Body contouring is the removal of excess fat and/or skin from the body to achieve a more natural or cosmetically desirable shape. Most body contouring is elective surgery done for cosmetic reasons. However, after massive weight loss of greater than 100 lbs. (45 kg), body-contouring surgery may be performed for hygienic or health reasons. Body contouring includes a number of different procedures, but as treated here excludes facial plastic surgery and breast reconstruction.
Abdominoplasty (also called a tummy tuck) is a procedure in which fat and skin are removed from the middle and lower abdomen and the abdominal muscles (rectus abdominis) are tightened, giving the individual a firmer abdomen. This procedure is often done on women whose abdominal muscles and skin have been stretched and lost elasticity due to multiple pregnancies. It is also done for purely cosmetic reasons to counteract the effects of aging. Occasionally, abdominoplasty is a medical necessity for individuals who have lost huge amounts of weight, usually as a result of bariatric surgery (gastric bypass or stomach stapling). In these individuals, the skin at peak weight became stretched to the point at which it will never be elastic enough to fit the new, smaller contour of the body after weight loss. Sometimes 25 pounds (11 kg) or more of skin will hang from the abdomen. This skin creates both psychological and physical problems. The creases of skin frequently develop rashes (suppurative intertrigo) and become infected. In addition, the abnormal body contour creates both practical problems in dressing and psychological problems related to appearance.
Flankoplasty and thigh lift or thighoplasty are similar procedures to remove excess fat and skin from sides of the abdomen and the thighs. These procedures are rarely done alone, but are sometimes done in conjunction with abdominoplasty.
Belt lipectomy is a surgical procedure often used to remove excess skin from the waist resulting from large weight losses. Especially in older individuals, once weight loss has been achieved, the skin around the waist develops extra folds like a deflated balloon. Belt lipectomy addresses this problem around the entire circumference of the body, removing the excess skin and lifting and tightening the muscles to produce a flatter abdomen, a better-defined waist, elevated buttocks, and tighter thighs. This gives the individual a more conventional body shape.
Brachioplasty removes excess skin from the inner portion of the upper arm. This procedure is done either after weight loss or to counteract the sagging effects of aging (ptosis).
Liposuction, or lipoplasty, is a body-contouring technique that is used either alone on small patches of fat or in conjunction with one of the other surgeries mentioned above to help shape and smooth the body. There are several different ways to perform liposuction, including suction-assisted liposuction (SAL), ultrasound-assisted lipoplasty (UAL), fluid injection lipoplasty, and tumescent liposuction. Each technique has advantages and disadvantages. The choice of technique depends on the doctor's preference, the location from which the fat is to be removed, the age and health of the individual, and the individual's cosmetic expectations. Liposuction is designed to be a tool to shape the body and is not a weight loss procedure. It removes fat but does not remove cellulite (reticular dermis).
Body contouring can be performed in a doctor's office, a freestanding surgical center, or a hospital. The choice of location depends on the extent of the surgery, the type of anesthesia used, and the age and health of the individual. Cosmetic body contouring is considered elective surgery and is almost never covered by health insurance; body contouring that is necessary because of major weight loss is sometimes covered.
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Source: Medical Disability Advisor