Body contouring is a general term that includes procedures that change the shape of the trunk and/or extremities. These procedures include liposuction, fat grafting, abdominoplasty, thigh lifts, buttock lifts, and brachioplasty (arm lifts). All these procedures have in common the fact that they remove excess fat but not all these procedures remove excess skin.
As physicians we promote a sensible diet and exercise regime as an important part of living a long and healthy life and although rigorous exercise can tone the body's muscles it does not by itself tighten the skin. In many patients, exercise leads to weight loss which can actually cause the skin to loosen further. In patients with excessive weight loss, such as Gastric Bypass procedures for morbid obesity, we see extreme loosening and sagging of the skin. Pregnancy is another common contributing factor for not only loose skin but also a separation of the abdominal muscles along the midline. Finally, no amount of exercise or creams can remove the notorious "stretch marks" that many people develop. Body contouring procedures that remove and tighten skin are an option for people who have experienced extreme loosening of the skin. Loose skin around the abdomen, buttocks, groin, thighs, or upper arms can be removed and tightened and thus improve the tone and appearance of the area. In addition, body contouring procedures often address loose muscles and excess fat accumulation.
For patients who have good skin elasticity and only moderate fatty accumulation, liposuction is a good alternative. As a procedure, liposuction is somewhat limited because it does not directly remove skin, but for the properly selected patient, liposuction can contour areas such as the abdomen, thighs, hip, and arms with imperceptible scars and quicker recovery. In many cases, a combination of liposuction and removal of skin is performed in order to obtain optimal results such as an "abdominoplasty with liposuction of the hips and thighs".
