about the male abdomen procedure
Some men may experience unwanted fatty deposits most commonly over the abdomen and in the flank (love handles). In some men, it can tend to increase with age. The aim with male abdomen liposculpture is not necessarily to remove all the fatty tissue, but rather enough to change an area in shape and appearance.
However, in some men with a “beer belly” this surgery may be of limited benefit because the fatty deposits are beneath the abdominal muscle wall and not accessible. This is called visceral fat. Liposculpture will NOT remove visceral fat. What is visceral body fat? Visceral body fat, also known as ‘hidden’ fat, is fat stored deep inside the abdomen, wrapped around the organs, including the liver and intestines. It makes up about one tenth of all the fat stored in the body. Most fat is stored underneath the skin and is known as subcutaneous fat. That is the fat that is visible and that you can feel. Only subcutaneous fat may be removed with liposculpture. The rest of the fat in the body is hidden. That is visceral fat. Visceral fat makes the abdomen stick out or gives a person an ‘apple’ shape. It also produces chemicals and hormones that can be toxic to the body. Visceral fat produces more toxic substances than subcutaneous fat, so it is more dangerous. Even in thin people, having visceral fat carries a range of health risks.
Male Abdomen Liposuction
Liposuction of the abdomen is the most commonly requested area in both men and women. Important factors that affect the success of abdominal liposuction include the amount and location of abdominal fat, pregnancy (past and future), age and sex of the patient. Liposuction of the abdomen does NOT remove visceral fat. Visceral fat may only be reduced by diet and exercise. Liposuction of the abdomen only removes subcutaneous fat (fat located between the skin and the muscle). Liposuction of the abdomen is unable to restore redundant excessive skin, nor is it able to repair separation of the abdominal muscles (that may have been separated during pregnancy). An abdominoplasty (“tummy tuck”) would be a more suitable procedure for those issues.
Abdominal fat may occur in 2 different layers for some people: superficial (subcutaneous fat) and deep (visceral fat). Careful examination of the abdomen is required before abdomen liposuction, to assess the skin quality, the abdominal muscles and the presence or absence of visceral fat, and the posture of the patient and the presence of hernias.
Abdomen liposuction extends from under the breasts to the pubic area with extension into the waist area.
The age of the patient may be variable. It is common for women and men in their 60’s to request abdomen liposuction provided they are in good health.
The upper abdomen may appear slightly wrinkled after abdomen liposuction, especially in older patients. Sometimes, if the upper abdominal fat is not suctioned or inadequately suctioned, subsequent weight gain may enlarge the upper abdomen disproportionately to the lower abdomen. It is therefore common to have whole abdomen liposuction in most individuals.
Liposuction of the abdomen typically takes approximately 4 hours to do and it is performed under mild to moderate sedation using the tumescent local anaesthetic technique and microcannulas. It may take more time to complete with microcannulas, but they are associated with less postoperative pain / soreness and allow for smoother results. Numerous 3-5mm incisions are required around the abdomen (approximately 6-8) and they do not require suturing. The open incisions allow drainage of the blood-tinged tumescent anaesthetic fluid. Compression garments are worn for a minimum of 2 weeks post operatively plus an elastic binder over the top for the first week. Liposuction of the abdomen is typically an isolated procedure. It is not common to have other areas lipo-suctioned at the same time as the surface area is large and it takes more local anaesthetic to numb the area effectively compared to other areas. It’s important to stage liposuction procedures to not exceed this local anaesthetic dose, that may lead to toxicity and subsequent serious medical risks. Liposuction of multiple areas also increases the time of the procedure and this may lead to prolonged recovery and the possibility of blood clots in the legs that could travel to the lungs. Such complications are extremely rare when liposuction of the abdomen is performed alone and using the tumescent local anaesthetic technique.
The swelling after abdomen liposuction tends to last longer than other areas of the body. The day after the liposuction of the abdomen, one is still leaking the blood-tinged anaesthetic fluid. Over the next few days, there is a gradual onset of swelling, that is maximal between the first and second week post-operatively, that decreases over the next 4-12 weeks. Bending over may be a challenge for some people. The abdominal muscles are active and contracting when one gets out of bed, rolls over in bed, or gets up from a chair, so soreness and stiffness is normal in the post-operative period after abdomen liposuction. The pubic area in women and the genital area in men, tend to become very swollen and possibly bruised, because of the effect of gravity and closeness to the area of abdomen liposuction. Firmness, lumpiness, swelling is normal for 4-12 weeks. This firmness of the abdomen skin and subcutaneous tissue gradually reduces over 3-4 months.
Visceral fat is more common in men than in women.
Diet and exercise are required to reduce visceral fat or to have weight loss surgery, often called bariatric surgery.
Liposuction does not completely tighten skin in all areas, or in all patients. It is best suited for people who are in good physical shape with firm and non-flaccid skin. This is more so in people under 50 years of age, although many people much older may have satisfactory results with or without some looseness of skin. For the few cases in the abdomen where excess skin remains after the procedure, possible excision of extra skin +/- surgical tightening of underlying muscles may be requested. Some men may have weakness or separation of the abdominal muscles (divarication of rectus abdominis muscles) but this is more likely in women after having full term pregnancies. Abdominoplasty (removal of excess skin +/- surgical tightening of abdominal muscles) together with liposuction / liposculpture may be a preferred option for a few men than liposculpture alone.
Liposculpture / Liposuction however is the only procedure that Dr Heckenberg does.
Tumescent liposculpture is a cosmetic surgery procedure that can be effective in removing subcutaneous fat from the abdomen in men and to reshape and reduce the size of the abdominal area. It is a not a procedure for obesity nor for men who have internal (visceral) fat.
Dr Meaghan Heckenberg performs abdominal liposculpture as a day-only procedure at hospitals.
Who is suitable for Liposculpture of the Abdomen?
People with excess subcutaneous (under the skin and on top of the muscle) abdominal fat may have this procedure. The amount of fat that may be removed depends on the volume present to start with, but a general approximation would be about 70% of the volume present.
Who is not suitable for Liposculpture of the Abdomen?
People with hernias over the areas to be treated will need to have these repaired before the procedure. Sometimes men have a large proportion of the abdominal fat within the abdomen itself (behind the muscles) and not in front. This is called visceral fat. Liposculpture will NOT remove visceral fat. What is visceral body fat? Visceral body fat, also known as ‘hidden’ fat, is fat stored deep inside the abdomen, wrapped around the organs, including the liver and intestines. It makes up about one tenth of all the fat stored in the body. Most fat is stored underneath the skin and is known as subcutaneous fat. That is the fat that is visible and that you can feel. Only subcutaneous fat may be removed with liposculpture. The rest of the fat in the body is hidden. That is visceral fat. Visceral fat makes the abdomen stick out or gives a person an ‘apple’ shape. It also produces chemicals and hormones that can be toxic to the body. Visceral fat produces more toxic substances than subcutaneous fat, so it is more dangerous. Even in thin people, having visceral fat carries a range of health risks. Visceral fat is more common in men than in women. Diet and exercise are required to reduce visceral fat or to have weight loss surgery, often called bariatric surgery.
Is it permanent?
Diet and exercise are necessary to maintain results. Remaining fat cells may get bigger if diet is not maintained. New fat cells are unlikely to grow or develop, but existing ones may enlarge. Ageing may contribute to future fat deposition.
Are there any scars?
The small access holes are 3-5mm wide. There are usually 6-8 incisions made to the abdomen. Scars may develop over the incision sites (3-5mm) or become darker or lighter in colour or become enlarged but generally they tend to become less obvious with time. Sutures are not required for most incisions and the incision sites act as drainage points post operatively to allow the excess anaesthetic fluid to drain out.
What support garments are needed?
Special lycra bodysuit compressive garments are used for about two weeks after the procedure. Double suits for the first week and a single suit for the second week. An elastic binder on top of the 2 suits for the first week. It’s important not to wear jeans or belts for 4 weeks post procedure in order to prevent indentations in the skin.
How long does the procedure take?
Most abdominal liposuction procedures will take approximately 4 hours to complete.
How much time will I need off?
In general, you should plan on taking 1 week off work or slightly longer if your work is active. It would be about 3 weeks before normal gym activities or jogging should be restarted.
Please take note
Liposculpture isn’t suitable for everyone. Only patients with a Body Mass Index of under 35 will be considered but only after they have been properly assessed during the consultation. Your BMI can be checked using the following online calculator:
Smoking increases the level of carbon monoxide in the blood, which deprives tissues of oxygen. Blood supply is a major concern during any surgical procedure. Combining smoking and cosmetic surgery can categorically result in increased pain, loss of skin, infections, death of tissue or fat cells, delayed healing, thick scarring, permanent vessel damage, or blood clots. Smokers should cease smoking 6 weeks prior to the procedure or consider to not have the procedure at all.
Patients with body dysmorphia disorder (BDD) are inappropriate for liposuction / liposculpture or any type of cosmetic surgery or procedure. Body dysmorphic disorder (BDD) is a mental illness. People who have this illness constantly worry about the way they look. They may believe an inconspicuous or non-existent physical attribute is a serious defect. They respond to this by performing repetitive acts such as mirror checking or comparing their appearance with others. The severity of BDD varies. For example, some people know their feelings and / or perceptions aren’t rational or justified, while others are almost delusional in their conviction. BDD causes severe emotional distress. It is not just vanity and is not something a person can just ‘forget about’ or ‘get over’.
The preoccupation of their appearances can be so extreme that the affected person has trouble functioning at work, school or in social situations. People who suffer from BDD can target any part of the body. They may seek out numerous cosmetic procedures to try to “fix” their perceived flaw. Afterward, they may feel temporary satisfaction or a reduction in their distress, but often the anxiety returns and the search for other flaws may resume, along with ways to “fix” them. Treatment of BDD may include cognitive behavioural therapy and medication after an assessment by a Psychiatrist.