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Next to facial beauty it is a “body beautiful” that is on everyone’s wish-list. While a few are naturally blessed, for many the changes, brought about by genetics, age, pregnancies, and sedentary living, refuse to respond to diet and exercise-the bulges and tires simply do not go away. While some seek that elusive goal of the perfect 10/10 figure, the majority just want a more acceptable contour. Enter body contour surgery the current buzz word. One hears of liposuction, body wrap, special contouring suits and magic cures.

What are the facts? Dr. Mohan Rangaswamy, Consultant plastic surgeon at Welcare hospital

Q: What is liposuction?
A: Liposuction or suction assisted lipectomy (SAL) involves removing fat tissue from between the skin and muscles i.e., what one can pinch or grab in one’s hand. Thin long metal cannulae connected to a special pump are used to permanently remove fat from selected areas of the body. The skin has to shrink down to the new size after this. If the skin has lost its elasticitv then SAL alone may not yield desired results.

Q: Which areas can benefit from liposuction?
A: Best areas: Arms, abdomen, love handles, chest in men, some breast reductions in women, fat under the axilla, buttocks and hips, outer thigh bulges, inner knees.

Good areas: thigh, under chin, back rolls, pubis, face in selected individuals.

Bad areas: upper back, bull neck, wherever skin is lax and loose, ankles.

It is not suitable for people who are round and obese everywhere. Ultimatley success also depends a lot on the skin elasticity.

Q: What is body contour surgery?
A: In body contouring surgery (BCS), in addition to SAL, there may be removal of excess skin, tightening of muscles, repair of hernias and even injection or insertion of fat or synthetic material in strategic places. BCS is done for the abdomen (tummy tucks), breast (reductions and lifts), neck (double chin), arms, buttocks and thighs.

Q: What about scars?
A: In pure SAL, the scars are miniscule and fade away with time, but in

some BCS procedures long but well hidden scars are unavoidable.

Q: Can the fat return in the same spot or elsewhere?
A. Fat removal is permanent from that part, however if the patient continues to overeat and gain weight, the remaining fat cells can accumulate more fat. SAL cannot remove fat from inside the abdomen and from around the organs.

Q: Is there blood loss? What are the dangers?
A: Modern SAL performed by qualified plastic surgeons is extremely safe and entails minimal bleeding, almost ALL the horror stories and deaths have been in the hands of charlatans and fly by night operators working in ill-equipped places. However, like all major surgical procedures, there are well known risks and side effects about which the surgeon will counsel the patient.

Q: How soon can the patient recover?
A: This is variable. In minor and moderate cases, the patient may be discharged the same or the next day and can resume light work in 5-7 days. More extensive cases obviously will take longer. Major liposuction is not a weekend procedure! Minor liposuctions however can be offered as a weekend procedure.

Q: How many kilos will the person lose after SAL?
A: This is the commonest question in consultation! Liposuction is NOT a weight loss procedure. In most cases we remove only 500 to 3000 ml of fat; usually one does not exceed 4000 ml. This is enough to produce significant changes in the shape but not in the weight. However after SAL or BCS, patients find it easier to move and be active and may notice that losing weight is easier.

Q: Is it possible to gain weight after liposuction?
A: As stated above, liposuction does not change the energy balance of the body; this is the responsibility of the person to see that he/she eats correctly and exercises regularly to maintain the body balance.

Q: What about the new laser liposuction?
A: Scientists are trying to destroy unwanted fat by using different energy delivery methods. Laser has shown some promise. In the present state of technology, Laser destruction of fat called laser lipolysis is only effective for small collections of fat. For larger volumes, laser assisted liposuction has merit. Here, laser energy is delivered to the body of fat followed by conventional liposuction at slightly lower vacuum. Traditional or modified traditionals such as pwere assisted and Vibro-assisted are still the gold standard of liposuction.

Q: Is liposuction only a cosmetic procedure for vanity and to look good?
A: The physical and psychological spin-offs from these operations are numerous and in well selected patients it is almost like getting a new lease of life. The patients find that they are able to do many things that they dared not do before, their self esteem is higher and in some patients with huge debilitating deformities (ex: large abdominal apron) the physical relief is enormous. Prevention of future knee and back problems is another health advantage.

Q: What about body wrap and other such treatments?
A: Liposuction is the only proven technique of permanent reduction of fat from an area, with the possible exception of endermology for cellulite control. There are many things on the market which may offer only temporary improvements at best.

Q: Any newer developments in body contouring?
A: Plastic surgery is an ever expanding field. Ultrasonic energy is being used to increase the efficiency of SAL. We also have vibration assisted liposuctions which aim to improve skin shrinking after liposuction. These are also useful for tough areas like the male chest. Laser power and ultrasound power are also used to enhance the efficiency of liposuction.

Fat harvested from liposuction can be re-injected to different areas to correct contour defects. Here the fat has to be harvested by gentle methods and re-grafted using special techniques.

Precision liposuction called liposculpture uses fine cannulae to do precise etching and sculpting. This is used to define the face, the ‘abs’ for a 6 pack look, get muscle definition in the arms, calf etc. Liposuction can be used to remove over-active sweat glands in the under-arm area.

These surgical methods can be supplemented and extended by the newer tools such as Radiofrequency devices [power-shape etc] and by laser waves.