combined with a mastopexy to achieve the best results.
Results?
Rounder, fuller breasts with higher projection and repositioned to a more youthful and attractive position. Notably, a mastopexy can help reduce the appearance of back rolls, or sagging skin on the sides and back of a weight-loss patient. By pulling the tissue upwards, and excising a significant amount of skin in the process, breast lifting can smooth, lift and tighten the skin around the patient’s rib cage.
Initial recovery takes around ve to seven days and resulting scars should fade over time. CBM
