BODY CONTOURING SURGERY , LIPOSUCTION , FAT REMOVAL , ABDOMINOPLASTY,


BODY CONTOURING COSMETIC SURGERY BY DR CHOUT : Liposuction, liposculpture, bad fat removal, transfer, lipofilling , tummy tuck reviews...



Video testimonial of a liposuction and fat transfer lipofilling with subcision to treat cellulite dimples, by dr Philippe Chout Paris.

This 25 years old lady was annoyed by her cellulite and stuborn fat. She benefited from a liposuction and liposculpture with fat transfer to thte buttocks. The cellulite dimples were efficiently treated by subcision plus fat transfer. r


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Video of liposuction of the abdomen sides and hips and fat transfer to the buttocks on a 25 years old lady.


This 25 years old lady was annoyed by her cellulite and stuborn fat. She benefited from a liposuction and liposculpture with fat transfer to thte buttocks. The cellulite dimples were treated by subcision plus fat transfer.



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LIPOSUCTION / LIPOSCULPTURE


Liposuction is a procedure to remove permanently the excess fat adipose tissue, i.e., the deep, thick deposits of fat forming a thick subcutaneous layer that modify the body outline, such as for example on hips, abdomen or thighs “jodhpur thighs “. It cannot treat or eliminate alone the dimples of cellulite the “ peau d’orange” aspect (pigskin oedema) of the skin, which corresponds to real cellulites, neither the stretch marks nor rippling skin. Best results are obtained on rather slim women who are embarrassed by two or three moderate localised stubborn fat deposits, particularly when her weight is stabilized or after she has lost 2 – 3kgs. Liposuction does not give good results when important dietary problems exist, and is not a treatment for obesity or bulimia of which treatment is a drastic change in nutrition habits.

If the excess of fat is fairly moderate and localised to one area, surgery is performed under local anaesthesia after the patient has been given oral sedatives. In this case, the patient enters the clinic early in the afternoon and leaves three hours after surgery. In case of larger fat deposits general anaesthesia or epidural block is preferred and will require 24 – 48 hours hospitalisation. Pre and post-operative pictures of the patient’s body contours in varied position are always taken.

Before the liposcuction during the consultations the surgeon will appraise the fat layer thickness by palpation, and draws on your body a series of guidelines around the areas to be reduced (pre-op marking), as evidenced by touching and observation f the naked body parts in various lights and position, and marks the position of short incisions, which average 7 mm. Some pictures will be taken. The tumescent technique principle of the surgical procedure is to infiltrate the fat layers in order to magnify them with adrenaline plus saline (tumescent technique) and suck subcutaneous fat through multiple thin tunnels made by the suction tubes and vacuum. The thinner the canula tubes, the more uniform the result. It is advisable to use number 2 and 3 canulas with inner diameter of respectively 2 and 3 mm. After surgery, the skin rewrapped itself to the new underlying volume, results being obviously better on a young and elastic skin. An older or slackened skin, as can be seen after thirty five may require further surgery to smooth out the skin by cutaneous resection, under tension; this is called dermolipectomy.

After liposuction surgery, postoperative swelling and bruising masks the final results for six weeks. Do not expect to look any thinner before 6 weeks! The patient must wear a tight girdle (day and night) for 4 weeks, in order to compress he operated areas and to eliminate the oedema. You may buy this compression garment . Results become visible after 60 days and totally achieved after 6 month depending on the treated areas. Obviously result can be discussed only if the patient did not put any weight back on due to improper food regimen. If the patient put weight back on due to improper food regimen (final weight above the initial weight minus the weight of fat removed) then no comment or claim is receivable. No retouching is due to the patient either unless her final weight is appropriate. Bruising and swelling, soreness or pain (ecchymosed, and oedema) are normal and usual after this type of surgery they will stay during a few weeks. The swelling will hide the results during four weeks. The final result is appraised only after three months. Oral prescription of arnica and local applications of Arnica help accelerate bruising desorption. Massaging with almond oil after one month is also very helpful. Painkillers are administered over the first few days to reduce pain and discomfort. The patient can usually resume work after a week and training (gym) after three weeks.


Complications are rare This operation is one of the most frequently performed. The complacations are rare such as bleeding, lymphorrhagia, lymph oedema, liquid oozing, haemorrhaging, anaemia, transfusion, infections, abscess, MRSA, scar contracture, or hypertrophic scars. An asymmetry, and surface irregularities such as some bulges, dents, rippling or hollow or waves are possible if poor skin quality, most often after thirty years old. One must also remember other possible complications: cardiovascular complications, respiratory or immunologic, related to the used medications, are extremely rarely lethal or invalidating with anesthesia, they can evolve unto themselves.


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FAT TRANSFER / Lipo-filling in general


This is the most important surgical innovation in the last ten years. Fat can be used as natural filler. When the technique is good , it can last up to 7 to 10 years. Fat removed by liposuction can be processed purified, filtered by centrifugation and used to fill in a hollow cavity in the buttocks ( buttocks augmentation or in the face. Fat transfer to the face can help to reduce the appearance of nasolabial folds, increase cheekbone area volume, improve hollowed under eyes area (tear through) increase or smooth chin projection and therefore create a more chiselled look (model look). For a limited area, this procedure can be performed under local anaesthetic plus a light sedation as a day case.

Fat can also help to increase the volume and height of the buttock when injected in, or below the muscle. This operation is called a Buttock Lift. The quality of the result is limited though by the amount and quality of the fat that the Surgeon will harvest. In order to get a visible buttock improvement the amount of fat transferred must be at least 200 cc). In order to have 200cc to inject after processing, the Doctor must harvest 800 to 1000 cc in the first place. Re-injection is made through a small incision, or without incisions just with a needle. This allograft is called lipofilling. As only 75 % to 80% of the injected fat remains in place permanently (in the best case scenario), the defect must be over-corrected by 10-20 % if enough fat tissue is available. Otherwise an additional lipofilling procedure will be required later at the patient’s expenses.

After the fat transfer :On the other hand, postoperative oedema, which is often spectacular for about two months, will temporarily mask results, due to transitory local swelling. One must be patient and realise that 10-15% of the injected volume will eventually disappear. The good side is that “what will stay after three months will stay permanently”. The patient must be aware of this usual delayed evolution, and must inform the partner and relatives as well as take the appropriate work arrangements. Otherwise results are often long lasting between five and ten years. The fat do not migrate: it will stay where it was injected. The desorption is local.

Complications are very rare, such as failure of the graft with total disappearance of the injected volume, asymmetry, lymphorrhagia, swelling, granuloma with visible dent or elevation, infection, swelling for several months, protracted oedema, scar. One must also remember the possible complications of liposuction and anaesthesia. To sum up, lipo-filling is an elegant and natural way to fill up unwanted, poorly aesthetic hollow cavities or other lack of volume. Results are appraised after the 3rd month, because swelling may occur initially at the injection site. The social appearance is usually possible as early as one week after the operation. The volume gained that will stay after three months will stay permanently.



Video Review Dr. Philippe Chout before/after liposuction and fat transfer video testimonial.


Body contouring. This 35 year old Lady, benefited from liposuction to the abdomen and hips and fat transfer to the buttocks.

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The body contouring operation brought harmony to the body with a better fat distribution


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Photos and video of Liposuction surgery results. Fat transfer to the buttocks Brazilian buttlift





This thirty years old ordinary Lady obtained a Slim & elegantly tone and Body revealed after a liposculpture to the abdomen, sides and hips surgery by Dr Philippe Chout.


COMBINATION : SUBCISION + LIPOFILLING + MACROLANE INJECTIONS


: Here is a very nice result of Cellulite treatment combining lipofilling and Macrolane injections done in the consultation room 15 minutes before the photos were taken bad looking cellulite dimples on the buttocks and back of the thighs, flat buttocks, and muffin top hips


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IMMEDIATELY AFTER: A NEAT SHAPED BUTTOCKS AND NO MORE CELLULITE

(the blue colour is the recent marking of the pen, and white is the local anaesthetic that will disappear within 30 minutes


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BEFORE BELOW : CELLULITE dimples on the buttocks and back of the thighs, plus muffin top fat deposit on the hips


AFTER: NEAT SHAPE AND NO MORE CELLULITE ( the blue is the recent marking of the pen, and white is the local anaesthetic that will disappeare within 30 minutes


Liposculpture n  subcicion lipofilling  Dr  Philippe Chout

This 43 years old Lady became very good-looking and self confident thanks to the combination of the liposcumpture that removed the fat bulges on the hips and shaped the buttocks, plus the subcision and lipofilling of cellulite dimples completed by the Macrolane injections. This does mean that in BKINI OR LINGERIE ANY 40 YEARS OLD WOMAN CAN LOOK AS GOOG AS A 25 YEARS OLD LADY.

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Photos and video of Liposuction surgery results. Visit Liposuction page to see the Videos.


Résult of a body contouring surgery , this Body design removed the fat from the abdomen sides and hips , and revaled the slim and tone body of thei 30 year old Lady

Video liposuction to treat love-handles on a man by Dr. Philippe Chout .



Lipoaspiration : liposuction procedure is efficient to trat love handle stuborn fat on a male patients.



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ABDOMNINOPLASTY TUMMY TUCK / THIGH LIFT / ARM LIFT IN GENERAL


When there exists an excess of skin, in addition to an excess of fatty tissue– for example on the abdomen or thighs – a simultaneous resection of the loose and wrinkly skin and of the fatty tissue may be detachment, and post-operative follow-up is not as simple as after liposuction. Either half of the skin unit below the belly button is removed (thin women) or the whole unit is removed with a larger undermining, a larger scar, some work on the deep muscles as well, more pain, a longer recovery. It means that a large incision will be done from one hips to the other and will leave a permanent scar and a permanent numbness above the scar. All the possible complications of the lipo can be seen after that procedure and are even more frequent.

Complications of abdominal dermolipectomy can include haemorrhaging protracted lymphorrhagia, seroma, leakage of lymph, poor scarring, infection, Scar disunion, delayed healing making repeated dressing by nurses necessary, deep vein thrombosis, thrombophlebitis with a risk of pulmonary embolism and cardiovascular failure.
There is always an inflammatory period for the scar between the 1st and the 4th months, during which unpredictably pigmentation of the scar may occur. The final scar is most often thin but may become red , elevated, and noticeable. The loss of sensitivity above the scar area is usual. It is not a complication but an unavoidable consequence of a large skin removal. Dermolipectomy of the large women will require at least four weeks of absence from work and recovery. A retouching maybe required to improve the final appearance of the scar and skin. The signature below indicates that the patient has read and consented to the information given on this page and the preceding pages, has accepted all the conditions stated above and all risks and precautions and is aware of and accepts the limitation of results.

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AFTER THE PREGNANCIES HOW TO HAVE A BEAUTYFUL BODY AND FEEL SELF CONFIDENT AGAIN




This 39 year old lady benefited from a Mommy tuck after three pregnancies. I did perform in two stages a tummy tuck abdominoplasty, a breast augmentation and mastopexy with silicon implants and a fat tranfer to the buttocks. The tummy tuck scar is placed very low in order to allow the Lady to feel comfortabel and attractive in Bikini and lingerie. The bodyshape obtained is good looking and attractive. This 39 years old Lady feels self confident again.



This 39 years old Mother of three children, benefited after three pregnancies from mommy make-over.
The combination in two stages of a tummy tuck abdominoplasty, a liposculpture with fat removed to the abdomen and hips, and fat transfer to the buttocks, and a breast up-lift and implant replacement augmentation. She became much more self-confident is now looking very good in a swimming costume...



ABDOMINOPLASTY : Tummy Tuck operation


Abdominoplasty, commonly called a "tummy tuck", is an operation to remove excess fat and skin from the abdomen = dermolipectomy. The surgeon may also tighten the tummy muscles.


The aim is to produce a tighter, flatter stomach and waist and it may partially reduce the appearance of stretch marks. The Tummy tuck procedure does not include a liposuction but this can be combined with the tummy tuck operation, either of the abdomen alone or of a different or multiple areas. In such a case the cost of each other will be added.

Why have a tummy tuck ?

Typically you need a tummy tuck when an excess of skin with bulges and rippling is visible or obvious when you seat down. The reasons why someone may choose to have a tummy tuck include having excess skin, stretch marks or loose abdominal muscles which may happen after: -Losing a lot of weight through dieting and exercise
- After Pregnancy
- Successful gastric surgery to treat obesity
A tummy tuck is not a treatment for weight control and is not a substitute for regular physical activity and a healthy balanced diet.

What are the alternatives ?
For some people, an alternative is liposuction (or liposculpture), where fat is sucked out through small holes in the skin, but if the skin is very loose it will remain loose and rippling. The liposuction alone is therefore not a real alternative but is rather a treatment for the less unfortunate if the skin is of a good quality, without stretch marks or looseness. For more information, please see the separate fact sheet on Liposuction. Many creams, diet supplements and beauty treatments claim to reduce stubborn areas of fat and even cellulite. However, there is no scientific proof that they work.

What happens before a tummy tuck ? It is important to discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect. The surgeon will discuss how to prepare for your operation. For example, you may be asked to :

• Lose weight if you are overweight - a tummy tuck gives the best results in people who are the correct weight for their height.
• Stop taking the contraceptive pill six weeks before surgery and use an alternative method of contraception as this reduces the risk of blood clotting (thrombosis) after the operation.
• Give up or cut down on smoking - smoking increases the risk of chest infection and slows the healing of wounds.

What should I expect in hospital ? Most people stay in hospital for one to three days.
Your surgeon and anaesthetist will visit you before the operation. This is a good time to ask any questions about the operation. Your surgeon may draw on your tummy to mark the operation site.You may also be measured for an elastic garment to wear around your tummy for the first month after the operation, to reduce swelling.

The Tummy tuck abdominoplasty operation


The operation is performed under general anaesthetic, which means that you will be asleep throughout the procedure and will feel no pain. Typically, you must not eat or drink for about seven hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand. During a tummy tuck, the surgeon will do a large and long incision and removes excess fat and skin from the lower tummy and if necessary, tightens the muscles of the abdomen. Liposuction may be carried out in the same operation. The amount of skin to be removed can be specifically tailored to your needs and the extent of the undermining (detachment) as well. The lesser the undermining and detachment the better and shorter will be the recovery. It is not always needed to cut the belly button. If needed (in the large tummy tuck) you will be left with a scar around the tummy button (which will often be moved to a higher position) and a long scar along the bikini line, which can usually be hidden within your large underwear.
A diagram showing the abdominoplasty incisions and scar lines

After the operation When you wake up after the operation you will find a drip in your arm. This is to give you fluid while you can't eat and drink. There will be a drainage tube in each side of your lower tummy to drain any blood or watery liquid that collects from the operation site. These drains are usually removed a few days after surgery. You may also be wearing anti-thrombosis compression stockings to help the circulation in your legs and help prevent blood clots forming (deep vein thrombosis or DVT). Your doctor or nurse will give you painkilling tablets or injections to reduce any pain that you have after the operation. For the first few days, you will be asked to keep your knees and hips bent when you sleep at night to reduce strain on your stitches. Stitches in your skin will normally be removed in five to seven days and deeper stitches closing the operation site may be taken out two to three weeks after surgery.

Recovering after a tummy tuck The shorter the undermining and detachment the shorter will be the recovery. For a large full-blown tummy tuck in general, healing can be slow, particularly in the central part of the operation site and sometimes dressings and liquid (lymph) removal are needed for a few weeks. You may experience some tightness around the operation site, but this is more common in patients who are overweight and who smoke. You should try to be careful not to strain or stretch the operation site when you first get home as this will increase fluid accumulation and reduce healing. As soon as you feel able, you should try to walk a little each day. This will also help to prevent a chest infection, and blood clots forming in your legs. You may find that wearing an elastic garment helps to reduce the swelling and makes you feel more comfortable in the first month. Most people are able to return to work between two to four weeks after the operation, but vigorous exercise is not recommended for at least six weeks.

Deciding on treatment
It's important not to rush into the decision to have a cosmetic operation. And it's sensible to discuss the issue with your GP. A tummy tuck is a commonly performed and generally safe surgical procedure. For most people, the benefits in terms of improved appearance are greater than any disadvantages. However, in order to give informed consent, you need to be aware of the possible side effects and the risk of complications. Side effects are the unwanted but mostly temporary effects of a successful procedure. For example, feeling sick as a result of the general anaesthetic. Anyone having a tummy tuck can also expect that :
-There will be swelling, which may not completely settle for a few months.
-The incisions will leave permanent scars, which will be pink and noticeable at first.
You should become finer and less noticeable after a few weeks.
The final appearance of scar is not totally predictable.


COMPLICATIONS

Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. The main complications of any operation are bleeding during or soon after the procedure, infection and an abnormal reaction to the anaesthetic. It's also possible for a blood clot to develop in a vein in the legs (deep vein thrombosis or DVT).

Specific complications of a tummy tuck are uncommon but can include those listed below.
Numbness in the lower part of the tummy which often reduces over the next 6 to 12 months following the operation but is often permanent.
- Poor healing, which results in noticeable scars, may mean you need more surgery.
- Final position of the tummy button may be off-centre.
- Bleeding can occur under the skin, causing the area to swell and become painful. This is called a haematoma. Sometimes it is necessary to return to theatre to stop the bleeding, remove the blood and help avoid infection.
Other serious complications of tummy tuck operations are rare. They include the following.

-The formation of fat or blood clots in the blood vessels this is called deep vein thrombosis. These can break off and move to the lungs. This is called a pulmonary embolism and can be life-threatening. Complications of the tummy tuck dermolipectomy can include haemorrhaging haematoma, protracted lymphorrhagia, leakage of lymph, infection, wound disunion, delayed healing making repeated dressing by nurses necessary, deep vein thrombosis, thrombophlebitis with a risk of lethal pulmonary embolism and cardiovascular failure. It could also involve deep organs, herniation, occlusion, deep organ perforation, peritonitis, infection, Mrsa, allergy ,necrosis’s, delayed scarring.
There is always an inflammatory period for the scar between the 1st and the 4th months, during which unpredictably pigmentation of the scar may occur. The loss of sensitivity above the scar area is usual. It is not a complication but an unavoidable consequence of a large skin removal.
While the short tummy tuck recovery can be two to three weeks the large tummy tuck with extended dermolipectomy and undermining will require at least four weeks of absence from work and for recovery. The chance of complications depends on the exact type of procedure that is being performed and other factors such as your general health. Your surgeon will be able to explain how the risks apply to you.

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The result of a tummy tuck and breast augmentation on a 40 years old Lady

The result of a tummy tuck and breast augmentation on a 40 years old lady , mother of three children. The tummy tuck scar is easily hidden in the panty.

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