Technologies Offer Body Contouring Alternatives

This is part 2 of a 2-part series.

Part 1: The Modern Mommy Makeover

Patients still need and want abdominoplasty as part of the mommy makeover. That procedure has also evolved, thanks to technology that offers new options. Products, including BodyTite (InMode) and Renuvion (J-Plasma; Apyx Medical) are helping to make the traditional tummy tuck less invasive for some patients, according to Dr. Kluska.

BodyTite is dual-plane heat energy and radiofrequency device, which causes constriction and contraction of deep subcutaneous connective tissue. It externally heats the skin and causes skin contraction.

Renuvion is helium-based plasma energy combined with radiofrequency in a multiplanar approach that causes connective tissue shrinkage and deep dermal tissue contraction, according to Dr. Kluska, who says he’s been using Renuvion almost exclusively for skin contraction for mini-abdominoplasties. After liposuctioning the entire abdomen, he heats the upper abdomen with Renuvion, then trims excess skin below the belly button.

“This allows for a quicker recovery time and overall skin contraction of the upper abdomen without going in and invading the upper abdomen. It’s more instant gratification,” he says.

But this version of the mini abdominoplasty isn’t for every patient. While patients who have had bariatric surgery aren’t good candidates, a 26-year-old mom of two kids with stretchmarks and skin laxity below the belly button, with only a little or no skin laxity in the upper abdomen, might make a good candidate, he says.

Dr. Gallus also has added subdermal skin tightening to her practice and says it can be used in some cases to avoid the need for an abdominoplasty.

“Using some modality—laser, radiofrequency or plasma energy—to tighten the skin in areas that are liposuctioned can sometimes [help patients] avoid tummy tuck surgery. For people who are willing to deal with a little bit of extra fat and some skin laxity and aren’t committed to a tummy tuck operation, this provides an alternative,” says Dr. Gallus who uses Renuvion to augment SAFELipo liposuction.

Another trend is adding labiaplasty to the surgical line up, she says.

“… patients are already under anesthesia. I just recently did liposuction and fat transfer to the breast (she didn’t want implants) and labiaplasty for a young mom.”

All About the Breasts

The most common breast surgery done in conjunction with mommy makeovers had been augmentation mastopexy, according to Dr. Gallus. But she said that’s changing.

“I’ve seen a trend in my practice for implant removal and mastopexy, where women had an augmentation before they had kids and now that they’ve had kids their breasts have changed in shape and size. Although they want to do something to improve the look of their breasts, they don’t want implants put back in. They want the implants out and either a lift or a lift and fat transfer,” Dr. Gallus says.

Part of the motivation for breast implant removal could be due to breast implant illness concerns. Other patients say the large breasts they wanted years ago don’t fit their lifestyles anymore, according to Dr. Gallus.

“Implant removal and getting an aesthetic result is challenging. I think you have to consider a few factors. One of the most important factors is the implant-to-breast tissue ratio. A large implant with minimal breast tissue is the most challenging, where the breast tissue has been over-expanded. The easier patients have small implants and a large amount of breast tissue. They won’t miss the volume and maybe they need a small lift,” Dr. Gallus says.

And those mommy makeover patients who want breast lifts can benefit from today’s skin tightening devices, according to Dr. Kluska.

The breast lift in the mommy makeover generally requires surgeons make an incision, causing a scar, that helps to get the nipple-areola complex back up onto the breast’s equator, according to Dr. Kluska.

“With new technologies, such as the BodyTite and Renuvion, we are able to offer a scar-less breast lift,” he says.

Again, not every mommy makeover patient is a candidate. The best candidates are patients with a slightly low-riding nipple-areola complex.

“We now can lift, I would say, up to 1.5 cm maximum with just heating the deep subcutaneous tissues,” Dr. Kluska says.

Dr. Kluska often adds either a gummy bear implant or fat transfer to the breast to create lifted breasts in mommy makeover patients.