“Choosing clothing in the morning used to be a daily chore. Now, after my contouring surgery, it’s a non-issue. Whatever I pull out, I can wear. What a pleasure, one less thing to think about.”
Karen bore great frustration and displeasure with her hips, wide thighs and buttocks that did not fit the upper half of her body. Despite an active exercise program, she could not contour these bothersome areas. Buying clothing a size larger was necessary to accommodate the discrepancy between top and bottom. Her pants were snug in all the wrong places, making her uncomfortable and self conscious. The answer for Karen? Liposuction.
Morgan, too, was disenchanted with her body. After multiple pregnancies her belly never returned to the flat toned shape she was used to seeing in the mirror. Sit ups did not seem to be the answer. Skin would drape over her pants, her belly muscle tone was gone and she contemplated never wearing a bathing suit in public again. Morgan’s solution lies with a tightening procedure called an abdominoplasty, more commonly known as a “tummy tuck”.
Body contouring is a permanent solution to improving both your shape and body image. These procedures fall within two categories: liposuction and abdominoplasty (or tummy tuck). Both remove fat from the belly area, but that is where the similarities diverge. If you are old enough to remember the Special K cereal commercial, you may recall that if you could “pinch an inch” you were told you can lose some weight by diving into their cereal. This saying can be used to determine which areas of the body to contour. Areas of the belly that show localized fat beneath the skin can be removed- forever– using either procedure. So then, what is the difference between liposuction and an abdominoplasty? Why can’t you just suck away the pounds?
Generally, neither procedure is appropriate for very overweight individuals until they have lost weight and have reached a healthier state. The path we decide to take is determined not only by the amount of fat present but where it is located. Other determining factors are how loose the skin is, how stretched and floppy the overlying skin appears, whether the muscles that support the inner organs are saggy or snug, if there are large areas of unsightly stretch marks and if the belly button is cute or has been widened. Showing these areas of concern to a Plastic Surgeon may be disconcerting at first; as no one likes to bear all, but the only way to choose the right course of action is through an examination.
Liposuction is ideal for those women and men with localized fat deposits. It is an amazing procedure which sculpts away selective fat deposits previously resistant to diet or exercise. Frequently, these bulging zones are genetically predetermined and easily found somewhere else in the family tree. Those with ideal body weight, who are unable to contour genetically determined areas, benefit greatly from this procedure.
For example, athletes who partake in multiple sports (as well as the people that train them) often become frustrated and despondent by their inability to sculpt their bodies despite vigorous exercise. It is difficult to achieve peak performance while feeling self conscious about one’s body image, be it a business meeting, playing tennis with your friends or just being you. There is help on the way! Universal areas of concern such as the hips, inner and outer thighs, abdominal area (belly), knees, waist, back and neck can be contoured with great success. Smoother & shapelier bodies are the end result.
Liposuction is immensely popular due to its ability to permanently remove fat cells. Either general anesthesia or sedation is followed by placing local anesthetics under the skin to numb and soften the areas to be suctioned. Tiny, well-placed, barely visible incisions allow for sculpting using various thin tubes attached to a medical vacuum device (not a Hoover!). Supportive elastic garments are worn for a few weeks after the procedure to keep the areas snug. Mild discomfort is treated with simple pain medicine and a period of bruising and swelling is tended to with cold packs. The difference in your new body is apparent in weeks. Thereafter your shape continues to improve as the swelling subsides. Since we are born with a finite number of fat cells, once they have been removed they do not return. This allows for a permanent contour improvement.
So, why do any other procedure than liposuction? Again, a careful examination will often be the telling factor. Those with loose skin, poor muscle tone of the abdomen or bulging of the belly from protrusion of the inner organs will not usually be good candidates for liposuction because simply removing fat from these areas will not afford optimal shaping. But there is another procedure that lifts, tightens and reshapes these difficult to manage areas of the belly. An abdominoplasty offers the greatest improvement to these problems by tightening and tailoring these structures.
Although pregnancy brings new life and love to your family, it usually results in stretching of the tummy skin and underlying muscles with accumulation of unwanted fat. Think of a deflated balloon that will never again retain its original shape once it has been blown up. Like a balloon, the belly of woman after extensive weight loss or pregnancy is often loose, floppy and wrinkled (prune belly). This is especially true of women with a narrow pelvis, allowing for the front and bottom of the abdomen to enlarge disproportionately. Muscles that support the front of the abdomen, that run from below the ribs to the pubic area (rectus muscles) are pushed apart and stretched like a rubber band and may be made worse after c-sections. This is very similar to pulling upon an elastic band until it no longer snaps back. The result is what we fondly call a pot-belly. The crunch machine will not help much in this situation, nor will dieting and exercise significantly improve these areas. However, a tummy tuck can.
An abdominoplasty is a far-reaching procedure that requires you to be asleep. Extra fat and sagging skin are removed along with tightening the underlying loose muscles from below the ribs to the pubic area. Stretch marks along the lower front of the abdomen are removed as the abdomen is toned and slenderized. The belly button is also contoured to fit your new appearance. Often, liposuction can be added to reduce troublesome bulges of the thighs or hips, as well. The objective is to produce a firmer, flatter and better shaped abdomen which might even put you back in a yellow bikini!
The scar runs along the lower belly and usually around the belly button. There is more discomfort for the first week or two than with liposuction, but then again, muscles and skin are tightened. Activities after this surgery are limited to prevent swelling or other harmful side effects. You will be pleased to note that this includes such mundane activities as house cleaning and cooking or for that matter any activity that would increase your heart rate and blood pressure for a number of weeks. During this time you will be wearing an elastic binder to aide in comfort and decrease swelling.
Why have an abdominoplasty? You probably already know the answer. Your body is proportioned once again, posture is corrected and a new wardrobe is attainable! And most of all the extra lower belly skin is no longer hanging. Although swelling and healing takes a while to disappear, you will note in a few weeks how well you look and feel. It is nice to have your body toned again and to be able to see you’re stocking feet.
Jane, another satisfied abdominoplasty patient said, “After three cesarean sections, sit-ups and weight reduction were of no help in hiding my pot belly. After my tummy tuck, I can now look in the mirror and see my toned, smooth body. My body is proportional again and my posture has never been better. It’s a gift to be able to buy a new wardrobe that looks great on me! The highlight of my experience was to find the body that I thought was lost forever. Tears come to my eyes when I think about how I found myself again.”
There you have it. You need to be comfortable with your body and the decisions you make to reshape it. Seek out a Board Certified Plastic Surgeon who can explain the various options with you and with whom you are ease with. Remember that Plastic Surgery is an art form that brings together both sculpting and science. During your consultation, ask questions and look for honest answers. You should be shown before and after photos of other patients who have had similar procedures. Being realistic in what can be achieved and what you can expect will only heighten your satisfaction, allowing you to delight in your new body. It is an amazing adventure which can offer a lifetime of joy.
Jeffrey S. Rosenthal, M.D.
Board Certified Plastic Surgeon
Private Practice Fairfield Connecticut
International/National Artist & Sculptor
Chief, Section Plastic Surgery at Bridgeport Hospital