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Body Contour Surgery

Sydney plastic surgeon Dr. Darryl Hodgkinson explains procedures to contour the body.

Without specific body contour surgery skills, plastic surgeons are limited in what they can offer. Patients present with such a wide variety of problems concerning their body in a varied age range.

Body Contour Surgery encompasses 4 different surgical manoeuvres:

  1. Resection of loose skin.
  2. Suctioning of excess fat.
  3. Tightening of loose muscles.
  4. Augmentation of deficient muscle.

Resection of loose skin has recently gained media attention with the “body lifts”. There are however, well established techniques of surgical excision and lifting including abdominoplasty, thigh plasty, flank plasty and buttock plasty. The South American surgeons have been particularly active in these areas.

Advances in body lifting have occurred in the understanding of how to extend the skin without undue tension and hence without such a high risk of poor scarring.

Before liposuction by 
Dr Hodgkinson
After liposuction by 
Dr Hodgkinson

The Artistic Rendering of Form By Surgical Techniques

Alberti in the early 15th century outlined the 3 essentials to drawing the figure – the outline, the composition and the colour.

Similarly, to shape the body, an understanding of the figure or contour for composition or internal modelling proffered by liposculpture and colour is required in addition to appreciating the subtle shadowing of the body achieved by defining the most attractive skeleton and muscular components of shape

The skeletal muscular and fatty components of a patient’s body must be evaluated and the surgical manipulations made to improve the shape or figure. Internal modelling by traditional, ultrasonic and pneumatic liposculpture contribute to reform the figure from within. Skin contracture needs to occur to establish the outline (“the figure”). To this end, efforts to pressure the skin with garments or massage, both manual and mechanised as well as surgical skin resection are applied to establish a more taut, smooth shape. In males, the final result must expose muscularity, whereas in females, the emphasis is on sensuous curves. Although there have been significant advances in technology, the limitations or restrictions depend on the volume of fat that can be removed, the underlying muscular and skeletalcomponent of shape and the surgeon’s artistic appreciation of the female figure (“the arabesque line”) and the male muscular body.

Thigh plasty

Many women complain of loose skin in the upper inner thighs. Thigh plasty initially described by Dr Ivo Pitanguy from Rio de Janeiro was accompanied by poor scarring. Advances made in the late 1980s particularly emphasise deeper suspension and stronger suspension of the tissues. Dr Ted Lockwood and I described these techniques which produced more predictable scarring with a lesser risk of scar migration.