Fat or loose skin?The surgery you need depends on which

Body Guide

Body Contouring: Where to Start

Body contouring is divided into liposuction, abdominoplasty and lifts by area depending on whether the problem is fat or loose skin, and it also includes body restoration after childbirth and weight loss.

Body concerns usually start from one of two things: fat that remains, or skin that has stretched. They can look similar from the outside, but when the cause differs, so does the surgery you need. If fat is the problem, liposuction or cryolipolysis reduces the volume; if stretched skin is the problem, the excess skin has to be removed and tightened.

The two are often present together. After childbirth or rapid weight loss, fat, loose skin and separation of the rectus muscles appear at the same time. In that case, liposuction alone can make the skin look even looser, and excision alone does not refine the contour. Body contouring begins with deciding what the problem is, how much of a problem it is, and in what order to address it.

At Atelier Plastic Surgery, we pinch the skin ourselves at consultation and check the thickness of the fat layer and the gap between the rectus muscles with ultrasound before deciding on surgery. We do not recommend excision to someone for whom liposuction is enough, and we do not recommend liposuction alone to someone who needs excision. Only one general-anesthesia surgery is performed per day, and the Director herself handles everything from consultation through surgery and follow-up.

Based on what the concern is

I have excess fat, but my skin is firmThere is fat you can pinch with your fingers, and the skin springs straight back when you let go. This applies when localized fat on the abdomen, flanks, thighs or arms does not go down with diet and exercise. Because skin elasticity remains, reducing the volume alone may improve the contour.

LiposuctionWhen you want a larger reduction in volume, or want to address several areas at once CoolSculptingWhen you want to reduce localized fat only, without incisions or anesthesia

My abdominal skin is loose and folds overWhen you sit, the skin below the navel folds over, stretch marks are spread widely, and the middle of the abdomen stays rounded even when you tense it. Stretched skin and separated rectus muscles do not return with exercise. The extent of the incision depends on whether the sagging is limited to below the navel or extends above it.

AbdominoplastyWhen the skin is loose both above and below the navel and the rectus muscles are separated Mini abdominoplastyWhen only the skin below the navel is loose UmbilicoplastyWhen you want only the shape of the navel or an umbilical hernia refined on its own

My abdomen and breasts both changed after childbirthAbdominal skin stretched by pregnancy and separated rectus muscles remain, together with breasts that have lost volume and sagged after breastfeeding. The approach to the abdomen depends on whether diastasis recti is present, and for the breasts we choose between a lift and augmentation depending on whether the problem is sagging or volume. Whether to do both areas in one surgery or in stages is decided by looking at the surgery time and your recovery environment.

Postpartum body restorationWhen planning the abdomen and breasts together AbdominoplastyWhen diastasis recti is present and the abdomen is the main concern Breast Surgery GuideWhen the breast concern comes first

I lost a lot of weight and now have loose skinAfter weight loss, the skin sags and folds in several areas such as the abdomen, arms and thighs. The fat has gone but the skin has not shrunk, so excision and lifting, rather than liposuction, are the focus. When several areas are involved, we plan the priorities and stages.

Post-weight-loss body restorationWhen planning several areas in sequence AbdominoplastyWhen the abdomen is the biggest concern

The skin on my arms or inner thighs is looseThe inner upper arm swings when you raise your arm, or the inner-thigh skin sags and chafes when you walk. If fat is also present, liposuction is combined, but the loose skin itself can only be addressed by excision. The position and length of the incision line that will remain is confirmed in advance at consultation.

Arm liftWhen the skin of the inner upper arm is loose Thigh liftWhen the skin of the inner thigh is loose LiposuctionWhen skin elasticity remains and fat is the main problem

At a glance

Surgery · Treatment	Main concern	Incision · Approach	Anesthesia	Recovery
Abdominoplasty	Loose abdominal skin · separated rectus muscles	Horizontal lower-abdominal incision · around the navel	General	About 2–3 weeks
Mini abdominoplasty	Loose skin below the navel	Short horizontal lower-abdominal incision	General or sedation	About 1–2 weeks
Umbilicoplasty	Navel shape · depth · umbilical hernia	Around the navel	Local or sedation	About 2–3 days
Liposuction	Localized fat with remaining skin elasticity	Access ports of a few mm	Sedation or general	About 3–7 days
Postpartum body restoration	Abdominal · breast changes after childbirth	Varies with the combination of surgeries	General	About 2–4 weeks
Post-weight-loss body restoration	Loose skin left after weight loss	Excision lines by area	General	About 2–4 weeks
Arm lift	Loose skin on the inner upper arm	Vertical incision on the inner upper arm	General or sedation	About 1–2 weeks
Thigh lift	Loose skin on the inner thigh	Groin crease · inner thigh	General	About 2–3 weeks
Intimate surgery	Enlarged labia minora · vaginal laxity	Edge of the labia minora · inside the vagina	Sedation or local	About 1–2 weeks
CoolSculpting	Localized fat (non-surgical)	No incision	None	Return to daily life the same day

Recovery periods are typical ranges and vary by individual.

Procedures

Abdomen · Fat

Abdominoplasty

Removes loose skin and fat and sutures the separated rectus muscles to refine the abdominal contour.

Mini abdominoplasty

Removes only the loose skin and fat below the navel through a short incision.

Umbilicoplasty

Refines the shape and depth of the navel and repairs an umbilical hernia. Also performed on its own.

Liposuction

Removes subcutaneous fat from the abdomen, thighs and arms with an approach suited to each area, to refine the contour.

Body Restoration

Postpartum body restoration

Plans the abdomen and breasts together after childbirth. Whether diastasis recti is present decides the approach.

Post-weight-loss body restoration

Removes and lifts the skin left after rapid weight loss, area by area.

Lifts by Area

Arm lift

Removes loose skin and fat on the inner upper arm to refine the line of the arm.

Thigh lift

Removes loose skin on the inner thigh. Often combined with liposuction.

Intimate Surgery · Body Care

Intimate surgery

Corrects the shape and function of the vulva and vagina, such as labia minora reduction and vaginal tightening. Performed by a female board-certified plastic surgeon.

CoolSculpting

A non-surgical treatment that reduces fat cells by cooling. Addresses localized fat by area without incisions.

After surgery

After surgery and recovery care

In body contouring, the larger the area of excision, the longer recovery takes. Return to light daily activities is typically after about 3–7 days for liposuction and about 2–3 weeks for abdominoplasty and lift surgery, and a compression garment is worn for about 4–6 weeks. After surgery you visit on a set schedule so we can check the wound and look for seroma, and ultrasound examinations and scar care continue as needed. Only one general-anesthesia surgery is performed per day, so we can focus on one person in the recovery room. The standards for everything from anesthesia management to infection prevention and recovery care are described on the Safety Care System page.

Safety Care System · Aftercare schedule

Related treatments in other categories

CoolSculpting

A non-surgical option that reduces localized fat without incisions or anesthesia when skin elasticity remains and only fat is the problem. Reviewed at consultation alongside liposuction.

Ulthera

Non-surgical lifting for mild loose skin that does not call for excision; focused ultrasound is used with the aim of improving elasticity in the dermis and fascial layer. Performed on the body as well as the face.

Facela

Non-invasive lifting that uses radiofrequency to stimulate collagen production in the fascial layer; considered to supplement mild loss of elasticity left after liposuction or excision surgery.

Related research

Dr. Juyoung Go's academic activity in this field

PaperFirst author

The Reverse Lip Design: A Design for Safe and Effective Abdominoplasty

Archives of Aesthetic Plastic Surgery · 2021DOI ↗

A study proposing a design that pre-plans the skin excision line in abdominoplasty as an inverted lip shape, so that the extent of excision and closure tension can be predicted and the navel shape planned at the same time
ConferenceSpeaker

Strategies for Safe and Effective Abdominoplasty

Korean Society of Plastic and Reconstructive Surgeons, 79th Congress (PRS Korea) · 2021.11 · Online

Korean title: Safe and Effective Abdominoplasty
ConferencePoster

A New Design for Safe and Effective Abdominoplasty: The Reverse Lip Design

Korean Society of Plastic and Reconstructive Surgeons, 76th Congress (PRS Korea) · 2018.11 · Seoul

Korean title: A New Design for Safe and Effective Abdominoplasty — Reverse Lip Design
ConferenceSpeaker

Cryolipolysis for Body Contouring and Fat Reduction

Korean Society of Plastic and Reconstructive Surgeons, 80th Congress (PRS Korea) · 2022.11 · Seoul

Korean title: Cryolipolysis for Body Contouring and Fat Reduction

Each treatment page lists the items relevant to it; the full list is on the Academic Activities page. View all academic activities

FAQ

Q1How can I tell whether I need liposuction or abdominoplasty?

Standing, pinch the skin of your abdomen and let go. If it springs straight back, fat is the main problem; if it stays slack, or folds over when you sit, loose skin is the main problem. If the middle of the abdomen stays rounded even when you tense it, diastasis recti may be suspected. At consultation we decide by checking the thickness of the fat layer and the gap between the rectus muscles by palpation and ultrasound.

Q2Can CoolSculpting also improve abdominal sagging?

CoolSculpting is a treatment that reduces fat cells by cooling; it does not reduce loose skin. It is suitable when skin elasticity remains and fat is the problem; if the skin is loose, excision surgery should be considered.

Q3Can several areas be operated on at once?

It depends on the surgery time, your health and your recovery environment. The longer the surgery, the greater the risk of bleeding and blood clots, so we calculate the expected time together with an anesthesiologist and plan combined surgery only when it falls within our limits; otherwise we divide it into stages.

Q4How soon after childbirth is body surgery possible?

We recommend a point at least 6 months after your last delivery and the end of breastfeeding, once your weight has stabilized. If you plan to have more children, pregnancy can change the result, so it is usual to have surgery after your family plans are complete.

Q5How much scarring will there be?

Liposuction leaves only the scars of access ports a few mm in size, while excision surgery leaves an incision line as long as the width of the skin removed. For abdominoplasty it sits within the underwear line on the lower abdomen, for an arm lift on the inner upper arm, and for a thigh lift in the groin crease and inner thigh. Scars fade over about 6 months to 1 year, and this varies by individual.

Q6What happens if I gain weight again after surgery?

The fat cells that remain in a treated area enlarge again if you gain weight, and skin that has been excised can also stretch again with changes in weight. Keeping your weight stable after surgery is a condition for maintaining the result.

Q7What is checked at consultation?

We check the extent of fat and loose skin while you stand and sit, and measure the thickness of the fat layer and the gap between the rectus muscles with ultrasound. We also go over previous surgery, plans for childbirth, smoking and your recovery environment to decide the type and timing of surgery. Because only one general-anesthesia surgery is performed per day, we give each consultation ample time.

Q8What should I prepare for the recovery period?

After excision surgery, daily activities are restricted for about 2–3 weeks and a compression garment is worn for about 4–6 weeks. Lifting heavy objects or picking up a child is restricted, so arrange in advance for someone to help and an environment that supports you during that period. Smokers must stop smoking before and after surgery.