Everything You Need to Know About Body Contouring

Written by Marixie Ann Obsioma, MT, undergrad MD on November 23, 2021

Regular exercise and healthy eating habits are the foundation for achieving a certain body goal. For most people, that goal is a toned, more defined body. As much as diet and exercise are vital, they need more support and assistance. That's where body contouring steps in. Body contouring is becoming increasingly popular, and in this post, you can learn all you should know about it.

What is body contouring?

The term body contouring or body sculpting refers to procedures and methods whose primary objective is to improve the appearance of skin and tissue after a major weight loss. Removal of fat and body reshaping improve the esthetic through a toned and defined appearance.

These procedures and methods have evolved significantly over the past decade (1). But they have been around for many years. Body contouring, also called body sculpting, dates back to the 1920s, but it took off about 50 years later, in the 1970s, with the development of liposuction (2).

Body contouring techniques have evolved significantly over the years. Today, a wide range of options is available depending on the specific body goals and needs of each patient. Besides surgical, nonsurgical procedures are also available, less invasive, and oftentimes more affordable.

In this post, we are going to cover both surgical and nonsurgical approaches to body contouring.

Surgical body contouring procedures

Major weight loss is an amazing achievement resulting from hard work, effort, and lifestyle modifications. However, a common problem for many persons who’ve lost a lot of weight is sagging skin. You see, skin loses its elasticity to conform to the decreased body size.

The main objective of body contouring treatments is to remove excess sagging skin and fat. At the same time, it improves the shape of the underlying support tissue.

While exercise and diet led you to the important achievement – weight loss, plastic surgery procedures act as a supporting strategy for a more defined look.

Who is the ideal candidate?

The most suitable candidate for most body contouring procedures generally meets these criteria (3):

Body mass index (BMI) less than 30 – you can calculate your BMI here
Excess skin following weight loss
Weight loss has been stable (within 10 lbs) for six months
Healthy lifestyle and well-balanced diet with adequate protein intake
No nicotine/tobacco use
Positive outlook and realistic goals
Good health; without medical conditions that impair the healing process

Procedures

Body contouring is not a single procedure but involves several operations. The exact surgeries depend on each person and their individual circumstances. In most cases, they include the following (4):

Facelift (rhytidectomy) – not only does it improve visible signs of aging, but it also tackles other problems such as sagging skin, jowls developing in the cheeks and jaw, and loose skin and excess fat of the neck that appear as "turkey neck" or double chin.
Arm lift (Brachioplasty) – a procedure that reshapes the under portion of your upper arm, from the underarm area to the elbow. The procedure aims to decrease the excess sagging skin that droops, tightens the underlying supportive tissue, and reduces localized fat pockets.
Breast lift (mastopexy) – lifts the breasts through the removal of excess skin. It also tightens the surrounding tissue to create a youthful breast contour.
Tummy tuck (abdominoplasty) – removes excess fat and skin to restore weakened muscle for a smoother and firmer abdominal profile.
Lower body lift – improves the shape and tone of the underlying tissue that supports skin and fat. The procedure removes excess fat and skin, too. As a part of body contour, lower body lift refers to correcting sagging of the abdomen, buttocks, inner and outer thighs.
Medial thigh lift – reshapes the thighs by reducing excess skin and fat for a smoother and more contoured look.

Not everyone needs all the above-mentioned procedures. Remember, the exact body contouring procedures depend on each patient and their needs.

Since body contouring is not a single procedure, there is no specific or uniform process. Instead, the exact course of action depends on the procedures necessary for each patient.

Body contouring procedures require general anesthesia. That means you’re asleep the whole time.

To perform body contouring procedures, surgeons generally need to make large incisions. Of course, the length of an incision depends on the location of your body and the amount of excess skin that needs to be removed. That being said, medicine and science have evolved significantly over the years, thus allowing surgeons to place incisions strategically. As a result, incisions are easy to conceal in most cases.

For instance, the incision pattern in the body lift procedure may include a circumferential incision around the body in order to remove the “belt” of excess fat and skin. In some cases, a near-circumferential incision is necessary (5).

When it comes to a breast lift, the surgeon has several options regarding incisions. The exact choice depends on the type of procedure. For example (6):

Crescent lift – incision runs halfway across the top edge of the areola, works well for women with minimal breast sagging.
Donut lift – the incision is made in a circle around the areola
Lollipop lift – requires two incisions; one from the bottom of the areola to the crease below the breast and a second incision around the areola. This is one of the most common breast lift procedures
Anchor lift – involves one horizontal incision along the breast crease, one incision in between the crease and the areola, and around the areola edge. This type of breast lift is suitable for women with significant breast sagging
Horizontal mastopexy – horizontal incisions only

To enhance the shape and size of the breast, a surgeon may recommend breast implants.

To perform an arm lift, a surgeon will make an incision that extends from the underarm area to the inside or back of the upper arm. On the other hand, thigh lifts require incisions in the groin extending downward to the knee. The incision extends down the inseam of the thigh. In some cases, a surgeon may need to make an incision extending from the groin around the hip to improve the contour of the outer thighs.

Upon making the incision, a surgeon moves on to remove excess fat and skin that will give a patient a toned physique.

The duration of body contouring varies depending on each procedure. A multi procedure (a combination of different procedures performed simultaneously) can last eight or more hours (7).

What to expect after body contouring?

Right after the body contouring procedure, you can expect (8):

Pain and discomfort
Swelling and bruising
Numbness
Bandages or dressings around the treated areas
Drainage tube in the wound to prevent accumulation of fluid
Having to wear compression garments to decrease swelling

Your surgeon will explain how to treat pain and discomfort. You may need to take over-the-counter painkillers. Keep in mind it’s normal to experience pain and swelling, but they go away as your incisions heal.

Risks

Every procedure comes with certain risks, and body contouring is not the exception. During the consultation, a surgeon informs patients about all benefits and risks associated with procedures they need. The most common risks of body contouring procedures include:

Anesthesia risks, e.g., allergic reaction
The buildup of fluid beneath the wound
Bleeding
Unfavorable scarring (excessive, widened, unsightly, inflamed, or itchy scars)
Infection
Slow wound healing
Prolonged swelling
Damage to underlying tissues, e.g., muscles
Skin loss
Blood clots, pulmonary embolism, and deep vein thrombosis (DVT)
Changes in skin sensation, e.g., numbness
Contour irregularity (uneven skin)
Having to undergo another surgery to address these complications

Recovery

Body contouring produces immediate results in terms of your figure appear slimmer and tighter. However, the actual recovery process may take several months. In fact, it may take two years or more to see the final results.

During the first four weeks post-op, you are likely to feel sore. You need to adhere to the surgeon’s instructions and take care of your incisions properly. As the incisions heal, your pain, swelling, and other symptoms will go away (9).

For several days to a few weeks after the surgery, you will need to avoid lifting, bending, and straining. Patients who undergo abdominoplasty or other procedures involving the abdomen will need to avoid standing upright and sleeping with knees elevated by pillows.

How long do results last?

Results of body contouring procedures are meant to be long-lasting. That said, these procedures can’t prevent weight gain or increased body fat percentage. It's not uncommon for patients to think once they do the surgery, they're safe, but that's not how it works. To maintain results, you will need to adopt healthy lifestyle habits such as regular exercise and a well-balanced diet.

You also need to bear the natural aging process in mind. As you age, it’s natural to lose a bit of your body’s firmness. But you can expect most of your initial results and improvements to remain.

Nonsurgical fat reduction treatments

Besides surgery, nonsurgical body contouring is also available. They’re becoming increasingly popular for several reasons, such as:

Noninvasiveness
Practically no recovery
No incisions and bleeding
More affordable, in most cases
Easily accessible

Below, you can take a look at the most common nonsurgical body sculpting approaches.

Cryolipolysis

Cryolipolysis, or fat freezing, is a nonsurgical procedure whose main objective is to reduce fat with the help of cold temperatures. The procedure is most suitable for localized fat deposits that you were unable to remove through diet and exercise. Cryolipolysis, patented under the name CoolSculpting, is not intended for persons who are overweight or obese.

The FDA approved the procedure to treat fat deposits in areas such as:

Under the chin
Upper arms
Inner and outer thighs
Abdomen
Hip and flank (love handles)
Upper back
Lower back
Underneath the buttocks

During cryolipolysis, a patient is awake. The practitioner uses a handheld device (applicator) to freeze the layer of adipocytes (fat cells) underneath the skin. But first, they will apply a gel pad to the affected area to protect your skin.

What happens next is the suctioning or vacuuming of the fatty bulge into the applicator. During this time, you may feel a pulling or tugging sensation. You can expect these sensations to weaken in five to 10 minutes as the cooling process numbs the area. The target temperature to which the area is cooled ranges from 30.2°F to 39.2°F. Cold temperature injures the fat cells and triggers inflammation. As a result, those fat cells die (10).

The process of cryolipolysis may last up to an hour. You may need several sessions, but you can’t go undergo the second session within six to eight weeks after the first one (11).

Laser lipolysis

Laser lipolysis is a type of nonsurgical procedure that relies on laser energy to improve the shape and tone of your body. The procedure is suitable for persons who want to decrease localized fat bulges in the abdomen and flanks. On the other hand, it is not suitable for persons with loose skin or fat inside the abdomen, deep to the muscles.

Lasers use high temperatures to break apart the fat cells, thus decreasing the volume of fatty tissue. This process may also tighten the skin in the treated area. Laser lipolysis, also known as SculpSure, is not invasive. It takes about 12 weeks for the body’s lymphatic system to get rid of dead fat cells.

Each session is about 25 minutes long, but you may need multiple sessions for desired results. It’s not certain how long the results will last. Individual differences and expectations play a major role here (12).

Radiofrequency lipolysis

Radiofrequency lipolysis is also known under terms such as UltraShape and BTL Vanquish ME. It’s a nonsurgical procedure that uses ultrasound technology to contour the body. An ideal candidate for radiofrequency lipolysis is a person who wants to decrease localized fat bulges. If you have loose skin or poor tone, you may not be a suitable candidate.

During the procedure, which doesn’t require anesthesia, radiofrequency heat the fat. Here, the device doesn’t have physical contact with your skin. Instead, it heats the affected area from a 1cm distance. This heats fat cells, which are eventually destroyed (13).

A typical session lasts about an hour, and you may need several appointments to achieve desired results.

Injection lipolysis

Injection lipolysis, or Kybella, is a nonsurgical approach that uses a synthetic form of deoxycholic acid as an injection to disrupt fat cells and induce their death. Basically, deoxycholic acid is naturally produced by the body, and its purpose is to aid fat absorption. This chemical can kill fat cells, and the body gradually metabolizes them over a few weeks.

People who want to reduce fat under their chin are the most suitable candidates for injection lipolysis. You are not considered a good candidate if you have loose skin or poor tone (14).

While injection lipolysis usually doesn’t require anesthesia, it’s possible to get a local anesthetic.

A typical session lasts about 30 minutes, and several appointments are necessary to achieve optimal results.

Surgical vs. nonsurgical fat reduction: What’s best for you?

Saying one approach is better than the other would be wrong because they benefit people with different needs.

Body contouring surgery is more suitable for persons who have lost a lot of weight and have a great deal of excess skin (15).

On the flip side, nonsurgical approaches are more suitable for persons who want to remove a localized fat budge and do not have a lot of excess skin.

Therefore, the best approach for you depends on the amount of excess skin and your goals and expectations.

Conclusion

Body contouring surgery has become widely popular as more and more people turn to them in order to achieve the desired body goal. While exercise and diet help you slim down, you still may need more help to tighten your skin. Surgical approaches give immediate and long-lasting results but also come with longer recovery. They are more suitable for persons who have lost a significant amount of weight and have a lot of excess skin. Nonsurgical approaches are more accessible, require no downtime, less invasive, but may require several sessions. They are useful if you want subtle tweaks in specific areas.