2023 Body Procedures

Abdominoplasty (tummy tuck)

A tummy tuck (abdominoplasty) removes excess skin and fat from the abdomen and is performed under general anaesthetic.

The procedure suits those with problems such as excessive skin laxity (looseness), excess fat and laxity of the abdominal wall muscles, often resulting in the skin flapping downwards. Typical patients have often experienced extreme weight loss or pregnancy and wish to create a more svelte looking abdominal area. It is often performed in combination with liposuction.

During the abdominoplasty procedure, skin and fat are removed from the stomach area and the abdominal muscles are repaired, tackling a number of conditions at once. While liposuction is used only to remove fat, an abdominoplasty can flatten the stomach area by tightening the muscles as well as recapturing a more hourglass figure.

An incision is made across the lower abdomen, above the pubic bone, and is positioned in such a way as to be invisible under swimwear and underwear. A circular incision is then made around the navel and the skin is then separated from the muscle, working up toward the ribs, stitching the muscles together then tightens the stomach. Excess skin is removed, and a new opening is made for the belly button.

Patients usually take around three weeks off work. Results are a flatter stomach with repaired abdominal muscles and removal of excess skin. A scar is created across the lower abdomen, which can be hidden within the bikini line, and minimised with various scar therapies.

Brachioplasty (arm lift)

Brachioplasty, also known as an arm lift, reshapes the underside of the upper arm from the armpit to the elbow, and involves the surgical removal of excess loose skin and fat from saggy underarm areas, sometimes referred to as “bingo wings”.

As well as the surgical excision of loose skin, the procedure may also incorporate liposuction to remove excess fat. Performed under general anaesthetic, the procedure may require an overnight stay in hospital but patients are often allowed to go home on the same day.

Results include improved appearance of the upper arm, with more definition and no flapping skin. Most people can resume normal activities around two weeks after surgery. A scar will be visible, typically running along the inside of the arm from the armpit to the elbow; however, scar management techniques and products can help minimise the appearance.

Breast lift (mastopexy)

A breast augmentation can return shape to a flattened, sagging breast, but it is commonly combined with mastopexy (breast lift surgery) to raise the breasts to a more youthful position. In other patients, a breast reduction may be more suitable following weight loss, and again this is usually combined with a mastopexy to achieve the best results.

For a small lift, the peri-areola mastopexy is commonly used, with an incision made around the nipple. The nipple is elevated and the skin envelope is moved so the nipple sits higher on the breast mound.

For a larger lift, the anchor-incision technique may be used. It involves an incision being made around the nipple and vertically down, with another incision horizontally under the breast. Another common breast lift method is the shorter scar LeJour technique. In both cases, the excess skin is removed and the nipple placed higher.

Results include rounder, fuller breasts with higher projection and repositioned to a more youthful and attractive position. A mastopexy can help reduce the appearance of back rolls, or sagging skin on the sides and back of a weight-loss patient. Initial recovery takes around five to seven days and resulting scars should fade over time.

Breast reduction (reduction mammoplasty)

Breast reduction (or reduction mammoplasty) is a surgical procedure that reduces, lifts and reshapes the breast. It is used to remove excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body. The procedure is designed to alleviate the discomfort associated with overly large breasts.

The operation seeks to relieve symptoms and pains caused by very large breasts. Overly large breasts can cause health issues and emotional problems for some women. In addition to self-image issues, it can also cause physical pain and discomfort. This includes back pain, neck pain, breast tenderness, shoulder grooving (from bra straps), intertrigo (rash between folds of skin), and overall breast discomfort.

Many breast reduction surgery procedures usually call for just one vertical incision around the areola down to the breast crease, and in some cases along the crease as well. A portion of fat and excess tissue is then removed. The nipple and areola are then pertly repositioned and the skin under the breast is re-sculpted. This results in smaller breasts that have a more aesthetically pleasing shape and improved support, lift and overall fullness.

Breast reduction surgery is performed under a general anaesthetic, with a recuperation period of around three weeks. Scars are an inevitable part of any invasive surgery. The resulting scar can usually be seen from around the nipple down to the breast crease in a vertical line, and may fade over 12 – 18 months after the procedure. This scar generally takes longer than other types of scarring to settle.

Liposuction

Liposuction is a surgical procedure performed under anaesthetic to remove deposits of fat from specific areas of the body. It can be performed almost anywhere on the body where there are pockets of fat, including the neck, arms, stomach, back, chest, buttocks, thighs and ankles.

It is usually performed as day surgery, although some cases may warrant an overnight hospital stay.

Generally, the area to be treated with liposuction is infiltrated with a tumescent fluid containing local anaesthetic and a vaso- constrictor before small cannulas are used to vacuum out the fat. Alternatively, a syringe can be used to withdraw the fat.

Power-assisted liposuction, where radiofrequency, ultrasound or laser technology is used to improve liposuction results, can help increase skin contracture and tone and tighten the skin’s surface. These types of techniques are also typically less aggressive.

The ideal liposuction patient is at or near their ideal body weight (within 30 per cent), has good skin elasticity and is seeking reduction of diet-resistant localised pockets of fat. They also need to understand the risks of surgery and have realistic expectations that liposuction is not a way of losing masses of weight or a cure for obesity.

Bruising can last for a few weeks and swelling for around one to two months. A compression garment is usually worn for about four to six weeks in most cases. Patients can usually return to work after around three to seven days. Final results – a trimmer-looking, more proportionate and shapely form – can be seen from six months to a year as swelling subsides. Results are long lasting provided the patient maintains a similar weight.

Thigh lift

A thigh lift is a surgical procedure performed under general anaesthetic to remove excess skin and fatty tissue, typically in patients who’ve lost considerable amounts of weight. A thigh lift can be combined with liposuction for a smoother result. During the procedure, an incision is made in the upper inner thigh – in some cases this may extend to the groin line or buttock fold – and excess fat and tissue is removed via this incision.

Results include improved contour of the upper leg, with tauter skin and more defined musculature. Normal daily activities can usually be resumed, and are encouraged for circulation, within several days following surgery.

Non-surgical fat reduction

Non-surgical body contouring procedures use medical-grade energy-based devices to dissolve fat and/or tighten skin. The energy is emitted via an applicator through the skin without damaging the outer layers, only targeting the underlying fat and tissues.

Targeted fat cells are destroyed and excreted naturally via the body’s lymphatic system over a period of several weeks. Most devices require a series of treatments spaced several weeks apart for optimum results. Fat reduction treatments can reduce fat in the targeted area by as much as 20%.

Although non-surgical body contouring devices offer an effective means for achieving a more streamlined body shape – commonly targeting treatment areas such as the abdomen and thighs – it’s worth remembering that no non-surgical device can achieve the level of fat removal possible with liposuction. It’s therefore important to have realistic expectations of what non-surgical body contouring can achieve, both in terms of the amount of fat that can be targeted, and the length of time it will take to see results.

The best candidates are usually those with small to medium localised fat deposits that are resistant to diet and exercise, rather than those seeking large-volume fat removal. For muscle building and toning treatment, just about anyone is a suitable candidate.

Today’s most popular energy systems use fat-freezing technology (cryolipolysis treaments), radiofrequency, latest- generation microwave energy and laser technologies.

Cryolipoylsis (non-surgical body contouring, including Clatuu, CoolSculpting, Cooltech)

This method uses almost-freezing temperatures to kill fat cells without traumatising the surrounding tissues or harming the skin. A gel drape is placed onto the target area to protect the skin before the applicator head is placed onto the fat pocket, where it remains for approximately one hour. The applicator acts like a vacuum to suck the area into position and direct the cold temperature to the target fat cells under the skin, which are then destroyed and eliminated naturally by the body.

Radiofrequency energy (Bodytite, Trusculpt ID)

This non-surgical treatment uses radiofrequency (RF) energy to reduce pockets of fat. The energy is emitted via an applicator through the skin without damaging the outer layers, only targeting the underlying fat and tissues.

With RF body contouring treatment, the heat generated from the RF energy dissolves fat cells and causes microscopic changes to tissues and collagen fibres, with further collagen remodelling occurring over the subsequent months following the procedure. The broken down fat cells are drained via the lymphatic system and then excreted as urine. An added bonus is that it can also improve skin tone and the look of cellulite.

The full effects may not be visible for several months as the improvements are cumulative. You will gradually notice changes such as circumferential reduction of the treated area, a reduction in cellulite and a more streamlined body shape. Radiofrequency body contouring treatments are non-invasive, cause minimal discomfort and typically require no downtime.

Microwave energy (ONDA Coolwaves)

ONDA Coolwaves by Deka is the first device to use smart microwave technology for body contouring applications including localised fat deposits, cellulite and skin tightening. Its propriety Coolwaves technology targets deeper layers, while keeping the skin cool and comfortable. It treats fat pockets, cellulite and skin laxity at the same time.

There is no other device that emits microwaves in the same way as the Onda system’s smart handpieces. Microwaves are absorbed by molecules in the target tissue, which causies
them to oscillate and heat up. The Onda handpieces generate microwaves at 2.45GHz, a frequency that is preferentially absorbed by fat molecules rather than by water molecules. The epidermis and the dermis of the skin contain a high percentage of water but little fat.

Therefore, when the Coolwaves penetrate the skin, they pass straight through the top layers without depositing excessive heat (about 20% of the thermal effect from the microwaves). The majority of the Coolwaves energy affects the subcutaneous fat, which is heated far more rapidly that the skin (about 80% of the thermal effect).

Laser technology (Sculpsure)

Non-invasive fat reduction using hyperthermic laser uses heat to destroy the fat cells and can work wonders on the love handles and abdomen.

It uses a specific laser wavelength to target and destroy fat cells below the dermis. Multiple areas can be treated at once in just 25 minutes, and all skin types are suitable. The controlled hyperthermic laser induces fat cell injury by raising fat temperature to a range of 42 to 47 ̊C – the ideal temperature to eliminate fat cells, without damage to surrounding tissue.

There is no downtime and minimal, if any, discomfort. Results can be seen around six weeks after treatment as the body naturally metabolises the destroyed fat. A series of treatments is typically recommended for optimum results.

Muscle sculpting & body toning

Even the most disciplined gym-goer will typically have little pockets of fat they just can’t budge or areas on the body lacking in definition, despite repeated weights and workouts. With the latest advancements in body contouring technology, there are options out there to remove fat and sculpt muscle without lifting a finger.

Muscle building, toning and sculpting devices are an exciting new addition to the non-surgical body contouring market and quickly rising in popularity.

Most use electromagnetic stimulation to strengthen and tighten the abdominal, gluteal and thigh muscles through methods of contraction and stimulation (called supramaximal contractions) – delivering tens of thousands of muscle contractions in a 30-minute session (obviously not physically possible during normal exercise).

During muscle toning treatment, applicators are placed on areas of the body and generate an electromagnetic field that stimulates the motor neuron cells of the body’s muscles, causing the muscle to contract as it would during movement or exercise.

When exposed to supramaximal contractions, the muscle responds with a deep remodelling of its inner structure, resulting in the growth of myofibrils (muscle hypertrophy) and creation of new protein strands and muscle fibers (muscle hyperplasia). Increased muscle density and volume lead to a better definition and muscle tone.

Some muscle building devices have shown a 16% average increase in muscle mass, and even a reduction in reduction in Diastasis recti (abdominal separation caused by pregnancy).

A series of treatments is usually recommended with results seen 3-4 weeks after completion of the treatment plan.

Muscle building and toning devices currently available in Australia include EmSculpt by BTL, teslaFORMER and truSculpt FLEX. CBM