Body Contouring with Body Definition Surgery





In today’s world, how we look is important and something that gains more and more attention both for males and females is their body definition. Although physiologically, females have more subcutaneous issue that gives them a more curvilinear look, today’s trend of having a more defined look is changing the imaginary ideal for females who today ask also for more body definition. Also, it is important to remember that when there is too much skin laxity, definition is not enough; excess skin also needs to be trimmed.


This is why it is so important for surgeons who do body contouring surgery to have an artistic view and a good knowledge of the normal human anatomy, but it is more important to really listen to the patient so we can end up with realistic results. As surgeons, we must focus on giving the patients the right expectations. Today we do have new technologies that help us achieve better results, but when there is a lot of excess skin with a big abdominal muscle diastasis, more than just liposuction is needed, new technology can help, but it is not magical.


Once again it is important to set the right expectations. If you exam a patient and see that she has a rectus muscle implantation above the rib cage, it will not be right to promise a flat tummy. You can see this in body builders who have no subcutaneous tissue and have extreme muscle definition, and yet many do not have a flat abdomen, so the point is not to think that following the procedure I am going to leave this patient flat, but how I can deliver a natural look, considering the natural anatomy of this individual and our artistic view and taste.


Why Offer Body Contouring Combined With Body Definition Procedures?


Being fit has become an important part of our culture. Fitness is synonymous with health and since many people just do not have a naturally defined body because of their bone and muscle structure, they seek these procedures. Others are simply lazy and pretend to end up with a body-builder’s physique with plastic surgery. With today’s trend, it is important to not only do body contouring procedures and tummy tucks, but to combine these with body definition options. This is essential in our armamentarium, and so it is crucial to get the knowledge, training, and experience in muscle body anatomy for good natural results.


Why Is It Important as Doctors to Have Different Treatment Approaches?


If we really want to end up with a well-defined body quickly, the easiest way is to sculpt it with liposuction. Other options can be nonsurgical treatments that will not give you immediate definition, but in conjunction with exercise and a balanced diet can help you get to a more fit look. However, when excess skin or muscle diastasis is present, liposuction or nonsurgical devices will not be enough; here, we need to combine procedures such as tummy tucks to end up with better results. We must never forget every patient is unique, and surgery plans need also to be unique to each patient. Performing only a liposuction without addressing excess skin and or loose muscles or performing only a tummy tuck without improving body definition is not what our patients are looking for today.


Important Anatomical Differences Between Males and Females


There are important differences between males and females when addressing body definition. For example, the six-pack in men is more defined and in women, it is more discreet. With women, the shadow is more important; for men, you can go ahead and create a more abrupt indentation. The thorax area is very important in male definition and in women, the hip–gluteal–back thigh areas are more important. Arms are a great complement for a well-defined body in both men and women.


Let us see what our expert has to tell us.


Expert Approach: Ultrasonic Liposuction-Assisted High Lateral Tension Abdominoplasty Technique





  • Cemal Senyuva



  • Plastic Surgeon



  • Istanbul, Turkey



Why did you decide to do this technique?


Although I hold different aesthetic concerns in body shaping in women and men, I basically use the same surgical technique.


I have been using ultrasonic-assisted liposuction and high lateral tension abdominoplasty for over 15 years.


Preoperative drawings of the patients show differences between men and women.


Advanced technical body liposuction teachings and experiences are decisive.


In modern philosophy, body shaping requires three-dimensional shaping rather than two-dimensional.


When did you learn it or if it is your own, how did you end up doing it?


In the late 1990s, I learned the technique of high lateral tension abdominoplasty surgery from Ted Lockwood. I started practicing immediately.


In the same years, I received third-generation ultrasonic liposuction training from William Cimino and started to use it.


There was already the necessity of wide and simultaneous liposuction in high lateral tension abdominoplasty, instead of classical technique liposuction. I thought of combining ultrasonic liposuction that emulsifies the fatty tissue selectively and protects perforating blood vessels, connective tissue, nerves and lymphatics better, and I started performing these surgeries in 2003.


In 2010, I hosted Dr. Alfredo Hoyos’s HiDef liposuction training in Istanbul and started using HiDef liposuction in body shaping.


With the experiences I have gained from this, I use high-definition approaches and philosophy, ultrasonic liposuction technology, and high side tension technique in the marking and application in body contouring surgeries.


Can this technique be compared to others and why?


Complications are still high in classic abdominoplasty and there are limitations in treating excess fatty tissue. It is difficult to advance the thick flaps and close the wound and to overcome the tension. Aesthetic results may not be satisfactory.


Nonultrasound technologies such as lasers damage the anatomical structures important for tissue circulation in abdominoplasty and are not recommended to be combined. The fat harvested with this technology cannot be used for grafting.


The results obtained with nonsurgical firming or thinning technologies will be suboptimal.


What do you consider are important landmarks and anatomy to be able to better perform this technique?


We divide our patients into groups according to their fat pattern and soft tissue laxity. We call the group of patients with skin laxity and low fat accumulation the “skinny patient group.” We use ultrasonic liposuction technology for tunneling and minimal aspiration and advance the flaps in an oblique vector from lateral to medial .




Fig. 1.1


The first group of patients, “skinny patients”; after excision, the upper abdominal flaps will be advanced medially with a slight lateromedial angle.



Fig. 1.2


Preoperative and postoperative 6-month anterior view of the patient.



Fig. 1.3


Preoperative (left) and postoperative 6-month (right) sitting position with rough grip.


In the second group of patients with fat storage and severe laxity, we use “extended” abdominoplasty marking and techniques. The surgery starts in the prone position with love handle and lumbar liposuction, followed by posterior excision of excessive soft tissue. Abdominoplasty is completed by turning the patient on their back. Advancement and closure with vertical vectors are performed in this group of patients.




Fig. 1.4


The third group of patients, “epigastric laxity.” CAPE or CAP abdominoplasty is planned. After excision, abdominal flaps will be advanced from medial to lateral.



Fig. 1.5


CAP abdominoplasty was performed preoperatively (left) and 2 months postoperatively (right) .

Jun 23, 2021 | Posted by in Aesthetic plastic surgery | Comments Off on Body Contouring with Body Definition Surgery
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