Welcome to the special Body Contouring issue of Aesthetic Surgery Journal, in celebration of the journal's 30th anniversary. In this Editorial we describe the evolution and innovation of body contouring surgery, both in the broader plastic surgery landscape and in the pages of ASJ, the #1 journal in aesthetic and plastic surgery. Arguably, one of the most pivotal points of genesis for the field of surgical body contouring was the adoption of bariatric surgery—particularly the gastric bypass, first performed in 1966 by Dr Edward E. Mason.1 This procedure evolved and its popularity grew over subsequent decades.2 Revolutionaries such as Thorek,3 Passot,4 Vernon,5 Pitanguy,6 Grazer,7 and many more, helped to lay the groundwork and pioneer the body contouring specialty into its current glory. In the modern era of this surgical “boom,” Ted Lockwood, as published in Aesthetic Surgery Journal, revolutionized our understanding of the anatomy and strength of the superficial fascial system to optimize lifting in standard procedures for panniculectomy, abdominoplasty, brachioplasty, thighplasty, and lower body lifts.8 Body contouring procedures then began to evolve beyond the aesthetic treatment of weight loss patients, as well as incorporating more sophisticated techniques, including autoaugmentation of the breasts and buttocks, and oblique truncal excisions, defying the norm for a relatively new subspecialty.9-11 More recently, minimally invasive or noninvasive technologies such as radiofrequency, helium therapy, and cryotherapy have become serious market players and are modalities that we would not have ever imagined when we began our practices in the mid-2000s.12-16 The Body Contouring section of ASJ was first established in 2009, under then–Editor-in-Chief Dr Foad Nahai. Dr Al Aly (Figure 1), who has since become Editor-in-Chief of ASJ Open Forum, served as the sole section editor until Dr Jeffrey Gusenoff joined as co–section editor in 2015 (Figures 2, 3). Dr Jamil Ahmad joined the section in 2024 (Figures 4, 5), with Dr Pat Pazmiño joining in 2025 (Figures 6, 7). Over this period, the Body Contouring section has become one of the highest-volume subject sections of ASJ in terms of manuscript submissions. The section has grown rapidly over the past 17 years, echoing the growth in popularity of patients seeking body contouring procedures. Weight loss–related procedures have evolved over this period from the popular gastric bypass to the prevalent gastric sleeve, with increased revisions of the gastric band. And now, glucagon-like peptide-1 |(GLP-1) receptor agonists have ushered in an entirely new population of weight loss patients, driving the need for innovative technologies and procedures to meet their needs. During this evolution, we have seen a change in practice patterns as more surgeons have altered their practices to perform drainless procedures, including the use of quilting or progressive tension sutures.17-19 Eliminating the need for drains, reducing complications such as the dreaded seroma, and optimizing the patient experience have become paramount. Dr Foad Nahai (left) presenting Dr Al Aly (right) with a Best Panelist of 2007 award at The Aesthetic Society's annual meeting in San Diego, CA in 2008. Dr Al Aly served as an ASJ Body Contouring section editor for over a decade prior to taking on his current role as editor-in-chief of ASJ Open Forum. Body Contouring Section Editor Dr Jeffrey Gusenoff emceeing the ASJ Book Giveaway event at The Aesthetic MEET 2025 in Austin, TX. Body Contouring Section Editor Dr Jeffrey Gusenoff participating as a panelist at the “Predictable Techniques for the Massive Weight Loss Patient” mini-symposium at The Aesthetic Society's annual meeting in Miami, FL in 2023. Editor Emeritus Dr Foad Nahai (left), Body Contouring Section Editor Dr Jamil Ahmad (middle), and Clinical Editor Dr Robert Singer photographed together at The Aesthetic MEET 2024 in Vancouver, BC, Canada. Body Contouring Section Editor Dr Jamil Ahmad receiving the 2023 Walter Scott Brown Award at The Aesthetic Society's annual meeting in Miami, FL in 2023. ASJ Senior Managing Editor Abby Pugh, 2020–2026 (left), photographed with Body Contouring Section Editor Dr Pat Pazmiño (right) at the annual ASJ Champagne Toast event at The Aesthetic MEET 2024 in Vancouver, BC, Canada. Dr Onelio Garcia, Jr (left) and Body Contouring Section Editor Dr Pat Pazmiño (right) receiving The Aesthetic Foundation Safety Award at The Aesthetic MEET 2024 in Vancouver, BC, Canada. Outcomes research has been highly focused since 2009 on describing risk factors for complications and trying to identify better ways to educate patients prior to surgery and manage expectations. Fat transfer has found new indications, such as muscle augmentation to accentuate contouring, while safety in gluteal augmentation has been paramount.20-22 It is evident that the Body Contouring section of ASJ has played a pivotal role in documenting and disseminating the research that has driven these advances. With a 56% increase in manuscript submissions since 2015, the section has become a valued resource and comprehensive “go-to” publication for all aspects of body contouring. The Body Contouring section of ASJ has highlighted many advances in the field, but has also been a beacon for safety in body contouring surgery. The landmark report by Dr Mofid et al, “Report on Mortality From Gluteal Fat Grafting: Recommendations From the ASERF Task Force,” took on the contentious issue of gluteal augmentation safety. This paper, which has since become the most-cited Body Contouring paper in ASJ's history with 261 citations and more than 52,000 views and counting, provided essential recommendations for reducing complications in gluteal fat grafting.23 Rather than calling for a moratorium on gluteal fat transfer, literature from ASJ has further emphasized that board-certified plastic surgeons should be the ones leading the way on conducting this procedure with the utmost safety and use of ultrasound.24-27 Over the years, the Body Contouring section has embraced the rapid pace of innovation in minimally invasive treatments. The introduction of CoolSculpting, a noninvasive fat reduction treatment based on cryolipolysis, and the subsequent publication of articles such as “Broad Overview of a Clinical and Commercial Experience With CoolSculpting” by Dr W. Grant Stevens and colleagues, highlighted the growing trend of nonsurgical body contouring.12 This paper has been cited 101 times and has reached over 16,000 views, validating the importance of noninvasive methods in modern body contouring. More recently, the inclusion of radiofrequency-assisted liposuction and other advanced technologies has broadened the scope of treatment options available to patients.28 As the popularity of body contouring surges, ASJ is proving to be a key platform for reporting and advocating for patient safety. The article “Cosmetic Liposuction: Preoperative Risk Factors, Major Complication Rates, and Safety of Combined Procedures” highlights the safety of performing liposuction in combination with other aesthetic procedures. The importance of this study lies not only in its impact on clinical safety protocols but also in its high citation rate (128 and counting) and wide readership (over 15,750 views and counting).29 The development of new technologies and procedures has also been paired with an increasing focus on patient outcomes and long-term results. The study “Prevention of Seroma Formation Following Abdominoplasty: A Systematic Review and Meta-analysis” consolidated the findings from multiple studies to provide clear solutions for one of the most common and frustrating complications of abdominoplasty, and a newer ASJ paper titled “Complications and Risks Associated With the Different Types of Abdominoplasties: An Analysis of 55,956 Patients” further explored the potential adverse events and risk factors associated with this procedure, providing a helpful resource for improving patient safety and outcomes.30,31 New techniques and approaches to body contouring published in ASJ, including nonsurgical options such as CBL-514 injection32 and high-intensity focused electromagnetic therapy and synchronized radiofrequency,33 continue to expand the scope and possibilities of aesthetic clinical practice. ASJ has been and continues to be at the forefront of technical advances in abdominoplasty, such as progressive tension sutures or running barbed sutures for seroma prevention.34 Refinement in patient selection and perioperative patient management have been shared in ASJ, allowing for a safe and effective delivery of outpatient body contouring surgery at ambulatory and office-based surgery centers.35,36 As the adoption of injectable GLP-1 receptor agonists continues to rise in the United States, surgeons and aesthetic practitioners are seeing a greater demand for body contouring procedures, much like the uptick that was seen in the years following the increased adoption of bariatric surgery.37-39 As evidenced by numerous articles published in ASJ on the topic,40-43 this journal will continue to be at the forefront of meeting this demand. In providing emerging information and insight for practitioners seeking to meet the needs and goals of this ever-growing patient population, ASJ and its editors will continue to prioritize the publication of research that seeks to continually improve patient safety standards, outcomes, and evidence-based practice. Looking ahead, we predict that in 10 years’ time, when ASJ celebrates its 40th anniversary, we will see an even greater integration of artificial intelligence and machine learning into the body contouring field. Imagine a patient standing in front of a visualizer that can simulate vectors of pull, and the surrounding residual deformities, to provide a real estimate of expected outcomes. These technologies will allow for more personalized treatment plans, including assessment of diet, BMI, age, and current medications (such as GLP-1 receptor agonists), enabling surgeons to perioperatively prepare patients for surgery with diet recommendations and timing of meals relative to medication use. We will also be able to predict the results of various procedures with unprecedented accuracy, ultimately enhancing patient satisfaction and safety. Moreover, advances in regenerative medicine, beyond simple fat transfer, will offer aesthetic enhancement with biological restoration. Stem cell therapies, gene editing, and other regenerative treatments will restore youthful contours and improve skin elasticity without the need for traditional surgery. Such advances will revolutionize the way we approach aging and body aesthetics. As we reflect on the past 30 years of body contouring, we see the tremendous amount of progress that has been achieved through technical innovation, as well as patient safety and procedural optimization. Looking to the future, one area that remains ripe for innovation is skin tightening after liposuction and other body contouring procedures. Every year, new devices appear that make the current ones obsolete. Practices cannot sustain the initial investments demanded by such a rapid turnover of technological advances. We are hopeful that we will soon see a noninvasive, universally effective solution for postcontouring skin laxity. Such a breakthrough would elevate the results of body contouring procedures, offering smoother, more toned outcomes and reduce recurrent skin laxity, without the need for additional surgical interventions. As we look toward the next decade, we are confident that the body of literature in ASJ will continue to provide clarity to plastic surgeons on what techniques and technologies prove to be the best for our patients. Despite the institutional challenges faced by research efforts, we would like to see more high-level randomized, controlled trials to complement the practical lower-level, but very important, clinical results data to drive proper care. The Body Contouring section of ASJ has been an invaluable resource for documenting the evolution of this dynamic field. With its impressive manuscript submission growth and the remarkable articles that have shaped practice, ASJ has mirrored advances in the field of body contouring and helped lead the way. As we celebrate ASJ’s 30th anniversary, we recognize the incredible contributions of researchers and clinicians who continue to push the boundaries of what is possible in body contouring. Please continue to submit and share your fine work with us and encourage your colleagues to do the same. The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. The authors received no financial support for the research, authorship, and publication of this article.
Gusenoff et al. (Fri,) studied this question.