Composite Body Contouring: Safety is demonstrated in new study.

Scottsdale – Composite body contouring is relatively new on the plastic surgery scene.  The composite body contouring procedure includes a tummy tuck along with a certain amount of lipo, based on the patient’s desires and needs and fat grafting to deficient areas. In many cases, the liposuction can be circumferential and can include lipo of the upper and lower back, love handles and extremities. A modified technique is used to perform the tummy tuck which can reduce the risks of wound healing complications. Restoration of body contour with fat transfer can be used to give better shape to the buttocks or thighs. I have been performing composite body contouring since 2005 and have been impressed with the  outcomes.

It is very important  to provide the greatest amount of safety for our patients when performing such cases and the key with this set of procedures is to perform them only in a surgical facility that can admit patients for recovery and observation for at least 24 hours after surgery. I use a specialty surgery hospital that is specifically designed to meet the needs of cosmetic plastic surgery patients.

In many ways, “the composite” is a variation of the “mommy makeover” concept of combining multiple procedures to reverse the changes associated with pregnancy. Previously published studies demonstrate that the combination of cosmetic breast surgery and Arizona tummy tuck is safe when performed in an appropriate environment. That combination of surgery is the classic “mommy makeover” duo I have used since 2003. On the other hand, the “composite” mostly excludes breast surgery, but targets different areas that can affect women either post-pregnancy or with weight gain or loss, including the tummy, back, thighs and buttocks.  I report here on a  recently published study that documents the safety and efficacy of composite body contouring.

The article was published in the July issue of  Aesthetic Plastic Surgery. The study included 64 consecutive female patients who underwent tummy tuck and circumferential liposuction with fat grafting to the buttocks (45), thighs only (6), and buttocks and thighs (13). The surgeons report a 90% satisfaction rate with the surgery, with 63% of patients judging the results as excellent or very good after a follow-up time of 3.2 years. Approximately 10% of patients were dissatisfied with their results.

The group reported that, on average, they removed 2478 milliliters (range 1500 to 4600 ml) of fat with lipo. The average injected volume into the buttocks was 346 ml (range 165 to 625 ml) and into the lower limbs, it was 195 ml (range 75 to 270 ml).  The revision rate was 14% for the entire group, but a good number of these were related to the abdominal scar, which can often times be revised under local anesthesia. The major immediate complications after surgery included infection (3%) and bleeding with hematoma formation (2%).

I find that the complication and revision rate is acceptable for this extensive set of procedures. Patients should realize that there is no perfection in plastic surgery. Even these world-renowned experts had a dissatisfaction rate of 10% in their patient population. The more procedures you have, the more likely a revision will be required. Revision in this study included the need for additional liposuction, fat grafting and scar revision. Two patients requested silicone buttock augmentation.

The authors should be congratulated in keeping the number of immediate post surgery complications at a low level. Patients should realize that a bleeding complication usually requires immediate re-operation to evacuate the trapped blood collection, probable blood transfusion and a possible hospital admission. Infection may also require admission for the administration of intravenous antibiotics. This review goes to show that no surgeon or technique is free from complications and patients should be thoroughly prepared for the known potential complications before undergoing composite body contouring. This article is an important contribution to the advancement of Phoenix plastic surgery techniques.

The case above demonstrates the typical results with composite body contouring. In this case the patient had a tummy tuck and liposuction, including her back performed elsewhere 5 years before consulting with me at the AB Guerra Plastic Surgery Center. The patient is shown before and 6 months after composite body contouring procedure with revision tummy tuck, circumferential liposuction, and buttock fat grafting. The benefits of the surgery are a flatter and tighter tummy, a smoother back with a significant reduction of the rolls, and firm round buttocks. For more before and after photographs please see our main website at www.myfaceandbody.com