Mark Edinburg, MBBCH, FRACS (retired)

Hello and thank you for your question.

Liposuction is still the gold standard for removing fat, particularly if it is not confined to a small pocket. Having said that, at my clinic in Sydney, I looked for a long time for a reputable and scientifically based non-surgical fat reduction system, so that I have a medical-grade option(there are so many 'fluff' options on the market) to offer those patients who were unwilling to go to liposuction and willing to accept the differences. And we have had great results and many happy patients.

So, in your case, I would probably suggest that you consult with a board certified Plastic Surgeon(in Australia we use the term 'Specialist Plastic Surgeon') who has experience with both. That way, you can hear about your options, and be in a better place to make decisions about your treatment, together with your surgeon.

I hope this has helped.

Mark

Hello, and thank you for your question.

Briefly, liposuction address the excess fat issue, but does nothing for the loose skin causing the sag or apron effect- that is where the tummy tuck comes in. In my many years experience as a Specialist Plastic Surgeon, I have usually add a small amount of liposuction to all tummy-tucks, as quite simply, everyone needing a tummy tuck usually has some excess fat as well. And also, even though various procedures. like liposuction alone, or non-surgical Fat-freezing(CoolSculpting) may result in a some skin tightening after the fat and resulting bulge on the skin has been removed, this is fairly small, and if you have a lot of excess skin and skin laxity, then surgery will be needed to address this. That skin sag is not going to bounce back by itself- a tummy tuck will most likely be necessary.

I must stress that, until you and your Plastic Surgeon get to meet, and he can do a thorough and detailed examination, and listen to what concerns you and what you are trying to achieve, you cannot get a realistic list of options that may or may not be appropriate for you. People are so different in their anatomy and concerns and expectations. I find once I sit down and talk with my patients and explain what the advantages and disadvantages are for different options, and specific for that particular patient, then patients feel much better equipped to make decisions.

Hello, and thank you for your question.

By now it is probably obvious to you that this is not the usual tummy tuck presentation, and you can see there is some divergence of opinion about what exactly would work for you.

Although you have sent photos, I cannot stress strongly enough how important the physical examination is. There are lots of components that will help your surgeon to arrive at an options list for you. Then the 2 of you can discuss together the advantages or disadvantages of the different options.

You want to look great, and you want to be safe, and you want to consider not doing anything that will be detrimental in for your lifestyle and in the future, like having kids.

So, I'd suggest consult with an experienced Board Certified Plastic Surgeon. I always feel establishing a good communication style with my patients is essential, so that we are both 'on the same page' when we discuss your options and what is likely to help you.

And, by the way, well done for the weight loss. Your body will love you for it.

Hope that helps.

Mark

To give you perspective, I am a Plastic Surgeon and I have a number of surgeries available to treat my patients' concerns with areas of fat. However I could not find a non-surgical option that might work for some of those patients who were not candidates, for a number of reasons, for liposuction and/or tummy tuck or other appropriate surgeries. I looked for years for a product that was available that has credible research and technology to support it. And CoolSculpting has been a very useful addition to my practice.  Pathophysiology is why only the fat cells are affected by the cold. I don't find a difference in results of fat or thin people- its more about the area you are treating(will reducing the fat benefit you is the question 

We have 2 machines (mainly so that we can treat 2 areas, or left and right at the same time). As long as the assessment is done by someone professional(I only employ registered nurses in my clinic, not non-medical personnel), and as long as the treatment is carried out by a credible practice, I think your results should be great. I recommend a Plastic surgeon in your home town. That way you are speaking to a practice that deals with, and advise on, many different aspects of cosmetic surgery from a specialist's perspective. And they can advise if this is indeed the most appropriate treatment for your situation.

I have been using CoolSculting for over 3 years in my clinic in Sydney Australia, with really outstanding results. We have no patients with long term problems. Their results have been well maintained(as long as they don't put on weight obviously). Lumpy is not a result of the reduction in the fat, but can occur due to the size and shape of the applicators leaving an area untreated. An experienced appropriately trained and skill therapist should be able to allow for this in planning.

And of course, be realistic in your expectations. Speak to your therapist about this.

And finally, beware of cheaper imitations. As with many cases, there is a often a reason they are cheaper that is not good for you and the professional outcome! It's your body.

I hope I have helped.

Mark

Hello and thanks for your question.

The story you tell, and the picture you paint, is typical of many people I see at consultation. Men and women. That saggyness you describe will require a tummy tuck(abdominoplasty). There is no other way to get rid of both the skin and underneath layers of sagging. In my practice, I tend to include a small of abdominal liposuction as a part of my surgery to target the fat sitting there.

This problem varies from patient to patient in the way it presents, how you body looks, and how it affects your lifestyle. I recommend you consult with a board-certified Plastic Surgeon (we use the term 'Specialist Plastic Surgeon' here is Australia). This gives you the opportunity to discuss your individual concerns with someone who is a Specialist in this field, who can advise you of what options are practical for you. The you can both arrive at a treatment plan together.

In my practice, I find that communication between my patient and I helps set expectations that are realistic, and sets the stage for happy fulfilled patients. So many patients report that their lives have been so improved by having this surgery.

I hope I have helped and wish you well.

Mark