Non-Surgical and Surgical Body Contouring: Setting Realistic Expectations

Body Contouring Expectations

As we kick-off the summer months and have officially reached bathing suit season, it is natural that many of us take a look in the mirror and think about how we might change our body.  In addition to keeping a healthy diet and exercising regularly, there are now more choices than ever in how we might achieve our goals. But with so many choices, both surgical and non-surgical options, choosing what body contouring procedure is best for you can be difficult.  How can you know which is best, and how can you make sure that your expectations are realistic?

 At the Annual Meeting of the American Society for Aesthetic Plastic Surgery (ASAPS), held this year in Montreal, Canada, plastic surgeons from around the world discussed exactly these kinds of questions. This year, I participated in back-to-back panels on body contouring, and thought that the folks here in Atlanta would be very interested in hearing what the experts are saying about the various body contouring procedures and the kind of results that can be expected.

The first panel, which I chaired, was on non-surgical body contouring, and how it compares with liposuction. Anesthesia is not required for these non-surgical procedures and usually one can return to full activities virtually the same day. Such procedures include cryolipolysis, radiofrequency, and different types of external ultrasound. These technologies all work differently but are designed to accomplish the same thing – remove unwanted fat without surgery. Cryolipolysis, better known as CoolSculpting®, does this by freezing the fatty tissues; radiofrequency treatments heat the tissue under the skin; and ultrasound uses sound waves to break up fat cells.

After the panel discussed issues for an hour, several “take home” messages were clear to the doctors. First, non-invasive body contouring procedures do work and are well tolerated by patients, but the results can be significantly less dramatic than those from liposuction. Second, to get the desired results, most patients need repeat treatments of the same area. And third, not everybody is a good candidate for non-surgical fat reduction. The best patients for non-surgical body contouring are at an overall good body weight, have firmer, elastic skin and have a limited number of areas to treat. Patients who will do better with liposuction or a tummy tuck include those who are older or have less skin elasticity, women post pregnancy who may need a tummy tuck, or those with larger, more diffuse fat collections.

The second panel was on abdominoplasty, otherwise known as tummy tucks.  Despite the new non-surgical technologies that are emerging, the number of tummy tucks done each year in the United States continues to grow. There are several reasons for this continued growth in the number. First of all, tummy tucks really work, and the results can be among the most dramatic of the body contouring procedures. Second, there have been significant improvements in the way abdominoplasties are performed. These include better ways to control pain after surgery (for example with pain pumps and long lasting local anesthetics), the eliminated need for drains in many patients, and better control of scarring. Third, as many are working hard to control their weight and keep their body in shape, they realize that neither non-surgical treatments nor liposuction will tighten their loose skin, something that is at the core of abdominoplasties.

So as you look in the mirror, how do YOU make sure that you choose a body contouring method that is best for you, and what should you expect? The most important thing is to have a consult with a physician who can offer you the entire spectrum of options – non-surgical, liposuction, or tummy tuck. Listen to what they say. In some cases, patients will have loose skin of the abdomen and weak muscles after pregnancy, and in these cases, nothing short of a tummy tuck will give significant results. In other cases with isolated, small fat pockets, non-invasive CoolSculpting® may be an excellent option. And still in other cases where there are many body areas a patient may want to treat, liposuction may be more effective and cost less in the long run than non-surgical treatments. Ask the doctor about how your skin will change after the procedure, what your recovery will be like, how many treatments will be necessary, and how the treatment options compare. Working with a cosmetic surgeon who has experience with all the options is the very best way to set expectations that are realistic for you.

There is a great old saying that “if the only tool you have is a hammer, the whole world looks like a nail”. In the world of body contouring, nothing could be more true. Many centers that offer non-surgical treatments can’t offer you liposuction or a tummy tuck, so guess what? They’ll offer you what they have. Even worse, in many cases you might not even be evaluated by a physician who is trained in all the different techniques, so they can’t help guide you to compare realistic expectations between the options. And for those who are not good candidates for non-surgical technologies, this can be a prescription for disappointment.

At the Emory Aesthetic Center, we not only offer the full spectrum of body contouring options – from CoolSculpting® to liposuction to abdominoplasty (tummy tuck) – but we also require that all patients interested in body contouring have a consultation with one of our board certified physicians to discuss exactly these issues. We want you to love the results of your treatment, and we will work with you to help you find the best body contouring option for you and to set realistic expectations.


About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

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