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Body Contouring Options: Your Body Might be Speaking for Itself

Scott W. Mosser, M.D.

article courtesy Scott W. Mosser, M.D.

CLICK HERE to visit the website of Scott W. Mosser, M.D.

The Internet is wonderful for medicine, and Plastic Surgery is no exception. Previously, very few patients were very informed about plastic surgery procedures when they arrive at my office for a consultation. But now, my new patients arrive more knowledgeable than ever before. Instead of starting the educational process at ėground zero' I'm finding that most patients now show up already understanding the basics regarding surgery. This moves things along and helps us get into more extensive discussions about the subtleties of the patients' goals, needs and anatomy. However, there still seems to be a widespread view that abdominal contouring is just a choice of having liposuction or a tummy tuck (abdominoplasty), with the decision simply being based on how much surgery someone wants to have. In reality, the types of body that benefits from one or the other of those procedures are very different. In fact an ideal candidate for liposuction is almost the opposite of the ideal candidate for a tummy tuck.

In liposuction contouring, the fat beneath the skin is removed carefully with a tubular cannula that is connected to the suction device. Certainly there are variants in technology for different body areas, but the basic principle is the same: fat beneath the skin gets removed, but the amount of skin stays the same. So the important thing is what happens to the skin after this volume ėdeflation' occurs. In the perfect liposuction candidate the skin has excellent elasticity so that it can bounce back as the swelling resolves; in those cases the final body contour can look fantastic with liposuction alone. On the other hand, patients that have areas of fat beneath the skin but also start with droopy excess skin may have the skin droop look more pronounced. Many people see this same effect when they go thorough considerable weight loss - if the skin can't snap back to accommodate the drop in volume, then there's a good chance it'll wrinkle or sag.

Tummy tuck surgery, however, is best suited for the opposite body type, namely a patient who has extra skin but very little extra fat beneath the skin. A tummy tuck is a procedure to remove excess skin of the abdomen by making an incision very low in the pubic area. Then the skin is elevated, the excess skin is removed and the incision is closed. The scar is hidden within the bikini area, and the wrinkles on the belly from the extra skin can disappear with the tightening of this skin. There are other things that a tummy tuck can do in addition to remove extra skin: routinely, the muscles are tightened (restoring the waistline) and the belly button can be rejuvenated as well.

In some patients, they may have both extra skin and extra fat. Sometimes these individuals are candidates for a tummy tuck that is combined with liposuction in one procedure. I determine whether this is an option with a physical exam during a consultation, and in some infrequent cases it's best to stage the surgery with liposuction first and then perform a tummy tuck a few months down the line.

So as you can see, in many cases your body will determine for you whether you're best suited for a liposuction procedure, skin removal through a tummy tuck, or a combination of both. Your body speaks for itself!

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