Tuesday, October 25, 2011

What Is The Body Contouring Procedure by Dave Stringham

The term: 'body contouring' gives the impression of the human body as a lump of clay that the 'artistic' plastic surgeon sculpts it into a work of fine art - like Michelangelo's David, perhaps. Very few plastic surgeons are artists in the generally accepted meaning of the word - despite self-indulgent posturing, marketing hype and the occasional art creation. The sad truth is that we are dealing with a pre-existing musculoskeletal structure and skin envelope that we can only alter in well-defined and limited ways. We do not have a free-handed liberty to shape the body into whatever form the patient desires.

Body contouring is therefore a misleading term that includes such procedures as liposuction (foolishly and even more misleadingly rendered 'liposculpture' by those with artistic pretensions); excisional surgery after weight loss; body, leg, breast and arm lifts; abdominoplasty and fat injection.

Liposuction (suction assisted lipectomy, liposculpture, suction lipectomy) can remove unsightly bulges of fat from areas where there is a disproportionate amount of it. It has become the most common aesthetic surgery procedure performed in the United States, and is highly effective in the right circumstances. The surgery itself leaves tiny scars. However, if large amounts of fat require removal and if the skin tone is poor - for example, after massive weight loss - the results are frequently disappointing. The loose skin, now unsupported by fat, becomes looser, taking on ripples at best; and, at worst, hanging in folds.

Body contouring involves dealing with the loose skin by removing it and thereby tightening that which remains. Since long incisions are necessary, the scars are more prominent than with liposuction, but are hidden - as far as possible - in inconspicuous places. For example, in arm reductions (batwing correction, brachioplasty) the scar is placed in the armpit or down the inside of the upper arm; in thigh lifts, the scar is located in the groin crease or down the inside of the thigh; in lower body lifts, the scar is sited within the bikini line, and with breast lifts, the scar is positioned around the nipple-areola complex and on the undersurface of the breast.

People who experience massive weight loss, be it from gastric bypass, banding or dieting alone, experience wildly different patterns of skin redundancy. Like all sensible plastic surgery, the techniques used, their combination and their staging have to be individualized to the patient and his or her physical condition. At your initial consultation, I will take a detailed history and perform a thorough examination with the object of finding out your aims, determining what combination of procedures would best satisfy them and ensuring that any pre-existing medical conditions may be appropriately managed to minimize risk at the time of surgery. You will have ample time to ask questions and discuss your options in a professional yet friendly environment.

Finally, if you are ever sitting in a plastic surgery office and you glimpse a bronze cast of the 'artist's' hands, take my advice and head for the door.