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:
- Patient's body build and height
- Breast size, shape and symmetry
- Nipple position in relation to the breast
- Chest wall shape and dimension
- Patient's desire for cup size andshape.
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 StudyThis 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.
