Body Contouring in Santa Barbara- Abdominoplasty vs. Liposuction

When is Liposuction the right answer?

Yesterday I did a liposuction operation on a young woman here at my Plastic Surgery Center in Santa Barbara. She was in her mid 30’s, and she’s going to get a great result because she was an excellent candidate for the operation. A lot of my patients come to the office looking for a change in their body form, often in the abdominal region. Some patients are excellent candidates for the liposuction procedure, and some are better off with actual excisional body contouring plastic surgery. Often I spend a good deal of time explaining the difference.

Liposuction is a process where extra fat is removed- literally “sucked” out of the areas where it has inappropriately accumulated- without significant manipulation of the overlying skin. There are small incisions made in the skin through which the cannulas are passed- these are the tubes that suck out the fat. The skin overlying the fatty area is left to contract over the newly contoured reduced fatty layer. This requires something called elasticity. Your skin has multiple components that allow it to have various critical properties. Plastic surgery relies on many of these natural properties of the skin for its success in changing the form and appearance of your face and body.

Collagen is the principle protein in your skin that gives it strength. Without proper collagen, your skin would tear with the slightest injury. Similarly, youthful soft skin has the property of elasticity, which is provided by the protein elastin. Think of this as the property of your skin much like an elastic waistband. Excellent elasticity allows the skin to contract and tighten over the underlying contour. When liposuction is performed in a plastic surgery patient with good elasticity, the “elastic waistband” properties of the skin allow the skin to re-drape over the newly contoured region with good tone.

Unfortunately, the elastin protein is one of the first things to succumb to the process of aging. As we get older, the elastic properties of our skin increasingly fail. This is why we get more saggy skin that seems to fall from it’s youthful original position This results in aging appearances in the face as well as the body, and gives the skin a more waxy, less glowing appearance. Additionally, the elastic properties of the skin allow only so much contracture. When the skin has been stretched excessively due to significant weight changes and sometimes pregnancy, it’s elastic properties get overwhelmed. Loss of weight or delivery of your child may then result in what appears to be actual skin excess, and this is often accompanied by stretch marks- tears in the elastic binding properties of the skin. If you have had these issues, it is possible that liposuction is not the right operation for you.

Fortunately, there are many types of plastic surgery options for many different kinds of patients. You want to make certain that your plastic surgeon is proficient in all of the different means by which the body can be made more youthful. At my Montecito Plastic Surgery Center in Santa Barbara, if your skin elasticity is appropriate, and the other conditions are appropriate for you to get liposuction- that’s what I’m happy to do for you. If, however, you are better candidate for what we call excisional plastic surgery procedures, then that is another option that I’m going to discuss with you.

Excisional procedures are operations that involve actual excision of the skin overlying the excess fat, and direct removal of the fatty tissue of concern. Some of these operations, such as abdominoplasty, also allow manipulation of the underlying muscle layers. Using this technique I can also actually narrow your waistline somewhat by tightening the muscles of your abdomen. Other excisional procedures include arm lifts and thigh lifts, as well as breast reductions. Some of these procedures may be performed in conjunction with liposuction. This can provide reduction of the fat in areas near the excision, but allows removal of redundant excess skin that would be unsightly.

Whatever your particular situation- excess fatty tissue, excess skin, or a combination of both, there is likely some plastic surgery procedure that can be an option for you. It’s critical, however, that any of these plastic surgery procedures are teamed up with a program of good diet, regular exercise, and a healthy lifestyle in order to maintain the new you. While I can help you get there, I need you to help me keep you looking and feeling the best you can!

-Dr. Adam Lowenstein

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