Body contouring is reconstructive surgery to remove sagging skin and extra fat, and to improve the shape and tone of underlying tissue. The result is a body with smoother contours. Body contouring may be carried out following major weight loss, when the skin may not shrink back fully.
Body contouring is often performed in stages and may take months or even years to complete. Areas that are often affected by loose, unsupported skin include the upper arms, breasts, abdomen, buttocks, groin and thighs.
If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives. These may include lifestyle changes or learning to accept yourself the way you are.
Before choosing body contouring surgery
Before you opt for body contouring surgery, some important issues to keep in mind include:
- Body contouring surgery is not suitable surgery to remove excess fat alone. Liposuction can remove excess fat deposits if your skin has good elasticity (stretchiness) and is able to follow your new body contours. In cases where skin elasticity is poor, a combination of liposuction and body contouring techniques may be recommended.
- Your weight loss must be stabilised. Weight loss after surgery will create loose pockets of skin. Weight gain will stress your tightened skin and cause stretch marks and widened scars.
- If you have had weight reduction surgery, your plastic surgeon will work closely with your doctor to determine when it is appropriate for you to begin body contouring.
- There will be many incisions (cuts) made. You must be prepared for extensive scarring.
- Think about the financial cost. Cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance. However, reconstructive surgery does qualify.
- Smokers are at increased risk of complications. If you are serious about undergoing surgery, you should try to quit smoking.
Finding a body contouring surgeon
You may want to ask your doctor for advice about finding a suitable specialist surgeon or hospital where body contouring surgery is performed. At your first consultation, you should ask the surgeon about their training and experience – it is preferable to have this procedure done by a surgeon who is specially trained to perform body contouring surgery and has a lot of experience in carrying out this operation.
Medical issues related to body contouring surgery
Before the operation, you need to discuss a range of medical issues with your doctor or surgeon. They will talk to you about your:
- physical health – an examination will help your doctor or surgeon to decide if the treatment is appropriate
- medical history – some pre-existing medical conditions and any surgery you’ve had in the past may influence decisions about this operation, including the type of anaesthetic that is used
- risks and possible complications – it is important that you understand the risks and complications so that you can weigh up whether body contouring is right for you
- medication – tell your doctor and surgeon about any medications that you take regularly or have recently taken, including over-the-counter preparations like fish oils and vitamin supplements
- past reactions to drugs – tell your doctor and surgeon if you have ever had a bad reaction or a side effect from any drugs, including anaesthesia
- preparation for surgery – your surgeon will give you detailed instructions on what you should do at home to prepare for surgery. For example, you may be advised to take a particular drug or alter the dose of an existing medication. Follow all instructions carefully.
Body contouring operation
Body contouring surgery is usually performed under a general anaesthetic. Sometimes an epidural (a local anaesthetic that numbs the body from the waist down) may be used. The surgeon will make every effort to place incisions (cuts) within natural skin folds and in areas where the scars will be hidden by clothes. However, this is not always possible and some scars may be visible.
There are different types of body contouring. Depending on your individual circumstances, the surgeon may recommend one or more surgeries to achieve the desired results.
The types of body contouring surgery include:
- lower body lift – excess skin is taken from the abdomen, hips, buttocks and outer thighs. The surgeon may decide to make a cut that circles the body at the hips. This procedure can also improve a dimpled, irregular skin surface, commonly known as cellulite. In some cases, the lower body lift can be performed during a single operation. In other cases, two or more operations must be planned
- thigh lift – the surgeon makes a cut in the groin that runs down the inner leg to the knee. Extra skin and fat are removed. In some cases, the surgeon opts to continue the cut from the groin to the outer hip in order to improve the shape of the outer thigh
- buttock lift – the surgeon cuts across the top of the buttock and, depending on the extent of the operation, sometimes along the sides as well. Crescent-shaped sections of skin and fat are removed and the skin is pulled together and sewn
- breast lift (mastopexy) –- the surgeon cuts around the areola of the nipple and makes a vertical cut from the areola to the underside of the breast. A horizontal cut may also be required across the breast crease. Extra skin is removed from this ‘lollipop-shaped’ series of cuts. A breast implant can be included during this procedure to increase the size of the breast
- arm lift (brachioplasty) – the surgeon makes a cut on the inner surface of the upper arm from the armpit to the elbow. Underlying muscle is tightened with stitches to smooth and define the shape of the upper arm. The extra skin is cut away.
Immediately after the body contouring operation
After the operation, you can expect:
- a drainage tube in the wound to help prevent fluid build-up
- bruising and swelling
- possible numbness
- pain and discomfort
- dressings or bandages on the wound
- to wear compression garments to help reduce swelling.
Complications of body contouring surgery
All surgery carries some degree of risk. Some of the possible complications of body contouring include:
- risks of anaesthesia, including allergic reaction, which may (rarely) be fatal
- surgical risks such as bleeding or infection
- blood clots that may cause potentially fatal cardiovascular complications such as heart attack, deep vein thrombosis or stroke
- collapsed lung
- fluid build-up beneath the wound
- tissue death along the wound, or skin loss
- sensory nerve damage, which may cause prolonged or permanent numbness
- prolonged swelling
- damage to underlying tissues such as muscles
- asymmetry (unevenness) of the skin
- unsightly, inflamed or itchy scarring
- further surgery to treat complications.
This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. You need to speak to your surgeon for more information.
Self-care at home after body contouring surgery
Be guided by your surgeon, but general self-care suggestions include:
- Rest as much as possible. Only gentle walking is recommended for the first seven to 10 days.
- Avoid strenuous activities or exercise for at least four weeks.
- Make sure that your stitches are not placed under stress. For example, don’t wear tight clothing that may rub at your wounds.
- Wear compression garments for several weeks if required by your doctor.
- Report any bleeding, severe pain or unusual symptoms to your surgeon.
Long-term outlook following body contouring surgery
For the future, remember that:
- Your silhouette in clothes is changed immediately. However, body contouring surgery will not stop your skin from sagging if you gain and lose a large amount of weight in the future.
- You need to expect and accept a certain degree of sagging as you age.
- Scarring will be permanent but should fade in time. Be patient – improvements to scars may take around a year or so.
- While it may have taken you two years or more to lose the excess weight, it may take just as long for the results of your body contouring to be complete. The plan for your surgery will depend on what you are trying to achieve, as well as your surgeon’s best judgement.
Alternatives to body contouring surgery
Other options include:
- eating a healthy, low-fat diet
- regular exercise
- wearing foundation garments or flattering clothes
- accepting yourself – talking to a counsellor or psychologist may help you overcome your concerns about your appearance and you may decide that you like yourself the way you are.
Where to get help
This page has been produced in consultation with and approved by:
Australian Society of Plastic Surgeons
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.