Body contouring: the pleasures and perils of surgery

Dr Brian Monaisa. Picture: Supplied

Dr Brian Monaisa. Picture: Supplied

Published Jul 31, 2024

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Dr Brian Monaisa

As a plastic surgeon, I get a lot of questions about the difference between liposuction and abdominoplasty. Most women tend to gather fat around their central upper body: the tummy, back and bra fat rolls are a common problem.

Plastic surgery offers a promise of great improvement in the appearance of these areas, by using liposuction or a tummy tuck to reconstruct and enhance the natural body shape. Liposuction and abdominoplasty are cosmetic procedures that aim to enhance the appearance of the abdomen, but they differ significantly in their goals, techniques, risks and outcomes.

Liposuction is primarily used to remove localised fat deposits from areas such as the abdomen thighs, and arms. The procedure involves making small incisions to insert a cannula, which breaks up and suctions out fat from the body. The scars are small and well hidden. It is less invasive than a tummy tuck and typically has a shorter recovery time, so is the procedure of choice in appropriate patients.

Happiness with liposuction depends on selecting the right patient for the procedure and is best suited for individuals who have good skin elasticity and muscle tone, with no extra hanging skin. Persistent happiness depends on the client’s ability to maintain the weight after surgery, and weight gain should be avoided.

Abdominoplasty is a more comprehensive procedure, addressing excess fat but also loose skin and weakened abdominal muscles, known as diastasis recti. Diastasis recti results in a weak core and is associated with back pain and urinary incontinence post pregnancy, both of which can be improved with a tummy tuck.

It involves a larger incision (and scar), removal of excess skin and fat, and repairing muscle wall laxity. The procedure is often chosen by individuals who have experienced significant weight loss or women post-pregnancy, where the abdominal area has been stretched and requires more extensive reconstruction. In my experience, women with one child only may easily get away with liposuction, avoiding the long scar of abdominoplasty.

The complications associated with liposuction are mostly cosmetic, and include contour irregularities and skin burns, while other complications like bruising, swelling, and temporary numbness usually resolve.

Abdominoplasty carries additional risks such as longer healing time, scarring and a higher possibility of complications like infection or blood clots or deep vein thrombosis. Both procedures require careful consideration and consultation with a certified plastic surgeon to determine the most appropriate approach based on individual needs and health status.

It is also important to have realistic expectations and understand that neither procedure is a substitute for weight loss or a healthy lifestyle. Post-operative care is crucial for both procedures to ensure proper healing and optimal results.

Patients typically wear compression garments to minimise swelling and support the treated area. Recovery times vary, with liposuction patients often returning to normal activities within a few days to weeks, whereas tummy tuck patients may need several weeks before resuming their routine.

Ultimately, the choice between liposuction and abdominoplasty depends on the specific goals and physical condition of the patient, and should be made in collaboration with a qualified surgeon who can provide detailed information about the expected outcomes, potential risks and the recovery process for each procedure.

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