Body Contouring Surgery Sydney

Following significant weight loss and the associated changes that occur with the body, including changes to the body post-pregnancy, individuals may be left with skin that hasn’t shrunk back to its original state.

The now smaller individual is fitter and healthier; however, their skin hangs off them and is effectively like their old clothing designed for the former much larger body. Body Contouring Surgery is designed to address these issues.

Body Contouring Surgery encompasses a range to surgical reconstructive procedures that are tailored to you, to address the often-significant functional and aesthetic concerns associated with excess skin. Body Contouring Surgery improves overall function by decreasing pain and discomfort associated with excess skin while improving mobility and body form.

When it comes to determining the types of Body Contouring procedures that you may require to address your concerns, you will need a formal consultation with Dr Dona. It is within your formal consultation that you can discuss your concerns and Dr Dona can assess you and customise a surgical plan that will effectively reconstruct your body.

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Body Contouring eBook Includes

– Patient Case Studies

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What Procedures are Involved in Body Contouring Surgery?

There are a diverse range of surgical procedures that fall under the umbrella of Body Contouring Surgery – these procedures include the following:  

BRACHIOPLASTY (Arm Reduction) – removes unwanted excess and loose skin along the upper arm.

BREAST SURGERY (especially Breast Lifts and Breast Reductions) – reduce the size of the breasts by removing excess breast tissue and skin, and address issues with the overall size, shape and form of the breasts.

BRA LIPECTOMY – an operation performed to address excess skin rolls and associated fat in the upper and middle part of the back around the bra strap area – this area is often referred to as ‘bra rolls’. There are several names and variations for a Bra Lipectomy which include:

  • Bra Line Back lift
  • Upper Body Lift
  • Upper Truncoplasty

BELT LIPECTOMY – the surgical removal of rolls of excess skin and the associated fat in the lower back, flanks, and abdominal region. It also lifts the buttock and pubic regions. A Belt Lipectomy combines two operations: a Buttock Lift and a Tummy Tuck (Abdominoplasty), that results in one continuous circumferential scar contained within the belt line. The Belt Lipectomy can also be referred to as a:

  • Lower Body Lift
  • Total Body Lift
  • Lower Truncoplasty

BELLY SURGERY (Abdominoplasty, aka Tummy Tuck) – refers to various types of Abdominal Surgery. The type of Abdominal Surgery required will be determined by the amount of excess loose skin and fat, in the middle and lower abdomen. There are three main types of surgical procedures which include:

BUTTOCK LIFT – is an operation designed to lift and tighten the buttocks, remove excess skin from the lower back, and create far more comfortable form from along your back and buttocks. If combined with an Abdominoplasty (Tummy Tuck) it becomes a Belt Lipectomy, and can also help create a far tighter waistline. Buttock Lift surgery is also referred to as:

  • Gluteal Lipectomy

THIGH LIFT (medial Thigh Lipectomy)– is a surgery performed to tighten the skin and improve the form along the inner thigh. Excess skin and fatty tissue is removed, leaving a scar hidden along the fold where the thigh and the groin meet, and often down the inner aspect of the thigh to the level of the knee.

Body Contouring Surgery Explained

When discussing Body Contouring Surgery, it is important to understand the difference between Cosmetic and Reconstructive Surgery.

In Australia, all Plastic Surgeons are classified as Plastic and Reconstructive Surgeons. Dr Dona is a member of the Australian Society of Plastic Surgeons, whose motto is, ‘Corpore Mens Melior Refecto’ – this translates to ‘the mind is better when the body has been restored’.

Reconstruction means to restore to a state (or to create a state) that is ‘normal’ for that person’s age, race, and gender.

In the context of the human form, and excluding those rare individuals with body dysmorphic disorder, normal refers to something functional or acceptable for that particular individual. The spectrum of normal is broad, meaning what is normal for one person may be abnormal if applied to another. The prevalence of a specific body issue does not make it normal.

In light of these definitions, it follows that any surgery designed to address problems with the body following significant weight changes is primarily a reconstructive procedure. The fact that the person will look better afterwards is a secondary benefit to the reconstruction. This is a vitally important distinction because some people will try and trivialise a persons need for surgery when suffering from issues following weight loss. Such people will use the excuse that any such surgery would be purely a Cosmetic procedure and therefore it is only vanity that drives the person to want it – this is false!

In contrast to Reconstructive Surgery, purely Cosmetic Surgery is generally accepted as surgery designed to enhance a part of the anatomy that is otherwise normal in appearance and form. The best example of this is Breast Enhancement Surgery. Of course, a very complex topic worthy of a separate debate is how a person sees themselves and what they identify as normal in relation to themselves. This also leads into topics of Body Dysmorphic Disorder and even gender identity discussions which is well beyond the scope of this topic.

The most common cause of changes to the body leading to damaged tissues and skin is the massive weight change typical of many pregnancies. Stretch marks are scars on the skin caused by skin that has stretched too quickly and torn, resulting in the stretch scars. This also results in excess skin, skin folds, overhang and quite often are associated with muscle damage – all these issues are quite common.

People who are carrying a large amount of excess weight may choose to lose that weight, either through diet and exercise or via surgical assistance – such as lap band, gastric sleeve and gastric bypass surgery. No matter the cause, individuals who have lost a massive amount of weight experience the same issue – their bodies become smaller, but their skin does not. Skin does not contract, or ‘shrink wrap’ around a smaller body. Metaphorically, excess skin represents the former self – or an old dress. Individuals who have lost a massive amount of weight become smaller, fitter, and healthier but they are essentially wearing a dress that is too big. The bigger the loss, the baggier the dress.

Body Contouring Surgery is effectively surgery designed to tailor your skin to fit your body.

All Body Contouring Surgical procedures are complex reconstructive procedures and just like any surgery, they should never be trivialised. However, in order to help patients understand the patterns and scars necessary for these surgeries, Dr Dona will often use dressmaking as an analogy. In dressmaking, you remove material and run a seam; in surgery, you remove skin and the ‘seams’ are the scars. The greater the amount of excess skin to be removed, the more scars necessary.

Although the necessary scar patterns from these surgical procedures after massive weight loss can be compared to dressmaking, it is course far more complex. Skin and tissues are not rigid – they swell, stretch, shrink and sag. Additionally, the body beneath the skin also changes, which is especially true during the first few months after surgery. Therefore, as a surgeon, Dr Dona needs to reconstruct and reshape things that are 3D, and not static. He also needs to ensure that he does not make things too tight because that can result in serious problems with wound healing and breaking down. Therefore, after the initial post-surgery swelling starts to decrease and the skin settles into position, it is normal for your skin to not feel as tight as it did initially. Given this, it is not uncommon to require further surgery to fine-tune the results.

Although massive weight loss affects skin in every area of the body, the common areas are the arms, the breasts and chest area, back, buttocks, stomach, and the thighs. However, there is a limit to how much can be achieved in one day so you typically cannot have every procedure done at one time.

Basically, we start with the areas that most concern an individual and then we continue in stages depending on the degree of concern and other considerations such as lifestyle and financial constraints. The minimum time between each surgery is three months.

Any form of Reconstructive Surgery is complex and carries risks. However, to compound these risks, the skin and tissue quality of many of these patients is often poor, which increases the potential for issues such as poor wound healing. This leads to a higher risk of wounds breaking down with skin and tissue loss. Therefore, there is a high risk of further surgery being required in the postoperative stage to address these issues. Higher-risk patients must accept the possibility of experiencing wound healing issues that will warrant further surgeries and downtime.

Overall, the surgery required to address the issues experienced by patients who have undergone massive weight loss is Total-Body Reconstructive Surgery.


What to expect during the first consultation

We understand that your first consultation can be both exciting and daunting – it is natural to experience a combination of anxiousness, uncertainty and eagerness.

During your consultation with Dr Dona, you will discuss the areas that you would like to address. Dr Dona will examine and assess those areas and take clinical measurements. You will then discuss the surgical options available, the expected outcomes, risks, recovery period and any other essential considerations, such as your medical history.

The most important to remember throughout all of this is that dramatic weight loss is a great accomplishment, and it is to be celebrated!


What should my BMI be before surgery?

Some Plastic Surgeons may elect not to operate on patients with a high BMI, fearing an increased risk of perioperative and postoperative complications. There are several problems with this policy.

Firstly, BMI is a poor indicator of health and cannot accurately identify whether a person is at a healthy body weight because it fails to distinguish between fat and muscle or to consider fat distribution.

That aside, it is true that those individuals who are deemed overweight, by whichever measure one uses, do carry increased surgical risks. They have a greater risk of anaesthetic complications, and a greater risk of surgical complications, including would healing problems such as wound breakdown and skin necrosis.

However, if a person has aways been fuller figured, and they are either unable to lose weight, then it is Dr Dona’s opinion that they should not be denied reconstructive surgery to address their concerns. Patients with large abdominal wall aprons and overhang suffer tremendously with significant functional and medical issues, regardless of what their weight is. For an appropriately qualified surgeon to deny them important surgery and demand that they attain a certain unachievable weight is unfortunate.

Every decision for surgery is based on a risk versus benefits assessment, and if the potential benefits are deemed to exceed the potential risks, then surgery should still be offered. Insisting that a patient to be a weight that they are never going to achieve, or never be able to sustain is not appropriate. Of course, if someone is actively losing weight then it is best to wait until their wait has stabilised for at least six months before undergoing any surgery.

Also, if a patient is fuller figured and wants to be lighter, and also needs Reconstructive Surgery, then they are best advised to consult with a Bariatric Surgeon to determine if they may be suitable for a gastric sleeve or bypass surgery to help them achieve their optimal weight.

What causes excess skin?

Patients who have lost a considerable amount of weight are likely to struggle with excess skin. That is because the skin stretches and loses its elasticity with weight gain. The skin is then unable to contract and shrink to support the patient’s new figure. While extensive weight loss is a great achievement, the excitement can be undermined by the uncomfortable and often debilitating excess skin encasing and hanging from the now smaller body.

Am I a good candidate for Body Contouring Plastic Surgery?

You may be a good candidate for Cosmetic or Reconstructive Surgery if you are in good health, have realistic expectations and know the risks of the procedure you are considering. Contouring procedures, like an Abdominoplasty (more commonly known as a Tummy Tuck), are not weight loss procedures. If you need to lose weight before plastic surgery, then you should be close to or have plateaued at your sustainable weight well before the procedure. Smoking can also sabotage your surgery as nicotine constricts blood vessels reducing oxygen levels at the surgical sites, hindering the healing process and increasing your risk of complications. Smokers also face an increased risk of complications under anaesthesia; therefore, you need to give up smoking and all nicotine-based products well before surgery.


How many procedures can be performed during one surgery? Will I require multiple surgeries?

Massive weight loss affects every part of the body, with problematic excess skin issues often found in the arms, chest, back, buttocks and thighs. Therefore, surgery to reconstruct these areas is often requested.

However, whilst many patients would like to have multiple operations performed at the same time, this is not always possible. The larger the surgery, the greater the potential for post-operative problems to arise.

Each patient is assessed, and a plan put in place to address their concerns based on priority. It is often not wise to combine operations due to surgical safety issues. These decisions can only be made after a formal consultation and determining an individual’s suitability for surgery, and what type of surgery can or should be performed. For many patients that have lost a significant amount of what, they will often have to undergo surgeries in a staged manner over a period of time.

Of course, other issues such as financial and patients’ lifestyle/logistics also needs to be considered when planning these surgeries.

For some individuals, based on their unique circumstances, it may be possible to combine other procedures.

Some common combinations include:

  • Belt Lipectomy with a Tummy Tuck (Abdominoplasty)
  • Bra Lipectomy with an Open Book Tummy Tuck (Abdominoplasty)
  • Breast Surgery (Breast Augmentation, Breast Lift/Mastopexy or Breast Reduction), with a Tummy Tuck (Abdominoplasty)
  • Arm Reduction (Brachioplasty) with Breast Surgery (Breast Lift/Mastopexy or Breast Reduction).

However, Thigh Lifts (Thighplasty or Thigh Lipectomy) is a procedure which Dr Dona never combines with any other operation. Thigh Lift Surgery is a major operation with greater potential for post-operative complications. Combining this with another procedure would lead to a more complex and demanding recovery, which can compromise the quality of your results.

Ultimately, Dr Dona will begin with the areas that most concern the patient and then continue in stages depending on the degree of concern and other considerations, such as lifestyle, financial and health constraints.

How long do I need to wait between surgeries?

It is extremely common for a patient to undergo more than one Cosmetic or Reconstructive Surgery. In some cases, as outlined above, multiple procedures can be combined into the same surgery. In other situations, the minimum period of time between each surgery is approximately three months. Overall, there is no hard and fast rule about how long a patient should wait between surgeries; it largely comes down to your rate of healing and overall health.

What happens if I lose weight after surgery?

It is best that you achieve your optimal and stabilised weight before undergoing surgery. Losing an excessive amount of weight after surgery may lead to further excess, overhanging skin again, and ultimately, compromise your previous results. If this situation were to occur, you may require further surgery. In the event of slight postoperative weight loss, there may be no effect on the surgical outcome. This largely depends on the individual patient’s anatomy including the quality of the skin tissue.

What happens if I gain weight after surgery?

Body Contouring Surgery remove excess skin and fatty tissue to address issues after weight loss. However, removal of the excess skin associated with these procedures will prevent you from gaining additional weight.

Gaining an excessive amount of weight after surgery can damage your weakened skin, leading to stretch marks and wide scars. Gaining a small amount of weight after your procedure will inevitably cause fat cells to enlarge, but the overall enhanced body form provided by the surgery should still be visible.

Body Contouring Surgery is not an alternative to weight loss, a healthy diet or exercise. Severe weight fluctuations can reverse and compromise the results of your surgery, and in extreme cases, cause the same problems that caused you to seek out and undergo body contouring surgery in the first instance. That is why it is best to achieve a stable weight for a period prior to your surgery.

Will my surgery be covered my Health Insurance or Medicare?

You will need to have a consultation with Dr Dona to assess what your concerns are, and he will be able to decide what if any Medicare item numbers may apply to you. You will then take that information to your Private Health Insurer so they can clarify what might be covered with your policy. Ideally your Private Health Fund will cover all your hospital costs. However, they will not cover most of your surgical and anaesthetic costs.

What are the risks?

No surgical procedure is risk free, and understanding the possible complications is essential so that you can consider the benefits and risks before you undergo treatment.

For massive weight loss individuals, the skin and tissue quality are often poor, which increases the potential for complications to arise, such as poor wound healing and infection. This leads to a higher risk of wounds breaking down with skin and tissue loss. Therefore, there is an increased risk of further surgery being required in the postoperative stage to address these issues.

All surgeries carry general potential risks, and surgery specific potential risks.

The general potential complications for surgery can be found here – LEARN MORE

The operation specific potential complications can be found on our website on each of the specific surgical procedures page.

Find out more


Learn more about our procedures or schedule a one-on-one consultation at our Sydney clinic

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