Body contouring surgery

Body contouring is reconstructive surgery to remove sagging skin and extra fat, and to improve the shape and tone of underlying tissue. The result is a body with smoother contours. Body contouring may be carried out following major weight loss, when the skin may not shrink back fully.

Body contouring is often performed in stages and may take months or even years to complete. Areas that are often affected by loose, unsupported skin include the upper arms, breasts, abdomen, buttocks, groin and thighs.

If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives. These may include lifestyle changes or learning to accept yourself the way you are.

Before choosing body contouring surgery

Before you opt for body contouring surgery, some important issues to keep in mind include:

• Body contouring surgery is not suitable surgery to remove excess fat alone. Liposuction can remove excess fat deposits if your skin has good elasticity (stretchiness) and is able to follow your new body contours. In cases where skin elasticity is poor, a combination of liposuction and body contouring techniques may be recommended.
• Your weight loss must be stabilised. Weight loss after surgery will create loose pockets of skin. Weight gain will stress your tightened skin and cause stretch marks and widened scars.
• If you have had weight reduction surgery, your medical practitioner will work closely with your doctor to determine when it is appropriate for you to begin body contouring.
• There will be many incisions (cuts) made. You must be prepared for extensive scarring.
• Think about the financial cost. Cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance. However, reconstructive surgery does qualify.
• Smokers are at increased risk of complications. If you are serious about undergoing surgery, you should try to quit smoking.

Finding a body contouring medical practitioner

You may want to ask your doctor for advice about finding a suitable medical practitioner or hospital where body contouring surgery is performed. At your first consultation, you should ask the medical practitioner about their training and experience – it is preferable to have this procedure done by a medical practitioner who is specially trained to perform body contouring surgery and has a lot of experience in carrying out this operation.

Medical issues related to body contouring surgery

Before the operation, you need to discuss a range of medical issues with your medical practitioner. They will talk to you about your:

• physical health – an examination will help your medical practitioner to decide if the treatment is appropriate
• medical history – some pre-existing medical conditions and any surgery you’ve had in the past may influence decisions about this operation, including the type of anaesthetic that is used
• risks and possible complications – it is important that you understand the risks and complications so that you can weigh up whether body contouring is right for you
• medication – tell your medical practitioner about any medications that you take regularly or have recently taken, including over-the-counter preparations like fish oils and vitamin supplements
• past reactions to drugs – tell your medical practitioner if you have ever had a bad reaction or a side effect from any drugs, including anaesthesia
• preparation for surgery – your medical practitioner will give you detailed instructions on what you should do at home to prepare for surgery. For example, you may be advised to take a particular drug or alter the dose of an existing medication. Follow all instructions carefully.

Body contouring operation

Body contouring surgery is usually performed under a general anaesthetic. Sometimes an epidural (a local anaesthetic that numbs the body from the waist down) may be used. The medical practitioner will make every effort to place incisions (cuts) within natural skin folds and in areas where the scars will be hidden by clothes. However, this is not always possible and some scars may be visible.

There are different types of body contouring. Depending on your individual circumstances, the medical practitioner may recommend one or more surgeries to achieve the desired results.

The types of body contouring surgery include:

• lower body lift – excess skin is taken from the abdomen, hips, buttocks and outer thighs. The medical practitioner may decide to make a cut that circles the body at the hips. This procedure can also improve a dimpled, irregular skin surface, commonly known as cellulite. In some cases, the lower body lift can be performed during a single operation. In other cases, two or more operations must be planned
• thigh lift – the medical practitioner makes a cut in the groin that runs down the inner leg to the knee. Extra skin and fat are removed. In some cases, the medical practitioner opts to continue the cut from the groin to the outer hip in order to improve the shape of the outer thigh
• buttock lift – the medical practitioner cuts across the top of the buttock and, depending on the extent of the operation, sometimes along the sides as well. Crescent-shaped sections of skin and fat are removed and the skin is pulled together and sewn
• breast lift (mastopexy) –- the medical practitioner cuts around the areola of the nipple and makes a vertical cut from the areola to the underside of the breast. A horizontal cut may also be required across the breast crease. Extra skin is removed from this ‘lollipop-shaped’ series of cuts. A breast implant can be included during this procedure to increase the size of the breast
• arm lift (brachioplasty) – the medical practitioner makes a cut on the inner surface of the upper arm from the armpit to the elbow. Underlying muscle is tightened with stitches to smooth and define the shape of the upper arm. The extra skin is cut away.

Immediately after the body contouring operation

After the operation, you can expect:

• a drainage tube in the wound to help prevent fluid build-up
• bruising and swelling
• possible numbness
• pain and discomfort
• dressings or bandages on the wound
• to wear compression garments to help reduce swelling.

Complications of body contouring surgery

All surgery carries some degree of risk. Some of the possible complications of body contouring include:

• risks of anaesthesia, including allergic reaction, which may (rarely) be fatal
• surgical risks such as bleeding or infection
• blood clots that may cause potentially fatal cardiovascular complications such as heart attack, deep vein thrombosis or stroke
• collapsed lung
• fluid build-up beneath the wound
• tissue death along the wound, or skin loss
• sensory nerve damage, which may cause prolonged or permanent numbness
• prolonged swelling
• damage to underlying tissues such as muscles
• asymmetry (unevenness) of the skin
• unsightly, inflamed or itchy scarring
• further surgery to treat complications.

This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. You need to speak to your medical practitioner for more information.

Self-care at home after body contouring surgery

Be guided by your medical practitioner, but general self-care suggestions include:

• Rest as much as possible. Only gentle walking is recommended for the first seven to 10 days.
• Avoid strenuous activities or exercise for at least four weeks.
• Make sure that your stitches are not placed under stress. For example, don’t wear tight clothing that may rub at your wounds.
• Wear compression garments for several weeks if required by your doctor.
• Report any bleeding, severe pain or unusual symptoms to your medical practitioner.

Long-term outlook following body contouring surgery

For the future, remember that:

• Your silhouette in clothes is changed immediately. However, body contouring surgery will not stop your skin from sagging if you gain and lose a large amount of weight in the future.
• You need to expect and accept a certain degree of sagging as you age.
• Scarring will be permanent but should fade in time. Be patient – improvements to scars may take around a year or so.
• While it may have taken you two years or more to lose the excess weight, it may take just as long for the results of your body contouring to be complete. The plan for your surgery will depend on what you are trying to achieve, as well as your medical practitioner’s best judgement.

Alternatives to body contouring surgery

Other options include:

• eating a healthy, low-fat diet
• regular exercise
• wearing foundation garments or flattering clothes
• accepting yourself – talking to a counsellor or psychologist may help you overcome your concerns about your appearance and you may decide that you like yourself the way you are.

Where to get help

• Your GP (doctor)
• A medical practitioner specially trained and experienced in performing cosmetic surgery
• Cosmetic surgery hub and hotline, Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 361 041
• Cosmetic surgery, Department of Health and Aged Care, Australian Government
• Private Hospitals Unit, Department of Health Email privatehospitals@health.vic.gov.au
• Australian Society of Plastic Surgeons Tel. (02) 9437 9200
• Royal Australasian College of SurgeonsTel. (03) 9249 1200
• Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 419 495