Scope
Body aesthetics covers the correction of excess skin and localised fat deposits that appear with pregnancy, weight change and age. Procedures with different aims are gathered under this one heading.
| Procedure | Aim | Suitable candidate |
|---|---|---|
| Abdominoplasty (tummy tuck) | Removal of excess skin, repair of slackened abdominal muscles | Those with skin laxity after childbirth or weight loss |
| Liposuction | Reduction of localised fat that does not resolve with diet and exercise | Those whose weight is stable and whose skin elasticity is good |
| Arm and thigh contouring | Tightening of sagging skin | Those with marked excess skin |
| Post-weight-loss body contouring | Staged correction of excess skin arising in more than one area | Those at their target weight and whose nutrition has been balanced |
| Fat grafting | Transfer of fat taken from one area to an area where volume is needed | Those with a sufficient donor area |
A misconception that needs clearing up first
Liposuction is not a method of losing weight. Its purpose is to reduce, in a person whose weight is stable, a localised fat deposit that does not resolve with diet and exercise — that is, to refine the contour of the body.
In the same way, abdominoplasty is not a slimming operation either. It corrects excess skin and muscle laxity; it does not take the place of weight control.
A lasting result depends on the weight being maintained after the operation. For that reason the procedure is planned after the target weight has been reached and the weight has remained stable for a period.
Candidate selection
The assessment considers together: weight stability and body mass index, skin elasticity, the degree of separation of the abdominal muscles, an umbilical hernia if present, previous operations and their scars, smoking, chronic illnesses and medication.
Because smoking impairs the blood supply to tissue and delays wound healing, patients are asked to stop before surgery, particularly in operations covering a wide area. In patients who are planning a pregnancy, postponing abdominoplasty is advised.
Surgery and recovery
Procedures are carried out under general anaesthesia according to their extent; in extensive procedures the hospital stay is one or several days.
- A compression garment is worn for a period after surgery; it reduces oedema and helps the tissue to settle.
- A drain may be used in extensive procedures.
- Return to daily life is within a few days after liposuction and within 2–3 weeks after abdominoplasty.
- For heavy exercise and abdominal work, 4–6 weeks are awaited.
- Resolution of the oedema and the emergence of the final shape take 3–6 months; the appearance in the early period is not the result.
Risks
The subjects that need to be discussed: bleeding, collection of fluid under the tissue (seroma), infection, delay in wound healing, scar problems, irregularity or asymmetry of the skin surface, change in sensation.
In operations covering a wide area, the risk of a clot forming in the veins of the leg and travelling to the lung is particularly important. A risk assessment is therefore made; early mobilisation, compression stockings and, where necessary, blood-thinning treatment are used. Because operating on more than one area in the same session increases this risk, planning is made accordingly and, where necessary, the procedures are divided into separate sessions.
Patients after weight loss
After substantial weight loss, excess skin is seen in more than one area at the same time. Planning is different in these patients:
- Procedures are usually carried out in stages, in several separate sessions.
- Protein and vitamin levels and anaemia need to be assessed before surgery; in patients who have had obesity surgery, problems of absorption affect healing.
- The weight is expected to have remained stable for at least six months.
Assessment
In body aesthetics the right procedure is determined by distinguishing whether the problem is excess skin, excess fat or muscle laxity. A method chosen without making this distinction does not meet the expectation.
You are welcome to book an appointment for an assessment; information about the course of your weight change and about the operations you have had is decisive in planning.