Body contouring has two aspects. The reduction of localised fatty deposits by liposuction and the tightening of loose skin by skin excision. This surplus skin may be the result of pregnancy, weight loss, ageing and sun damage. The skin is attached through underlying fat to the fascia covering muscle. Surplus skin therefore tends to dimple and fold as it descends under the influence of gravity with the loss of elasticity. Unfortunately one cannot restore this elasticity which extends in all directions. Instead one can remove surplus skin in one or more directions. The skin itself will remain inelastic and this is the main limitation of this type of surgery. Many people believe that diet and exercise will improve the skin laxity and fat distribution. Unfortunately this is not the case.

Abdominal reduction

This is also called an abdominoplasty or tummy tuck. In this procedure excess skin and fat can be removed, abdominal contours and scars improved and the lax muscles tightened. Different procedures are combined into particular operations.

The Full Abdominal Reduction (High Lateral)

The excess skin of the abdominal wall between the pubic area and the umbilicus (navel) is removed leaving the umbilicus in place. The skin of the abdominal wall at the level of the umbilicus is drawn downwards and laterally to suture it at the pubic level. The patient is left with a long scar curving across the lower part of the abdomen and upwards over the crest of the pelvic bone. Liposuction may be carried out during this procedure. There is also a scar around the umbilicus where it is brought through the tightened abdominal skin. Any looseness of the muscles of the abdominal wall or hernia is repaired at the same time. Liposuction is carried out during this procedure to thin the abdominal wall. On occasions liposuction is carried out as a separate procedure before or after the main abdominal reduction.

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Endoscopic Abdominoplasty

If the skin is still elastic but there is an abdominal bulge and separation of the abdominal muscles it is possible to use key-hole surgery to carry out the surgical repair of the muscle and liposuction thus avoiding long scars

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Mini Abdominoplasty

In the Mini Abdominoplasty only skin below the umbilicus is tightened leaving a low curved abdominal scar but no scar around the umbilicus. Liposuction and abdominal muscle tightening is carried out at the same time if necessary.

The Extended Abdominoplasty

Surplus skin and fat of the loins are also removed so that the scar extends around the flanks onto the lower back.

Circumferential body lift

In this procedure the skin excision extends right the way round the body from the high lateral abdominal reduction incisions dipping down towards the buttocks centrally. This procedure will tighten the folds of skin which develop below the ribs and will lift the buttocks and thighs.

Thigh Lifts

• Inner thigh lift
The skin of the inner side of the thigh can be lifted with a scar high in the groin running through to the buttock crease. This is useful when the skin excess is severe but it can be difficult to completely hide the scar.

• The buttock and thigh lift
The buttock and outer, upper part of the thigh can be lifted with skin excision above the buttocks in the line of the crest of the pelvis.

• Outer thigh lift
The skin of the outer posterior and inner thigh can be lifted by removing skin in the buttock fold extending upwards at the outer end and through into the groin at the inner end.

Upper Arm Reduction

Liposuction of the upper arm will tighten the skin slightly but where there is a large surplus of skin a brachioplasty can be performed. This leaves a long scar down the inner side of the back of the arm running upwards into the armpit.

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Areas where the skin cannot be satisfactorily tightened are the elbows, knees and mid-thighs.