Body FAQs

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    When the fat cells are removed, it is critical that the surgeon creates a smooth contour.

    Creating this contour or figure for the patient requires the surgeon to remove fat to the right depth in both the area affected and all surrounding areas to avoid the pitfalls of dimpling. This can necessitate the use of multiple liposculpture techniques including tumescent and ultrasonic as well as many sizes of cannulae (instruments).

    In Liposculpture, the expertise of the surgeon is more important than any machine or method, as creating the right contour takes many years of experience.

    I was at the meeting where liposuction was first introduced by Dr. Illouz from Paris over 25 years ago and have enjoyed great success with these techniques for over two decades.

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    Liposculpture

    Yes, but there is a limit to how much fat can be removed. It is inadvisable to remove more than a total of 5000ccs at one time. This is because there would be too much trauma to the tissues with risks of fluid imbalance and the possibility of deep vein thrombosis (DVT) in the legs.

    It is no secret that the well-known Aussie beer gut is not a good look. Diet and exercise go a long way to helping get rid of it, but liposuction can offer a more rapid and predictable result. Liposuction for men generally includes the love handle area, the abdomen and sometimes the chest. The average male’s skin contracts better than women’s and skin etching techniques can define the six-pack, the pectorals and the waist area.

    If diet and exercise have failed to give you the shape you need, then you should not only keep up the good work but consider liposuction. I use the ultrasonic and power cannula techniques to refine the male torso. We have been delighted with the definition that can be achieved by using the newer operating procedures.

    This 40 year old male is a recent case shown here before and after liposuction.

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    Male Liposuction

    Many women gain weight on their hips and thighs during their teenage years. This if often related to genetics. The main contributor to later fat deposits is hormonal including pregnancies, menopause or HRT (hormone replacement therapy). Overeating is another contributor. We encourage a healthy diet and regular exercise but this is not enough for many patients. Treatment options include liposculpture, either with a traditional procedure or the newer ultrasonic method or for patients with more sagging skin around the abdomen, a “tummy tuck” may be more suitable.

    In some patients, particularly those with very large amounts of fat deposits or loose and sagging skin (possibly after a large weight loss) we may suggest a thigh or body lift. The scars from these procedures are extensive but generally tolerated in order to get rid of the large amount of excessive skin that accompanies dramatic weight loss.

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    Figure Liposculpture: hips, inner and outer thighs

    Despite diet and exercise sometimes those hips are near impossible to get rid of!

    Liposculpture is a highly effective procedure for a young woman like yourself who is fit and but still has pockets of fat that simply will not budge. The art in liposculpture, unlike simple liposuction, is not just to remove the pockets of fat but to sculpt a new figure for the patient.

    To achieve a new figure requires the surgeon to have an appreciation of the artistic modeling of the fat so that after skin retraction, visually appealing contours are revealed.

    Before and after 6 months, liposculpture to the hips, abdomen, buttocks, inner and outter thighs

    Before and after 6 months, liposculpture to the hips, abdomen, buttocks, inner and outter thighs by Dr Hodgkinson

    Liposuction is extremely effective for the love handle area. Men store fat in different areas to women and just like women, find these isolated pockets of fat hard to shift with diet and exercise. Liposuction, or the removal of fat cells, is ideal in such areas to restore or even improve a man’s physique.The major difference in liposculpture for men and women, is that in men the goal is to expose muscularity, whereas in women the emphasis is on creating sensuous curves. This procedure can be carried out as an outpatient at my licensed day surgery facility.

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    Before and after male liposculpture by Dr. Hodgkinson

    Male body-shaping is becoming more popular each year. To review some of Dr. Hodgkinson’s Liposuction cases, please check out our Patients’ Before and After Gallery.

    So many patients are coming to us now wanting liposculpture of their waist, hips and thighs to get back their figure so that they can fit into the summer fashions.

    Liposculpture to enhance your figure involves reshaping from the waist to the hips and thighs using the latest pneumatic and ultrasonic liposculpture cannulas. The procedure is carried out as an outpatient at my fully licensed facility, the Double Bay Day Surgery, under a light anaesthesia. Patients usually return to most activities and work within 7-10 days.

    No. Liposuction works on the deeper layer of fat, and cellulite is more superficial. Sadly, there are no truly effective treatments for cellulite.

    Maintaining a healthy lifestyle and avoiding weight fluctuations can help some people improve the appearance of cellulite.

    The compression garment helps reduce swelling for the first 24 hours and is essential to reduce serum loss into the tissue for the first few hours after the operation. It also helps flatten the tunnels caused by the removal of fat and rebinds the tissue into its new shape. After liposuction, swelling is normal and bruising will take two to three months to resolve.

    I recommend my patients wear the compression garment from four to six weeks to help the skin contract around the reshaped body.

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    Liposculpture of the outer and inner thigh

    A tummy tuck is an operation most commonly associated with women who have either or both skin on their abdomen that has not retracted after pregnancy or a tummy that is protuberant due to the muscles of the stomach being stretched out after pregnancy.

    The tummy tuck that is performed for patients who have lost a lot of weight, however, is somewhat different to the post-partem tummy tuck in that the incision is in a crease where the skin has previously hung down and is often similar to a low hanging belt.

    The skin only tummy tuck does not require repair of the abdominal wall muscles as does the operation for the patient who has had multiple pregnancies.  Hence, the post weight loss operation is less painful and is often performed in conjunction with liposuction in women to the hips and in men often to the love handle and man boob areas.

    The operation of the “tummy tuck” in the weight loss patient is an outpatient surgical procedure usually requiring approximately two and a half hours of surgery and the patient requires less postoperative restricted movements and management than does the post pregnancy patient.

    Before and After Tummy Tuck by Dr Hodgkinson

    Unfortunately after you have had children (especially large babies or multiple births) your stomach muscles may remain stretched, and while you can strengthen these muscles, no amount of exercise will shorten them.

    If you find the protuberance bothers you when wearing swimwear or fitted clothes, then a tummy tuck (abdominoplasty) can be an option to regain or even create a flat tummy.

    In fact, as an extra bonus with a tummy tuck the stretch marks on the skin are often also eliminated. Call us at the Clinic for details.

    Tummy-Tuck-before Tummy-Tuck-after

    Before and After Tummy Tuck by Dr Hodgkinson

    This is very common in women who have had a caesarian section. As time goes by the low scar may widen or look crooked and accentuate any bulging over it. The “tummy tuck” procedure (abdominoplasty) can be used here too. The scar can be revised and the abdominal muscles tightened to flatten your stomach.

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    Tummy Tuck (Abdominoplasty) by Dr Hodgkinson

     

    Yes!  Men do have tummy tucks.  Even though the abdominoplasty or “tummy tuck” procedure has been associated with the “Mummy Makeover” to deal with stretched skin or muscles after pregnancy, many men and women are looking at having abdominoplasties after weight loss.  Whether they lose the weight themselves or if the weight is lost after gastric surgery like “sleeving” or gastric bypass, a large amount of weight loss at any age can leave someone with loose skin.

    These festoons of skin can be anywhere on the body but the most common area of concern is the apron of skin that can be left around the abdomen.  Tummy tucks are highly successful for these patients and provide a high level of satisfaction.  The incision line can be made low and depending upon the amount of skin may be just in the front or all around the torso – circumferential.  When the incision is around the body the surgery is normally referred to as a “body lift”.  These skin lifts are less painful than the post pregnancy tummy tucks that often require the tightening of the muscles which have been stretched as well.

     

    Abdominoplasty Abdominoplasty

    Before and After Tummy Tuck by Dr Hodgkinson

    Excessive fat and/or skin in the upper arms can often be extremely embarrassing to many women, young and old.

    Another name for floppy arms is bat wings or tuckshop arms. The skin of the upper arm becomes very thin and fragile and does not contract quite as well after weight loss or liposuction.

    Sometimes the excessive skin in the arms causes such embarrassment that an arm plasty or brachioplasty can be performed.

    In this young woman of 23 years of age, I reduced the bat wings by the procedure of an arm plasty, carried out as an outpatient procedure at the Double Bay Day Surgery. The patient is now taking pleasure in wearing sleeveless dresses for the first time in several years.

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    Before and After Arm Reduction Surgery (Brachioplasty)

     

    The number one factor in whether or not you are a candidate for liposuction (reduction of fat alone) versus an arm lift (brachioplasty) or arm lift combined with liposuction is the quality of your skin. If your skin has lost elasticity, due to aging, weight loss or lifestyle and environmental factors such as smoking or excess sun exposure then liposuction is probably not for you as removal of the fat alone will most likely leave you with unsightly lose hanging skin.

    As a general guideline, generally younger patients up through their 30s who are not overweight and/or who have not lost a large amount of weight at any time in their lives may be candidates for liposculpture/liposuction alone to reshape their arms. Typically, these patients who have fullness in their upper arms have a genetic propensity to store fat in that area and may note that their parents or other relatives also have upper arms with a fuller shape than the average person. Some patients, especially the younger ones, may start with liposuction, even if it leaves some looseness, then later consider adding a brachioplasty when they have aged further and the need becomes more obvious and they are able to accept the incision lines that come with an arm lift.

    After surgery, the new tighter shape of your arms will become increasingly evident as the swelling and bruising subside. The scars where the incisions were made will remain but will become less evident and fade to some degree over time.

    The results of arm lift surgery can be long lasting, and the shape can be maintained to a great extent if the patient maintains a stable weight and fitness. Weight gain can lead to the arms gaining in size again and this in turn will stretch the skin and the result will be compromised.

    As with all surgeries, the procedure can set back the clock but as we continue to age, the skin will lose additional laxity and tone but if a stable weight in maintained, the overall shape of the arms will remain improved.

    As with all surgeries, following your surgeon’s post-operative instructions to the letter and refraining from smoking, excess consumption of alcohol and the use of recreational drugs or non-essential prescription medications are key to not only healing but the end result.

    Before and After Arm Reduction Surgery (Brachioplasty)

     

    Calf implants continue to be popular, especially in summer. Usually, women choose to have one implant on the inside of their leg to produce a nice curve below their knee, while men choose four implants – two implants in each leg – one on the inside and one on the out-side, to provide a much more bulked up appearance.

    A small incision is made at the back of the knee area in a crease in order to insert the implant. Careful planning is necessary and often patients undergo liposculpture at the same time.

    In the twenty years I have been performing this procedure, there have been very minimal complications and problems in these patients.

    Women who have had calf implantation are delighted to be able to wear a short skirts and men are much more comfortable about wearing shorts!

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    Before and After Calf Implants by Dr Hodgkinson

     

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    Aiache Square Calf Implant

    Calf implants are made of solid silicone.  Solid silicone implants used in plastic surgery come in a varieties of durometers or firmness as they are used to mimic a variety of tissues in the body from bone, to cartilage to muscle.  In the case of the calf implant they are intended to give the appearance of firm muscle tissue and hence have a greater durometer or one that would be firmer than gluteal (buttock) implants for example. Because these implants are solid they cannot rupture or leak like breast implants which need by the nature of breast tissue to be soft and are made of a shell filled typically with saline or silicone gel.

    Calf implants also come in a variety of shapes and sizes and are also side specific; their being a right calf implant and a left calf implant.  The sizing is critical as the implant must fit the contours of the individual patient’s leg(s) in length, width, and desired volume depending on the look the patient is trying to achieve.  Some patients, especially those who have one leg that is underdeveloped due to a disease like polio or trauma may be seeking only one implant to be sized and shaped to give a more symmetrical appearance to their legs.

    The expertise of the surgeon in this specific procedure as in all plastic surgical procedures is critical. The measurement, sizing, choice of implant are not only important but also the creation of the correct size of surgical pocket for the implant in the right position.  Too small a pocket can cause the implant to buckle and too large a pocket can allow the implant to move.  A pocket placed in the wrong position will not only render an unnatural look to the patient’s leg(s) but will compromise the ability for revision surgery and the potential to create a pocket that will securely hold the implant in its correct position.

    Calf implant surgery can render very pleasing results for the patient with withered or puny legs but it is a unique area of expertise in plastic surgery.  Make sure that your surgeon has a vast experience in this particular procedure before embarking on calf implant surgery.

    Calf implants if properly measured and surgically inserted can last a lifetime.  Dr Hodgkinson has up to a thirty year follow up on several patients whose implants are still in situ.  As calf implants are made of solid silicone, they do not rupture or leak.  The key to longevity is having the initial surgical pocket made exactly the right size and put in the correct place.  If the pocket is the right size then the implant can not rotate, move or buckle and if the pocket is in the right place then the calf implant will look natural and maintain its appearance.

     

    Before & After Insertion of Calf Implants (for previous club foot deformity) by Dr Hodgkinson

     

    Custom body implants are implants that are made specifically for the patient to camouflage their specific defect. The way that this is done is that Dr Hodgkinson in consultation with the patient assesses the defect and makes a plaster mould of the exact deficit that the patient is trying to mask. This mould is then sent off to a manufacturer in the United States who makes a solid silicone implant to match the exact dimensions of the required implant. The implant can be manufactured in various levels of hardness, called durometers, to mimic the tissue it is supposed to replicate muscle, bone etc.
    Areas and conditions for which Dr Hodgkinson has used custom body implants include:

    • Chest Wall Deformities
        Poland’s Syndrome
        Pectus Excavatum
        Pectus Carinatum
        Chest Asymmetry due to Scoliosis
    • Muscle Tears, Muscle Injury or Muscle Atrophy including Birth Defects
        Calf Implants (these can also be off the shelf if the sizing is appropriate)
        Pectoral Implants (these can also be off the shelf if the sizing is appropriate)
        Bicep Implants
        Tricep Implants
        Deltoid Implants
    Chest Wall Deformities
    Before & After Correction of Poland’s Syndrome with a Custom Chest Wall Implant by Dr Hodgkinson

     

    Custom body implants can be used to mimic the volume of the biceps and triceps muscles. Dr Hodgkinson has only used these implants where there is a marked asymmetry of the two sides due to a muscle injury or tear.

    Before & After Insertion of Custom Triceps Implant by Dr Hodgkinson

    There are no manufactured deltoid implants.  These are custom made body implants which must be made specifically to meet the need of the patient and to fit their defect.  These cases are uncommon, however, due to Dr Hodgkinson’s reputation for custom body implants and over thirty years experience in customising implants for patients with muscular injuries, defects and atrophy, he has had to opportunity to treat a few of these patients with deltoid injuries with custom solid silicone implants and achieve excellent results.

    Before and After Custom Deltoid Implant by Dr Hodgkinson

    Everyone has a bottom of course but some people have a flat bottom with no shape or a very small bottom. A fuller bottom can give a woman a more feminine shape.

    We also do implants on men—in men, a “flat butt” is an ageing butt. Implants can make the male buttocks look more in proportion with the rest of the body, especially if they have been exercising and building up the upper body.

    The three main groups of patients I do are South American women with flat bottoms, Chinese women with small bottoms and gay male patients.

    Some doctors have used injections of fat but the results can be quite unpredictable. I use implants made from solid silicone or cohesive gel. They come in either round or lozenge shape and in various sizes. The implant is inserted deep underneath the main muscle—the gluteus muscle (glute) via a small incision between the cheeks and the muscle.

    The number of women seeking buttock implants is definitely increasing, particularly since the popularity of the American Latino singer, Jennifer Lopez. The pioneers of buttock implants were actually the South Americans, particularly the Brazilians and the Mexicans, where culturally generous buttocks are more popular than breast enhancement.

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    Before and After Buttock Implants by Dr Hodgkinson