Body contouring surgery and body changes in the menopause

naked woman posing for picture

Dr. Jérémy Gliksman

Plastic and aesthetic surgery Clinique de Genolier, Genolier

May 3, 2021

Our bodies undergo a lot of changes. Body contouring surgery and body changes in the menopause are quite common. As menopause arrives, a woman’s body changes, mostly from a gynoid body shape to an android shape. It’s also due to the loss of oestrogen because it reduces the activity of lipoprotein lipase. That’s where the body contouring surgery comes into place. They are simple surgeries with little to no risk. What’s also amazing, the extracted fat can be used for various purposes. We have no reason not to believe that this will only get even better with age.

In order to learn more about this, keep reading the article by Dr. Jérémy Gliksman.

The facts

The change in weight and figure before the approaching 50th birthday is a very common reason for a visit to the plastic surgeon. Numerous scientific studies have shown that the average weight gain between 42 and 50 is 0.08 kg per year. However, there is some variation, as 20% of women gain 1.5 kg per year, while 3% lose weight. The facts clearly indicate that hormonal fluctuations have a non-negligible influence on weight gain, especially through the decrease in basal metabolic rate (calories needed for the organism to function and maintain body temperature at 37 degrees). Weight is the result of a balance between energy consumption (basal metabolic rate and physical activity) and dietary energy intake, so a decrease in consumption inevitably leads to weight gain and the build-up of excess fat. As menopause approaches, the figure of many women changes from a gynoid body shape (fat mainly on hips and thighs = pear shape) to an android body shape (accumulation of subcutaneous fat and intra-abdominal fat, visceral fat = apple shape).

The decline in oestrogen production that accompanies menopause is partly responsible for the change in the figure to an android shape because it reduces the activity of an enzyme called lipoprotein lipase. This decrease in enzymatic activity during menopause leads to an accumulation of fat in the adipocytes (fat-storing cells) of the abdominal wall. This new distribution of fat in favour of the abdomen results in a change in the ratio of waist and /hip circumference and ultimately results in an android body shape.

Possible solutions

Fortunately, there are surgical procedures that can rejuvenate the outer contours through simple operations with little risk. These are liposuction in combination with a so-called lipostructure (own fat treatment) and the injection of stem cells.

In the following, we will take a closer look at these procedures. Under a simple local anaesthetic or under a general anaesthetic, depending on the size of the fat layer under the skin, excess fat is removed with cannulas. The ends of these cannulas are rounded so as not to damage the vascular system of the skin. They are inserted through 3 to 4 mm incisions in the skin, made in the natural folds of the body so that no visible scars remain later. In most cases, this procedure is performed on an outpatient basis. The patient appears for treatment in the morning and can go home in the evening; follow-up treatments are usually not necessary.

The extracted fat can be used for different purposes

After a specific preparation procedure, it can be injected directly during the surgical procedure into areas where there is no longer enough fat. The physical changes associated with menopause often include flattening of the buttocks and sagging of the breasts and facial features. All of these areas can be corrected by lipostructure as part of global rejuvenation treatment.

The future

A new, very promising procedure is to retain a portion of the extracted fat and isolate stem cells from it. These so-called “mesenchymal stem cells” have the ability to regenerate certain types of tissue and can be used for direct injection into the face to improve skin quality. The fibroblasts (dermis cells that produce collagen) are stimulated and synthesise new collagen molecules. As a result, the skin becomes thicker again, wrinkles are smoothed, the skin gets new radiance and the skin structure is improved. This procedure is a preview of the medicine of the future, which will make it possible to regenerate all kinds of tissues that wear out over time by introducing stem cells into the organism. As we are at the beginning of a new era of medicine, it is all the more interesting to see these famous stem cells for later use until the medicine is able to repair a complete organ (liver, kidney …). So with the patient’s consent, part of the stem cell contingent can be injected to improve skin quality, while the rest is stored in a tissue bank for later use.

Complementary solutions

The change in fat distribution as menopause approaches is consequently no longer an unalterable fate. Modern surgery makes it possible to carry out permanent and simple corrections. However, although these procedures make the figure more even again, they are not a solution to the sagging of the skin as a whole. Therefore, it may sometimes be necessary to combine them with procedures to tighten the skin tissue. An example of such a procedure, which is limited to the lower part of the abdomen, is abdominoplasty (tummy tuck). This tightens the lower part of the abdomen and has the advantage that the scar left behind is under the underwear and can be well hidden. It is combined with liposuction in a single surgical procedure.

The procedure is usually not associated with painful post-operative consequences and makes it possible to reduce the volume and improve the tone of the skin on the abdomen. As part of liposuction, it is also possible to tighten the buttocks and the sides of the thighs by means of a buttock lift. Only an inconspicuous scar remains, which can be hidden under the underwear. However, experience has shown that injecting fat into the buttocks is often not enough to achieve high-quality results. Therefore, combining it with a tightening of the skin cover allows for optimal correction.

Women can therefore look forward to menopause and the associated changes in the figure with confidence. The removal of fat in areas where it is present in excess (liposuction), combined with its re-injection into those areas where fat is lacking (lipostructure), makes it possible to eliminate figure problems caused by hormonal fluctuations in women around 50 and to maintain physical and mental balance.

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