Non Surgical Procedures


Tummy tuck alternatives are often touted as a way to achieve a more slender, athletic-looking abdomen without having to undergo surgery or experience its tradeoffs—e.g., permanent scars, prolonged downtime, and risk of complications.

Unfortunately, non-surgical tummy tuck alternatives cannot replicate what a real surgery can accomplish.

tummy tuck alternatives

Photo credit: John Kasawa at FreeDigitalPhotos.net

Creams, laser treatments, and exercise cannot remove the redundant skin, which can only be addressed by direct skin excisions. The same is also true for the splayed abdominal muscles, which are caused by pregnancies or massive weight loss and can only be improved by a surgery.

Non-surgical tummy tuck alternatives such as lasers and CoolSculpting are only reserved for normal weight patients with minor contour irregularities.

For patients with good skin quality but have stubborn abdominal fats, they could have a liposuction instead. Although it is still a surgery, it is generally less invasive and entails a shorter healing time compared with tummy tuck (three days vs. two weeks).

In abdominal liposuction, doctors use 4-6 small round incisions about 4 mm in diameter to remove the excess fat with a suction probe called cannula. To achieve a smooth, natural-looking appearance, the skin should be able to redrape to the new contour, as suggested by leading Inland Empire plastic surgery expert Dr. Tarick Smaili.

Despite the less invasive nature of liposuction, it is still a surgery in which there is always some risk of complications (although serious problems are extremely rare due to the introduction of tumescent fluids and gentler techniques). For patients who want to avoid surgery altogether, they may consider non-surgical liposuction.

CoolSculpting is believed to be a good alternative to liposuction or even tummy tuck. It uses a paddle-like applicator to freeze and kill the fat cells, which the body will slowly flush out within a few months. Most patients will need at least two sessions to achieve the best possible results.

It is important to note that most non-surgical modalities such as lasers and CoolSculpting can only provide about 20 percent skin tightening versus 100 percent achieved by tummy tuck surgeries, warns Dr. Smaili.

On some occasions, non-surgical modalities used to tighten the skin (such as lasers) are performed after a tummy tuck surgery to further achieve a smoother contour.

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Plastic surgery alternatives offer some benefits such as no or minimal downtime, lower cost, and fewer side effects, as opposed to “nip and tuck” procedures that require more commitment and longer recovery.

The list below explains some of the possible plastic surgery alternatives; however, most of them cannot replicate the exact effects achieved by the “real thing.”

plastic surgery alternatives

Photo credit: botoxcosmetic.com

* Facelift alternatives. Perhaps Botox is one of the most commonly used non-surgical facial rejuvenation procedures. This injectable drug paralyzes the muscles responsible for the sagging appearance or dynamic wrinkles caused by repetitive facial expression.

Dermal filler injection is another good alternative. It works by plumping up the hollowed skin caused by loss of facial fat or soft tissue atrophy or shrinkage.

Other possible facelift alternatives include medical-grade chemical peels, Thermage, and laser skin resurfacing.

However, these aforementioned treatments provide little to no improvement if there is significant tissue laxity or redundant skin, problems that only a “real” facelift can address, as suggested by Los Angeles plastic surgery experts.

Facelift surgery uses incisions within the ear’s contour and/or behind the hairline (so the scars remain hidden), allowing the surgeons to trim any excess skin and tighten the underlying facial muscles. As a result, its effects can last up to 10 years, as opposed to several months in injectable treatments.

* Liposuction alternatives. Non-surgical alternatives often use laser or ultrasonic waves to penetrate the skin and “liquefy” the fats, which the body will gradually flush out, a process that could take several weeks to months.

Meanwhile, liposuction surgery uses a few incisions measuring 1/4 to 1/8 of an inch, which further contract as they heal that after about a year they are difficult, if not impossible, to detect.

Liposuction is ideal for treating a large surface area, while its non-surgical alternatives are only suitable for limited contouring. Simply put, having surgery is the only way to achieve dramatic improvements.

* Tummy tuck alternatives. A combo procedure that involves non surgical laser liposuction and Thermage—which uses radiofrequency that is known to promote new collagen growth, thus leading to a tighter, smoother skin—might provide good results to patients who require minimal correction.

But as with any non-surgical alternative, the combo procedure is only suitable for patients with very little loose skin. Anyone with a redundant skin can only benefit from tummy tuck, which typically uses a hip-to-hip incision within the lower abdomen and just above the pubic area to hide the scar.

Because tummy tuck involves a large flap of skin, it is only reserved for healthy individuals with no healing problems.

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Facelift alternatives are ideal for patients who do not want the prolonged downtime after surgery, or they have a medical condition that precludes any elective surgical enhancement, as suggested by leading Beverly Hills plastic surgeon Dr. Karan Dhir.

While facelift alternatives provide impressive rejuvenating effects, they cannot replicate what a real surgery can accomplish—i.e., literally remove the loose skin and tighten the deeper facial muscle so the results can last for many years without touch-ups.

facelift alternatives

The list below shows some of the most common alternatives to facelift surgery, as explained by Dr. Dhir.

  • Botox injection. Its goal is to paralyze certain group/s of muscle responsible for the wrinkles or saggy appearance, leading to a more rejuvenated appearance. While it has received notoriety due to some untoward side effects, most of them can be avoided or at least minimized by using a very small amount of Botox.

It is important to note that it is easier to repeat Botox injection than wait for the effects of overtreatment to dissipate, which could take up to six months.

  • Soft tissue atrophy or shrinkage results in hollowed cheeks, sunken temples, skeletonized eye sockets, and thinning lips. To address these problems, fat grafting or dermal fillers injection can be of great help.

Fat grafting is believed to favor patients who have large depressions such as sunken cheeks because the fat is as soft as the surrounding tissue, while dermal fillers such as Restylane and Juvederm are generally suitable for creases caused by loss of volume—e.g., laugh lines and marionette lines beneath the corners of the mouth.

  • Laser treatments. Laser resurfacing uses high-energy light to tighten the skin and/or destroy minute sections of skin (layer by layer) to promote new collagen growth.

While the treatment is notable for its precision and little damage to the surrounding skin and tissue, it must be only performed by a qualified doctor to avoid burns, skin changes, and injuries.

  • Healthy lifestyle and good skin care. Sunscreen and protective clothing are particularly helpful because UV rays are the main cause of fine wrinkles, leathery skin, and “blotches” that contribute to the aged appearance.

A skin care regimen that includes monthly microdermabrasion or chemical peels, Retin-A daily creams, and regular exfoliation can also help maintain a more youthful face.

Proper diet—i.e., more fresh produce and lean meat—can also do wonder for the skin appearance and prevent significant weight fluctuation, which causes loose, saggy skin.

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A forehead lift with Botox might be a good alternative to surgery, especially if the patient does not want the prolonged social downtime or has a medical condition that precludes elective surgery.

Botox works by paralyzing a certain group of muscle that is responsible for wrinkles or drooping brow appearance. Upland plastic surgery expert Dr. Tarick Smaili says the procedure is most predictable when used in the upper third of the face, specifically the forehead lines, crow’s feet, and glabellar creases or “11” lines between the eyebrows.

forehead with lift

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While forehead lift with Botox can provide rejuvenating effects, a more conservative approach (or less injected volume) is ideal to achieve natural-looking results.

If the tail of the brow sags, injecting a small amount of Botox above the upper lid can create some lifting effect. In doing so, some patients may also notice improvements in their eyelid platform, thus eliminating or at least postponing the need for an actual eyelid surgery.

Aside from lifting the brow that has sagged, judicious Botox injection can also reshape it (more arched in women, or more horizontally oriented in men) based on the patient’s cosmetic goals, gender, and underlying anatomies.

The good thing about Botox injection is that it truly is a lunchtime treatment, allowing the patient return to her work or usual routine. However, some may experience slight redness and bruising, which tend to disappear after a few days.

But Botox in patients with excess, loose skin and significant brow descent cannot expect the same amount of improvements provided by a surgery.

Forehead lift surgery typically uses a few incisions behind or within the hairline to lift the sagging eyebrow and soften the horizontal creases. But for someone with a significant brow descent, an ear-to-ear incision across the top of the scalp might be a better choice.

Also, the surgery’s results can last for many years, while Botox is supposed to be repeated 2-3 times a year to preserve its effects. For this reason, in the long run a forehead lift is cheaper than its non-surgical alternative.

Occasionally, Botox and forehead lift are combined to achieve a more youthful countenance. Dermal filler injection could further enhance their results by correcting the hollowed orbital rim or “skeletonized” eye socket.

Dermal fillers, also referred to as volumizers, can also provide some lifting effect when injected into the skin below the tail end of the brow, as suggested by some Upland plastic surgery experts.

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Instead of excision-based surgeries, some women want non-surgical breast reduction options to help them achieve a smaller bust size and/or find relief from physical symptoms caused by overlarge breasts.

The main concern with traditional breast reduction is the inverted-T scar, although this is always a tradeoff if you have overlarge breasts that are mainly caused by the excess glandular tissue.

breast-reduction-options

(Note: The inverted-T scar is caused by incisions around the areola’s perimeter, within the submammary fold, and from the nipple area to the natural crease.)

As of this writing, there is no non-surgical option that can simulate the results of traditional breast reduction surgery, says Beverly Hills plastic surgery expert Dr. Tarick Smaili.

Nevertheless, for a small number of patients liposuction can provide desirable results. This procedure removes some of the excess fat through tiny round incisions that fade into imperceptible scars within a year.

But the approach is only applicable to older women whose breasts tend to be mainly composed of fat instead of glandular tissue, which can only be removed with an excision-based technique. Also, there is always a tradeoff in removing large amounts of fats and that is the risk of sagging.

To reduce the risk of sagging, the amount of removed fat will be based on the skin elasticity and its ability to redrape to the new contour.

Meanwhile, some non-surgical procedures such as ultrasound, laser, and CoolSculpting are said to reduce breast volume, although no comprehensive studies and clinical trials can attest to this. For this reason, no respectable plastic surgeon will offer such treatments as alternatives to breast reduction surgery.

Sometimes, overlarge breasts are caused by obesity, so the best course of action is to lose weight through healthy diet and regular exercise. It is important to note that no body contouring surgery can provide predictable results if the patients are overweight or obese.

While physical therapy will not “actually” reduce the breast size, it might be a good alternative if the patient is having neck/back pain or rounded shoulder and does not want a surgery.

And even among patients contemplating to have breast reduction surgery, a therapy might be a prerequisite for medical insurance, especially if their reasons include physical pain and discomfort caused by their overlarge breasts.

Aside from therapies and other non-surgical treatments, it is also typical for health insurance issuers to require women to be near their ideal weight before giving them a pre-approval.

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Liposuction by “real” definition is a cosmetic surgery designed to remove the unwanted fat from under the skin, creating a more slender figure. It uses a few round incisions, as small as 2 mm, where a cannula or suction probe is inserted and moved back and forth to dislodge the fatty tissue.

Meanwhile, liposuction alternatives often refer to the use of non-invasive or non-surgical techniques, which lead to no or very minimal downtime that is suitable for patients with busy schedule and those with medical condition that makes them a poor candidate for an elective surgery.

liposuction-alternatives

These “alternatives” generally use cold, heat, and ultrasound from the skin surface to shrink and destroy the fat, which the body will flush out from its system, a process that could take up to several months. Examples include Cool Sculpting, Liposonix, and Smart Lipo.

Aside from little to no downtime, liposuction Orange County expert Dr. Tarick Smaili says another purported benefit of these non-invasive techniques is the slight shrinkage of the overlying skin, an effect believed to be caused by collagen stimulation. Nevertheless, he warns that patients whose skin is markedly poor—i.e., it hangs and appears redundant—will not see a good amount of improvement.

Also, non-surgical fat removal techniques result in minimal swelling, while in the traditional liposuction this symptom will take up to three months to subside to a significant degree.

However, Dr. Smaili says that liposuction alternatives cannot take off large volumes of fat, a feat the traditional approach can only address.

Also, patients whose fat is notably fibrous and dense—e.g., massive weight loss patients and men needing breast reduction via liposuction—are poor candidates for any non-surgical approach, explains Dr. Smaili.

These patients can only achieve a noticeable improvement from the standard liposuction in which large volume of tumescent solution is injected into the treated area to liquefy and make the fat swollen prior to its extraction. This technique not only paves way for more volume removal, but also allows for greater accuracy and more skin symmetry.

Because liposuction alternatives rely on the body to metabolize and flush out the destroyed fat cells, the results can take two to three months to become noticeable. Meanwhile, the effects of liposuction surgery are visible as early as two weeks.

Dr. Smaili says the postop swelling, which will improve after three to four weeks, will temporarily conceal the results of liposuction surgery, adding that it can take up to six months for the skin to fully redrape to the new contour.

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