Article: Shaping Your FutureRamsey J. Choucair, M.D.
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Getting back a more youthful shape
The
term body contouring often carries great hope for individuals seeking
improvement in body shape through plastic surgery. The word plastic is
actually derived from the Greek word for ‘molding’ or ‘giving form.’
Body
contouring can mean anything from performing liposuction to removing a
small localized fatty deposit from the thighs or abdomen to a
‘circumferential bodylift’ where excess fat and loose skin are removed
from both the front and back. With such a range of options, it is no
surprise that body contouring can be a confusing term.
As we
all age, the desirable contours of youth slowly escape, battered by
hereditary traits, pregnancy and the ravages of our occasional
overindulgence in food and drink. Even the most disciplined physical
fitness regimen may not prevent or reverse the inevitable changes
associated with aging. Liposuction is often appropriate for early
contour budges in individuals with firm skin. Removal of excess skin
and fat is necessary when skin elasticity is lost and excessive
wrinkling, stretch marks or loose skin is present. In many instances, a
combination of liposuction and removal of skin provides optimum results.
In general then, what techniques are available?
One
begins by evaluating variables such as the extent of fatty bulges, skin
tone and whether loose or excess skin is present. Treatment options
include 1) liposuction alone, 2) liposuction associated with some skin
removal (excess skin) such as a mini tummy tuck, 3) traditional tummy
tuck (abdominoplasty) where excess abdominal skin is removed and the
underlying abdominal muscles are tightened, 4) extended tummy tuck, or
circumferential bodylift where excess skin and fat are removed not only
from the abdominal area but also the flanks and back to
essentially remove a circle of skin around the trunk and lift the
lateral thighs in the process.
How do I know what operation would be best for me?
As
is hopefully becoming evident, there are many grey areas in determining
the most prudent body contouring procedure for an individual patient.
First, a comprehensive history, physical examination and assessment of
an individual’s goals and expectations is determined. A qualified
plastic surgeon, experienced in the various body contouring techniques
can then provide you with the options best suited for your needs.
In
general, liposuction is reserved for those individuals who have good
skin tone and little or no excess skin or loose skin such as stretch
marks. The concept behind successful liposuction is that the fat can be
removed and the skin tone is good enough to retract and leave a smooth,
firm, pleasing skin cover. Although ultrasonic assisted liposuction has
reportedly had a ‘skin firming’ effect, indications for liposuction
have not changed.
What about a mini tummy tuck?
Liposuction
alone is not adequate in individuals with early abdominal skin sagging
and loose underlying abdominal muscles. However, a standard
abdominoplasty (tummy tuck) may not be necessary. In a mini tummy tuck,
liposuction is performed on the abdomen and flanks and a small section
of the lower abdominal skin is removed through a curved incision below
the underwear line. The abdominal muscles can be tightened up to the
level of the belly button. This provides a flatter, tighter and more
youthful abdominal contour without the need for more extensive surgery,
which requires repositioning of the navel.
What is a tummy tuck?
A
standard tummy tuck (abdominoplasty) is performed through an incision
extending from hip bone to hip bone, usually beneath the underwear line
with repositioning of the belly button and removal of a large amount of
excess skin and fat from the lower abdomen. The abdominal wall muscles
are tightened. This differs from a mini tummy tuck in that 1) the belly
button is repositioned, 2) a large amount of excess skin and fat is
removed, 3) the abdominal wall muscles can be tightened all the way
from the pubic area to the breast bone, and 4) the incision beneath the
underwear line is typically longer.
What about the new bodylift?
Some
individuals require more extensive removal of loose skin and excess
fat, extending around to the lower back just above the buttocks.
This circumferential bodylift, or extended abdominoplasty,
provides dramatic results in individuals who would otherwise have only
modest improvement with standard techniques. A tightening effect is
often found in the outer thighs and upper buttock area.
What about recovery times?
As
one might suspect, the recovery time correlates directly with the
extent of the procedure. Patients who undergo liposuction rarely
require overnight hospitalization and are often back to work in 3-5
days. Recovery time is similar for a patient undergoing a mini tummy
tuck.
Tummy tucks are often done on an outpatient basis also, although
some patients elect overnight recovery with a private duty nurse. In
those individuals requiring more extensive procedures, such as
circumferential abdominoplasty, safety and comfort often dictate a one
or two night stay prior to discharge home.
Patients undergoing more
extensive procedures (tummy tuck or circumferential abdominoplasty)
return to work in 10-14 days, depending on job requirements.
Unrestricted sports activities can be resumed six weeks after surgery.
What about scars?
Liposuction
alone leaves small, narrow scars measuring often less than one
centimeter. As the extent of the procedure increases, so does the
length of the incision. With standard tummy tuck procedures, an
inconspicuous lower abdominal scar placed within the bikini line is
expected. The circumferential abdominoplasty requires an incision all
around the body, however, the benefit of excess skin and fat removal
outweighs the longer scar, which is covered by undergarments or bathing
suits.
So where do I go from here?
Everyone
agrees that a sensible diet and regular exercise are cornerstones to
good health and well being. However, the realities of life and the
effects of aging and heredity are not entirely controllable. For those
whose soul searching leads them to cosmetic surgery, there are safe
procedures performed by qualified surgeons which can reverse some of
the adverse effects of aging, and achieve rejuvenation of the body.
If
you are considering cosmetic surgery, call 214-754-9001 for your
complimentary consultation or informational brochure. And, you can
learn more about the procedures we offer by visiting us on the
Worldwide Web at www.drchoucair.com.
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