Aesthetic Procedures - Body

How fast does the skin shrink after liposuction?
Liposuction without removal of any skin is appropriate only for people with good skin tone, or elasticity. Height, weight, and age – as well as the patient’s expectations – are among the factors the doctor considers in evaluating the chances of a successful outcome.

Good candidates for liposuction can expect the excess skin to shrink completely in three to four months. Even in someone with good skin elasticity, certain areas tighten faster than others: the lower abdomen, love handles, knees, and saddlebags. The inner thighs and upper arms are softer regions and slower to shrink. They require greater care in fat removal.

When liposuction is done properly, the results are smooth and natural looking.

How do I know if I need a breast lift or implants – or both?
The answer depends on how big you wish your breasts to be. A very large implant can fill out a sagging breast, but not everyone wants to be huge. Before surgery is scheduled, you and your surgeon will review photographs of your breasts and discuss various options. For most people, a natural look is the goal.

If there is minimal sagging, an incision around the nipple is usually sufficient to lift the breast. However, if there is insufficient volume in the upper half of the breast, a small implant may be needed to create a natural shape. The result will be pleasing and realistic looking. If the breast is sagging so much that the nipple points down toward the fold under the breast, a vertical scar lift may be necessary. The incision around the nipple is continued in a vertical line extending down from the nipple to the fold under the breast, to further lift the breast and remove excess skin. If an implant is needed, one of larger size will fill out more of the skin envelope in the breast, making the vertical scar shorter.

What about silicone implants?
Silicone implants were banned by the U.S. Food and Drug Administration in 1992, after allegations that silicone “bleeding” into the surrounding breast tissue had led to diseases of the connective tissue, like lupus and rheumatoid arthritis, and even to cancer. Bleeding of silicone causes implants to become hard and misshapen, but research over the past 13 has years failed to find evidence that silicone implants cause serious disorders. Nonetheless, silicone implants were approved in the U.S. only for breast reconstruction patients participating in a study. Elsewhere in the world, silicone implants have remained in widespread use. In 2005, an FDA advisory committee recommended lifting the ban. Special interest groups are fighting the reinstatement, but full FDA approval is expected in 2006.

Saline implants, which have largely replaced the silicone, are very safe and, when positioned behind the muscle of the chest wall, create a pleasing result. The incisions are small and heal nicely. However, some people find that saline implants do not feel as natural as silicone ones. New cohesive-gel silicone implants – known as “gummy bear” implants because the material resembles jelly candies – look and feel very natural. Provisionally approved by the FDA, the gummy-bear implants don’t have the bleed problems of earlier models.

What about short-scar breast reductions?
Newer surgical techniques make a long incision in the fold under the breast unnecessary in breast reduction surgery. The incision under the breast may be eliminated altogether, or shortened so that it is entirely hidden. Sutures inside the breast shape the contour, then excess skin is trimmed. The result makes it possible to wear low-cut necklines and revealing swimwear, without scars visible. Over time, as scars "mature," they lighten and become much less of a concern.

Can I have a tummy tuck if I'm overweight?
Traditional abdominoplasty (tummy tuck) addressed only the fat and skin in the mid-abdomen, from below the belly button to the pubic area. For a good result, the patient had to be within ten per cent of the ideal weight for her height. But many post-partum women have trouble reaching their ideal weight because the fat around the middle is very difficult to lose. They abandoned the idea of having a tummy tuck.

Isn’t there a solution for a young woman who can’t get her figure back after childbirth?
Newer techniques make a tummy tuck possible even for someone twenty or thirty pounds overweight. These procedures protect the blood supply to the skin's surface and allow liposuction to be performed safely, without interfering with circulation in any way. The incision is made above the pubic hair and extends out toward the hipbone on either side, following the crease in the groin. Excess fat is removed either surgically or by suctioned. Then the waistline is recreated, the muscles in the mid-line of the abdomen are tightened, and the thighs are lifted.

This approach allows for extensive contouring of the abdomen and flanks, or “love-handle” region, with liposuction. It is a total-figure restoration. Many women report going down two or three clothing sizes as a result. The post-partum fat a woman couldn’t lose is permanently removed. The more balanced figure that emerges from the surgery provides an incentive to keep the weight off and stay fit.