Body Sculpting: latest concepts
In Australian culture, now more than ever, looking good is
becoming synonymous with being healthy. It's a well-known fact,
though, that no amount of dieting or exercise can remove fat
from certain problem areas of the body. In fact, paradoxically,
excessive exercise can lead to disproportionately large thighs,
calves and even smaller breasts.
Liposuction has been around since the early 1980s. Despite the
initial success, it was inevitable with our increasing desire
for contoured figures that liposuction would need to undergo
further advancements. Hence, through the genius of Professor
Marco Gasparotti from Italy and Dr Luiz Toledo of Brazil,
superficial liposculpture emerged as the next generation
liposuction.
Liposculpture is the technique of removing excess fat from
certain areas of the body and injecting the harvested fat into
adjacent areas to create shape and contour. The best example of
this technique is the sculpting of the buttocks region.
Superficial liposculpture is the next generation technique.
Where traditional liposuction is designed to remove the deep
fat, the new liposculpture technique takes the superficial fat.
By removing the superficial layer, the skin is allowed to move
freely as an independent entity and hence resume the new shape
that the surgeon intends to provide.
The current thinking is that liposuction should not be used only
for weight reduction but instead as a means of sculpturing the
body into a three-dimensional shape comprised of convexity and
concavity. We are moving more towards patients who want to have
overall changes in body shape. To varying degrees, liposculpture
treats all the three layers of fat under the skin - that is, the
superficial fat, the middle fat and the deep fat - and the
muscle layers to varying amounts.
After surgery, it is imperative that all liposculpture patients
enrol in a rigorous physiotherapy massage program, which uses a
special ultrasound technique for smoothing out any build-up of
scarring in the deep tissue that may occur as a result of the
liposculpture procedure. Patients need to wear an elastic
garment for four to six weeks. Although the results of body
sculpting can be apparent straightaway, due to swelling, the
final outcome is only seen after four to six months.
Breast enhancement is an integral part of body sculpting.
Women's breast shape must closely match their overall physique.
For the optimal result, the surgeon must foremost improve the
shape and volume of the breasts to match the liposculpted body,
preferably at the same time. Liposculpture to the hips, thighs
and abdomen will have a profound effect on the perceived shape
of the breasts.
The body surgery patient needs to: * Be healthy and physically
active * Be of stable weight and eat a balanced diet * Have good
skin tone * Be a non-smoker * Have realistic expectations * Be
committed to wearing a post-operative elastic garment and sports
bra * Be compliant with post-operative physiotherapy and massage
Therefore, where indicated, a combined body/breast approach will
be dramatically shape altering.
There are generally three procedures that address the breast as
part of the sculpting process: breast augmentation with
implants; breast lift (mastopexy) with implants and breast lift
without implants. Since fat injection to the breasts has been
largely abandoned in Australia, currently the only safe means of
breast augmentation is the use of an implant (silicone gel or
saline).
Before surgery, a patient should review photographic examples of
the breasts they would like, and explain what they want to the
surgeon, so there is a clear visual understanding of the desired
result.
There are five crucial clinical parameters in the aesthetic
assessment of the breasts:
1 Patient's body build and height 2 Breast size, shape and
symmetry 3 Nipple position in relation to the breast 4 Chest
wall shape and dimension 5 Patient's desire for cup size and
shape.
Generally speaking, if the breasts are of good shape but lack
volume, simple augmentation using an implant will be sufficient.
In breasts that are droopy with good volume, a breast lift can
be very powerful in giving the desired shape and perkiness.
Finally, breasts that have lost both volume and shape will
benefit from a combined breast augmentation and lift procedure.
Case Study
This young mother-of-two couldn't be happier with her recent
breast enhancement and liposculpture procedures.
Tatiana, 27, underwent both breast augmentation and
liposculpture procedures with Sydney plastic surgeon Dr Kourosh
Tavakoli. She had been disappointed when her breasts returned to
their original 10A size after breastfeeding her two children and
she wanted to improve their shape and volume. 'I had always
wanted larger breasts because I wanted them to be more in
proportion with the rest of my body. I couldn't fill out my tops
and I wanted to look more feminine,' she says.
Tatiana also wanted some liposculpture to remove some of the
stubborn fat that refused to budge from her outer hips, buttocks
and behind her knees, despite maintaining a healthy diet and
following an exercise regime. 'I had a personal trainer for
three mornings a week, but no amount of exercise would shift the
fat,' she says. Tatiana was enthusiastic about the whole
experience. 'I couldn't wait for the operating day, even though
some people told me I'd be in so much pain and that I was silly
to have both procedures done in one day. I wasn't worried at
all. I knew I was in good hands, and the only emotion I felt was
excitement.'
Dr Tavakoli told Tatiana she would be able to increase her
breast size from an A cup to a D cup, and she chose round
implants to give her the most natural result. Tatiana also
wanted the implant placed behind the pectoral muscle to ensure
the implants didn't look fake. She says the procedure was
'hasslefree'. She was the first patient of the day and was able
to leave later that afternoon. The pain was not nearly as bad as
people had told her it would be. In fact, Tatiana equated the
pain from the breast augmentation with breast feeding her first
child. 'My breasts were tender and uncomfortable, and I didn't
want them touched, but it wasn't unbearable,' she says. 'The
liposuction was probably more painful than the breast
augmentation. It hurt the most behind my legs. I found it
difficult to sit down and go to the toilet because the area
behind my knees was sore and bruised.'
Tatiana was told the recovery time would be about three weeks
for the breast augmentation and six weeks for the liposuction,
but she was back at work in four weeks.
Tatiana says the results have given her a huge confidence boost.
She is able to wear revealing tops and thinks she's a lot more
outgoing. She says the liposuction has also made a huge
improvement to her figure, although she says she'd like some
more fat to be removed in the future.
She says people noticed that she had had a breast augmentation,
because her breasts had increased to a D cup, but she was told
the result looked very natural. She says the procedures were
important to her, as she had wanted larger breasts and fat
removed from stubborn places for as long as she could remember.
The advice she offers to others is to do the research, choose an
appropriate surgeon, make an informed decision and, most
importantly, to do it for yourself and not for others.