Dr. Guy says that external ultrasound devices


“Body contouring is reshaping the body surgically through various


procedures, including abdominoplasty (tummy tuck), breast augmentation (enlargement) or reduction, liposuction or lifting procedures, such as upper-arm lifts, breast lifts, thigh, buttock or torso (central body) lifts. The procedures also are often combined with one another.”


– Dr. Roxanne Guy, founder Brevard Plastic Surgery and Skin Treatment Center


are being developed for fat “blasting,” while fat-freezing devices, such as Zeltiq, are being used to treat small areas of excess fat. Laser-body contouring, another alternative


to traditional liposuction, has been heavily marketed because it allows the patient to stay awake during the procedure using what is known as “tumescent” anesthesia. “This is injection of fluid which contains local anesthetic medicine and a blood vessel constricting medicine into the areas to be suctioned. Small areas can be safely suctioned at one time,” says Dr. Guy. But as with all liposuction techniques, the


Dr. Guy, who has practiced cosmetic surgery


for 26 years, is the founder of Brevard Plastic Surgery and Skin Treatment Center in Melbourne, and previously held the position of president of the American Society of Plastic Surgeons. She performs more than 100 various body contouring procedures each year.


BREAST & BODY IMPROVEMENTS


One of the most commonly requested body contouring procedures of Dr. Guy, and many cosmetic surgeons in general, is liposuction. In 2010, over 203,000 liposuction procedures were performed in the U.S., according to the American Society of Plastic Surgeons. While the traditional procedure, which is still


widely performed, uses a cannula to vacuum layers of fat, evolved techniques are now being adopted by more and more plastic surgeons. For example, Dr. Guy performs ultrasound-assisted liposuction, a cutting-edge technique that uses ultrasonic energy to liquefy fat before it is removed. The surgeon explains that the best candidates


for liposuction are those with “diet resistant” fat, or fat that is genetic, or doesn’t respond well to diet or exercise. While these people are not obese, they normally have certain areas – such as “love handles” on men, or “belly pooches” or outer- thigh “saddle bags” on women – that carry more fat than the rest of their body. “Since liposuction should not be a treatment for actual obesity, the surgery should be contemplated for someone who also is committed to a reasonably healthy diet and exercise regimen,” she says. Tummy tucks, in contrast, are appropriate


for those who have undergone major weight gain and loss, either due to pregnancy or other circumstances, and have excess skin that has lost its elasticity, thus resists tightening altogether despite diet and exercise. For these people, the best body contouring course of action is to “excise as much of this loose and damaged skin (usually in the abdominal region) as possible,” according to Dr. Guy.


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important variable is not the cannula, but the practitioner who is wielding the cannula. So, before undergoing any type of body contouring procedure, it is recommended that each patient ensure their doctor is board certified by the American Board of Plastic Surgery. Above all, however, use common sense. “If


Dr. Roxanne Guy discusses with a patient the latest body contouring techniques, and the appropriate surgery for her needs.


Taking the tummy tuck procedure another step


further, body lifts, which combine a tummy tuck with a lateral thigh and buttock lift, can benefit patients who have sagging skin all the way around their body, also usually after weight loss. “Mommy makeovers,” another popular combination body contouring procedure, is usually a combination of breast surgery and abdominal tightening surgery to restore contours which have changed in these areas after pregnancy. A typical “mommy makeover” would involve


a breast augmentation to put back the volume lost after pregnancy and breast feeding, plus a tummy tuck to re-tighten the skin of the lower abdomen. Liposuction of the torso might be added to provide optimal contour, if necessary. And if needed, a breast lift (or mastopexy) may also be added to the breast enlargement to make the breasts “perky” again.


THE FUTURE OF BODY CONTOURING As body contouring evolves, minimally and non-


invasive devices are gaining popularity, especially for smaller treatment areas. Treatments that involve laser, ultrasound, radio-frequency and fat-freezing devices are all emerging as proposed “external” solutions (meaning the treatment is performed on top of the skin with no incision) to traditional liposuction. While many of these techniques are still being perfected, the promised benefits – which includes quicker recovery times and increased skin tightening – are enticing, to say the least. “These energy-based devices are not for large


areas and will not replace liposuction just yet, but they are new and exciting,” explains Dr. Guy, who adds that they’re also still relatively expensive.


you do not have a rapport with the doctor, feel pushed into surgery, or don’t feel like the doctor has listened to you, get another opinion,” says Dr. Guy. “If the promises or the results sound too good to be true, they probably are.”


WHAT IS LIPOSELECTION?


LipoSelection represents one of the many new variations to standard liposuction. Dr. Roxanne Guy, who performs LipoSelection, explains its benefits:


“LipoSelection basically adds one extra step in the liposuction process wherein an ultrasound probe is inserted into the areas to be suctioned to loosen and break up the fat so that it can be suctioned out more easily, with less trauma and blood loss, and with a smoother result. The ultrasound also has some skin-tightening benefits. The latest research also is showing that these ultrasound-treated fat cells are still intact (although separated into smaller and smaller clumps of cells), allowing them to be excellent for fat grafting (a process which transfers fat from one area of the body and reinserts it into another area). The machine I use is called the Vaser, and I am thrilled with its performance.”


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