3 body-contouring plastic surgery procedures to fight fat and loose skin

A close-up of a woman pinching the loose skin on the underside of her upper arm, demonstrating excess skin or lack of muscle tone. — Shape-changing procedures can help men and women feel more self-confident.

All of us want to look and feel our best. But even if you eat a healthy diet and exercise regularly, you might still have problem areas in which no amount of exercise can burn the fat or tighten loose skin.

Men and women in their 20s through 60s come to us with concerns about double-chins, love handles, or excess abdominal skin. They eat right and work out regularly, but it’s not enough to give them the look they want to feel confident among friends and colleagues.

Today, patients have options to reduce and smooth these problem areas. Over the last decade, seeking plastic surgery or nonsurgical solutions has become less taboo for men and women. In fact, the American Society for Aesthetic Plastic Surgery cites a 21.5% increase in plastic surgery procedures from 2014 to 2018.

Depending on your goal, three body-contouring procedures – liposuction, tummy tuck, and cool sculpting – can help you achieve the look you want. All three can deliver fast, long-lasting results if you’re willing to maintain a healthy diet and stay active.

1. Liposuction to target stubborn fat

Liposuction is a shape-changing procedure that removes fat from a specific area of the body. Patients can expect up to 50% to 70% fat removal in a treated area in some cases.

We can treat the following areas of the body with liposuction:

A woman proudly shows off a significantly looser pair of jeans, indicating weight loss.

Abdomen
Arms
Breasts
Buttocks
Chin
Hips
Legs
Neck
Thighs

How is liposuction performed?

We use the SAFE technique at UT Southwestern: separation, aspiration, and fat equalization. The surgeon will separate the fat cells from the skin tissue, then aspirate them with fluid. The infiltration phase increases the space in the area for better surgical access and adds a medication called epinephrine, which shrinks the blood vessels and reduces bleeding.

After fat removal, the surgeon will equally distribute the remaining fat cells in the area for a smooth, natural look. The SAFE technique does not use lasers or heat-based tools, which can damage or scar the surrounding tissue. We have used SAFE for the last decade – patients’ results are smoother and more predictable than any other methods I’ve used in my practice.

Recovery time depends on the type of liposuction you have and whether it's combined with another procedure. When performed by itself, it is typically an outpatient procedure. For small treatment areas like the neck, abdomen and or flanks, most patients can return to work within a few days and resume their normal activities within two weeks.

For larger treatment areas encompassing most of the trunk and extremities, patients may require more time off from work and a longer period of time to resume normal activities.

Can liposuction help with cellulite?

Many patients ask this question, and most don’t like the answer: Liposuction is not a recommended treatment for cellulite. In fact, there is no treatment that has been proven to eliminate cellulite.

Fat and cellulite are not the same thing. Fat accumulates under the skin, whereas the dimpled look of cellulite on the skin is caused by excess fat accumulation around the dense fibers that run between the skin and deeper tissues.

Cellulite is extremely common, affecting 8 0% to 90% of women. It can appear in men, though much less frequently. The buttocks and thighs are the most commonly affected areas. While there’s no one specific cause of cellulite, estrogen levels during a woman’s period can make it more noticeable, as can swelling in the affected area.

We have evaluated various products and procedures, like Cellulaze and Cellfina, which are expensive and don’t deliver what we’d consider successful results. Though some studies suggest treatment can improve cellulite, none have been shown to fully eliminate it. Our patients are not interested in paying several thousand dollars for something temporary; we want patients to be satisfied with their results, so we don’t recommend these therapies.

Consider liposuction if you:

Have large or multiple areas of excess fat
Can afford a more prolonged recovery
Want a one-time procedure (assuming you maintain a healthy weight after surgery)

2. Tummy tuck to tighten loose abdominal skin

Tummy tucks (abdominoplasty) target loose skin and diastasis, a condition that happens when the abdominal muscles don’t properly reshape after naturally separating during pregnancy. Diastasis can lead to a rounded appearance of the abdomen and in some cases, weak abdominal muscles.

We approach tummy tucks differently for male and female patients. Men tend to have less loose skin and more fat to remove, whereas women have more loose skin and diastasis with some fat to remove. Some patients have a combined tummy tuck-liposuction-diastasis as part of a “mommy makeover” procedure.

How is a tummy tuck performed?

Tummy tucks require an incision, the size of which will depend upon the amount of loose skin and the quality of the skin and muscle tissue. Some patients require a hip-to-hip incision, which we often can make below the bikini line.

Essentially, we pull the skin taut across the patient’s abdomen, remove excess skin and fat, repair the diastasis if necessary, and then close the incision. The result is a flatter abdomen and tighter-looking skin.

Recovery time varies depending on the size of the incision and the combination of procedures a patient chooses. Most tummy tucks require an overnight stay with return to activity and work after two weeks.

One thing to note: A tummy tuck with liposuction does not address metabolically active fat, which is found inside the abdomen, around the intestines and can cause a rounded belly appearance. More common in men, this type of fat cannot be eliminated with surgery – only through weight loss.

Consider a tummy tuck if you:

Have diastasis
Are bothered by loose skin on your abdomen after pregnancy or substantial weight loss
Want to take care of excess fat and loose skin in one procedure

3. CoolSculpting to diminish unwanted fat

CoolSculpting is an office-based treatment that targets only fat. Over two to three months, patients can expect a 15% to 20% reduction of fat in the treated area. There is no recovery time involved in CoolSculpting, but it does require a minimum of two treatments over a month. Each treatment can take one to three hours. Most patients see results within three months.

A person adjusts their belt on a pair of pants, illustrating weight gain or clothing discomfort.

A patient can receive CoolSculpting on the abdomen, back, side ("love handles"), underarms, thighs, and below the jawline ("double chin").

How is cool sculpting performed?

The plastic surgeon will target fat cells and crystallize (freeze) them using CoolSculpting technology. Over time, the fat cells die and the body naturally eliminates them. Results can be permanent if patients maintain a healthy lifestyle including exercise and eating habits.

Consider CoolSculpting if you:

Have a few small stubborn areas to deal with (such as a “double chin” or “love handles”)
Can’t afford to have a few weeks of downtime
Don’t mind coming in for multiple sessions over a few months

Who is and isn’t a good candidate for shape-changing procedures?

To safely undergo a body-contouring procedure, patients must be in generally good health. Patients with certain health concerns might not be eligible. Some of these issues include:

Smoking: We will not perform shape-changing procedures on patients who’ve smoked a month prior to surgery. Smoking increases the risk of complications during and after the procedure. Check out our tobacco cessation program now.
Heart conditions: Patients with high blood pressure or clotting disorders might be at risk for excessive bleeding or other cardiovascular issues.
Uncontrolled diabetes: Patients with diabetes might heal more slowly and are at increased risk for infection.

Patient safety is our No. 1 concern, so please ask questions and be honest with your surgeon about your health. The potential benefits of an elective procedure are not worth risking your safety.

UT Southwestern surgeons collaborate to offer conservative recommendations paired with contemporary procedures, cutting-edge technology, and the latest research. We perform all procedures in a fully regulated, hospital-based center with an anesthesiologist and specialized staff so each patient has a safe and personalized experience.

In December 2019, our Frisco practice will be moving into a conveniently located, state-of-the-art medical office building located at 12500 Dallas Parkway, just north of El Dorado Drive. UT Southwestern Frisco is part of a 20-acre medical campus that will offer patients streamlined access to other specialists, as well as pharmacy and laboratory services. Learn more.

Body contouring is personal

Each patient’s goals are as unique as their bodies. We consider every body-contouring procedure to be a 50/50 partnership between you and your surgeon.

One thing we stress to patients is that surgery alone will not get you where you want to be. We can remove or shrink fat cells during your procedure, but that doesn’t mean they’re going to be gone forever. Fat cells can return if you gain a significant amount of weight, so it’s important to maintain a healthy lifestyle after your procedure.

Everyone deserves to feel happy and confident in their own skin. If you don’t, consider scheduling a consultation with a plastic surgeon. We’ll talk through your goals and options to help you choose the most beneficial and cost-effective solution. Call 214-645-8300 or request an appointment online.