Menopause changes where the body stores fat and what the skin does with it. Fat redistributes from the hips and thighs to the abdomen, skin loses collagen and elasticity, and the tissues that hold everything in place become laxer. The result is a body that has changed shape without the scales necessarily moving.
Surgery addresses some of that and not the rest, and the distinction is worth being clear about before anyone quotes you for anything.
What changes, and what helps
| Change | Can surgery address it? |
|---|---|
| Loose abdominal skin | Yes — abdominoplasty removes it |
| Separated abdominal muscles from earlier pregnancies | Yes — repair, where the criteria are met |
| Pinchable fat at the flanks with good skin | Yes — liposuction |
| Breasts sitting lower with lost upper fullness | Yes — lift, with or without added volume |
| Loose skin on arms and thighs | Yes — excision, accepting a scar |
| Firm, rounded abdomen you cannot pinch | No — that is fat inside the abdomen; weight loss is what shifts it |
| Generalised skin thinning and crepiness | No — excision tightens where skin is removed, not skin quality |
| Muscle loss and strength | No — resistance training and protein intake |
The one that matters most
The shift of fat to the abdomen after menopause is partly visceral — inside the abdominal cavity, behind the muscle wall. An abdominoplasty removes skin and fat outside that wall. If your abdomen is firm and rounded rather than pinchable, surgery will do considerably less than you are hoping, and you deserve to be told that rather than sold an operation.
Sit down and try to pinch it. What you can take hold of is treatable.
Skin quality is not the same as skin quantity
Excision removes a quantity of skin. It does not improve the quality of the skin that remains — texture, thinning and crepiness continue as before. A patient whose main concern is skin quality rather than a fold of excess skin is usually better served by dermatological care than by surgery, and Dr Kumar will say so.
Things worth attending to first
- Bone health. Worth discussing with your GP independent of any surgery.
- Weight stability. Six months of stability before body contouring, as with any patient.
- Resistance training and protein. Muscle loss accelerates after menopause and no operation replaces it.
- General health and medications. These are elective operations and fitness for anaesthesia is assessed properly.
- Nicotine. Complete abstinence from all nicotine, not just smoking, for six weeks before and after surgery, and eight weeks for body contouring after weight loss.
Medicare
Age does not change the items, and menopause itself is not a criterion. The usual body contouring items apply on their own terms: 30166 and 30177 where there has been significant weight loss with functional problems and a stable weight for six months; 30175 where there is a pregnancy-related diastasis of at least 3cm on imaging with documented symptoms and failed physiotherapy, claimable once per lifetime; 45558 for bilateral mastopexy where at least two-thirds of the breast tissue including the nipple lies below the inframammary fold, also once per lifetime.
Surgery performed for appearance alone attracts no rebate. More about costs.
Recovery, and age
Recovery is broadly the same — two weeks off work after body contouring, a gradual return over four, full clearance at about twelve weeks. What changes with age is not usually the timetable but the margin: wound healing is less forgiving, and factors like diabetes, medications and nicotine matter more. That is a reason for thorough preparation, not a reason to be declined.
Common questions
Am I too old? Fitness matters, not the number. Assessment is individual.
Will hormone therapy change the result? That is a question for your GP or specialist. It is not a surgical decision.
Will exercise fix the abdomen? It reduces visceral fat, which surgery cannot. It does not remove loose skin, which surgery can. They address different things.
Can several areas be done at once? Sometimes, and combining often costs less overall. Dr Kumar will tell you what he is prepared to do in one sitting.
Next step
Bring a GP referral — it is required to see Dr Kumar — and you will get a straight answer about which of your concerns surgery addresses. He consults at Westmead, Penrith and Orange. Call 1300 267 726. More about body procedures and your first visit.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
