We’ve heard all the terms: saddlebags, muffin tops bat wings. When applied to the parts of our body we love to hate, they hang over us like, well, saddlebags, muffin tops and bat wings. We can exercise and diet until we are blue in the face, but the basic shapes stay the same. We are plagued by our skin type and heredity. Fortunately, there is a lot we can do to have the body we want.

    Says plastic surgeon Dr. Judith Gurley, “Hanging skin and stretch marks anywhere on the body respond minimally to diet and exercise. Surgical removal is the best solution.” She notes that the various problem areas require different solutions, based on skin tone and location. The outer thigh saddle-bags need liposuction to truly recontour the area. Rolls on the back require fat to be suctioned out, but some of the rolls may remain. Muffin tops, the rolls that hang over the belt, need a tummy tuck or body lift.

    “Flapping upper arms, are largely an excess skin problem. No diet or exercise can help that,” says Gurley. “A dramatic difference can be achieved by removing that skin, but it may involve a scar from the elbow to the arm pit.” Other procedures Gurley does frequently these days are neck lifts and body lifts to remove excess skin after massive weight loss from bariatric surgery.

    Gurley says reaching the desired result frequently involves educating the patient on the procedures. “Sometimes patients come in thinking they need a tummy tuck for a bulging abdomen, when liposuction alone will do,” she says. Post-surgery, she counsels patients to commit to a balanced diet and exercise to maintain their surgical results.

    Dr. Michele Koo of Aesthetic Surgery Institute finds ultrasonic-assisted liposuction to be an important tool in helping patients achieve their desired shape. She uses it to shrink the skin and remove the fat in saddlebags, or “end tables,” as she calls them. She also uses it for back fat, especially in cases without much excess skin. “Muffin tops and bat wings are not good areas for liposuction,” she says, so she uses excision on these instead. “That can totally remove and flatten the entire abdomen with a hidden-scar tummy tuck,” Koo says.

    Dr. Terry Myckatyn, a plastic surgeon with Washington University School of Medicine notes there are a few other problems that don’t go away with diet and exercise alone. “The neck and jaw line suffer from gravity’s pull, as do the breasts, abdomen, flanks and buttocks. After patients do everything they can with diet and exercise, we talk about contouring surgery,” he says.

    Myckatyn stresses that a healthy lifestyle is more important than body contouring, and should be embraced first. “Cosmetic procedures can turn back the clock but can’t stop it,” he says. “For body contouring patients, it’s usually best to initiate healthy changes several months before surgery. Surgery alone rarely works as a catalyst to embark upon a healthy lifestyle. That should come from within.”