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Body Contouring

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Q: I am 35 and have had three children. Overall, I am very happy with my body, but I can’t seem to get rid of the loose skin and fullness of my tummy. What are my options?

A: It is important to be seen by a board-certified plastic surgeon to help you choose the best procedure to remove fat and excess skin from your abdomen area. When it comes to contouring and reshaping your body, there are a number of treatment options out there. During your consultation, you’ll be asked a series of questions about your desired goals, which can help your surgeon to determine the best treatment for you.

As is likely in your situation, after having three children, the abdominal muscles and skin are often stretched and will ultimately require a tummy tuck to return you to your pre-baby body. Some patients just have areas of unwanted or excess fat, without the associated skin or muscle laxity. Whether you only need to remove some unwanted fat from your stomach or tighten your entire tummy after pregnancy, here’s what you need to know about the differences between liposuction and a tummy tuck.

Traditional liposuction is a procedure in which an incision is made in the treatment area. A small tube known as a cannula is placed through the incision and used to break up fatty tissue. The fat is then suctioned out of the body, providing significant contouring to the treatment area. Although the results from liposuction can take up to six months to finalize, patients can see great results in four to eight weeks. Liposuction does not solve the problem of excess skin or muscle laxity, which is why some patients may want to opt for a tummy tuck.

In patients who undergo a full tummy tuck, the incision is made from hip to hip just over the pubic area. This results in a scar line that is horizontal and can be hidden when wearing undergarments. This technique allows the surgeon access to a large portion of the abdomen while repositioning the belly button so that its placement appears natural. Liposuction is performed to remove excess fat preceding the skin-tightening portion. The internal abdominal muscles are secured for a firm, toned appearance.

Q: I have been considering breast augmentation surgery for years, but I have no idea what implant size I should choose. What is your advice?

A: Successful aesthetic breast surgery, including breast implants, is all about a keen understanding of appropriate breast size and proportions. It is vital to take into consideration the overall body proportion, balancing the upper torso to the hips. It is equally important to consider the proportions of the individual breasts, in order to achieve for each patient their desired breast shape by choosing the appropriate breast implant.

During your consultation you will spend time trying on “sizer implants.” These can be tried on with a variety of tops and bathing suits, which will give you an idea of what your final results will be in a variety of clothing. Once the size of the implant is decided it’s important to take into consideration how the implant will be able to achieve the desired look. Through precise measurements of your breast dimensions, your surgeon will help you to choose the appropriate contour and profile of breast implant to achieve the shape of breast you seek. Implant manufacturers provide a wide array of implant shape and profile choices that help us to achieve the breast proportions each patient desires.

The majority of breast augmentation patients are looking to enhance the fullness of their breasts and to balance their upper and lower trunk. Individual preferences differ from wanting a rounder, fuller look on top, to having a more subtle, naturally shaped breast. Each patient has their individual idea of what proportion is best for them and therefore it is important to spend ample time during your consultation with your surgeon to choose the appropriate implant size. Other than choosing a well-trained, board-certified plastic surgeon, implant selection is the most important decision you will make regarding the surgery and will have the greatest impact on the ultimate result.

Written by: Dr. Nathan A. Kludt


Dr. Nathan A. Kludt, a Diplomate of the American Board of Plastic Surgery, received a BS from the University of California, Davis, with highest honors, and his MD from Eastern Virginia Medical School, where he was inducted into Alpha Omega Alpha, the National Medical Honor Society. He returned to UC Davis, where he completed his general surgery residency before being accepted into the plastic surgery program at UC Davis. Dr. Kludt has been published in the Annals of Plastic Surgery and Plastic and Reconstructive Surgery, and has presented at the California Society of Plastic Surgeons meetings and multiple other regional and national plastic surgery meetings. He is a member of the American Board of Plastic Surgery, the American Society of Plastic Surgeons, the California Society of Plastic Surgeons, the California Medical Society and the San Joaquin Medical Society.