Over the last decade, plastic surgeons have made significant technological advances in the field of body contouring. With the arrival of new devices, we are now able to offer improved results, often with less downtime and a less painful postoperative recovery. Also, we have seen the development of new procedures to augment both buttocks and breasts using a patient’s own adipose (fat) tissue, rather than relying solely on foreign material. Together, these advances make female body contouring an exciting, and evolving, field.
The (New) Mommy Makeover
After pregnancy, women are often left with rectus diastasis, in which the 6-pack muscles (rectus abdominis muscles), are considerably stretched out and separated. This gives an abdominal bulge, and in many women, this can be quite large and noticeable. Some are unfortunately mistaken for being pregnant when they are not. On top of this, many are left with skin laxity, which does not resolve despite diligent exercise and adequate nutrition.
A similar appearance can appear following significant weight changes. With weight loss, the skin is often incapable of tightening appropriately. This is especially true as we age and the amount of collagen and elastin (the structural proteins within the skin) decreases.
Traditionally, the surgical treatment for this issue is a “mommy makeover.” This usually involves an abdominoplasty and a breast lift (mastopexy) or a breast lift with implant placement (augmentation-mastopexy). An abdominoplasty, or tummy tuck, includes the removal of a portion of excess abdominal skin and tightening of the underlying 6-pack muscles with sutures. The incision is traditionally the full length of the lower abdomen above the hips.
Today, we employ multiple devices to improve the results of our abdominoplasties. Together, these technologies not only improve the overall contour and skin tightness, but can often allow a smaller incision, and sometimes, incisions longer than one centimeter.
First, we typically use an ultrasound-based device known as VASER to melt stubborn fat in the flanks, abdomen, back and the bra rolls. Once the fat is softened, we employ small liposuction cannulas to gently extract the fat and provide the appropriate contour. This combination greatly improves the appearance following a tummy tuck, whereas previously, women were left with a significant amount of residual fatty tissue.
The next major advancement is that of skin tightening. This has long been the Holy Grail of body contouring surgery, as the only way to reliably tighten skin was with excision and a resulting scar. Today, there are several devices which use some form of energy to tighten the underlying collagen network. In our practice, we use a device that uses plasma energy to reliably and safely tighten the skin. This is done at the same time of surgery. Often, patients that would previously have required a full-length abdominoplasty incision, can be treated with a mini-abdominoplasty (shorter) incision or with the combination of VASER, liposuction, and skin tightening alone.
We also now have a way to improve the 6-pack muscles themselves outside of the OR. We use a device called Emsculpt which uses electromagnetic pulses to stimulate and contract the abdominal muscles. A single 30-minute session can produce the equivalent of 20,000 crunches! This is done safely in our clinic. Multiple sessions can lead to even greater results.
New Advances in Buttock and Breast Augmentation
Today, we have witnessed multiple advancements in fat grafting, in which a patient’s own fat is extracted via liposuction, purified, and then injected to various areas for natural augmentation. We commonly augment the buttocks and the breasts in this manner. This often makes silicone implants or other foreign material unnecessary.
For buttock augmentation, the procedure (called a Brazilian Butt Lift or BBL) can be performed with safe injection of the fat in the subcutaneous plane above the buttock muscles. This can add the desired amount of volume to the area and greatly improve the curves of the buttocks. The accompanying liposuction can further improve the aesthetic result.
For breast augmentation, the fat tissue can be injected into the areas of the breast which provide a natural, augmented appearance. Cleavage lines and upper pole fullness can both be improved dramatically along with an enlargement of the breast itself.