Chapter IIHow Liposuction Helps People: Some Typical Cases The wide applicability of the liposuction procedure can best be illustrated by examples of some of the actual cases that I and the group of physicians I work with have treated over the past few years. Following are the outlines of a few cases, chosen because they exemplify the kinds of problems that liposuction has solved, and the ways in which these patients lives have been enhanced.
As you will see, the emotional aspects of these stories are often the most important of all.
All these cases are real, and the medical details are accurately reported. Only the identities of the patients have been modified to protect their privacy.
CASE STUDY: LINDSAY D.
At 34, Lindsay was, by anyone's standards, a very attractive woman. No one who looked at her as she went about her daily routine could imagine the secret anguish of her life. Only those who were her nearest and dearest-her family and her closest friends-knew what she was going through. Everyone else, however, including those with whom she dealt in her career as a hospital dietician, had no suspicion of the truth. What they could not know was that Lindsay's body was the object of a fierce, relentless battle with fat deposits that refused to disappear, no matter what Lindsay did.
She watched every calorie that entered her mouth. She worked out every day...savagely, angrily, desperately. But even though she counted calories and followed a well-balanced diet, even though she exercised regularly and at length, she continued to have specifically located fat deposits which would not disappear.
Lindsay was desperate. She knew she was doing all the right things. Still she saw no improvement. Then Lindsay heard about liposuction. She was skeptical of its claims for body sculpturing. Nevertheless, she decided to investigate the procedure.
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1. Heavily padded belly, with fat deposits, before surgery.
2. The same abdomen and hips after surgery showing smoother contour and flatter belly.
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3. Left photograph shows patient's abdomen protruding above clothing.
4. View from right shows the same patient following surgery, with flattened contour, and healthier looking silhouette.
After a thorough examination and review of Lindsay's history, I was able to reassure her that her figure problems were in no way her own fault. Clearly there was a genetic disposition at work.
Even though she was still a relatively young woman, as the years went by, her inherited tendency for refractory fat deposits-deposits of fat that persist, despite dieting and exercising-was becoming more obvious. No matter how frequently Lindsay exercised, no matter how she watched her food intake, her unattractive bulges repeatedly threatened to burst beyond the bounds allowable to one in her demanding profession. So it was that she came finally to consider liposuction-skeptical, but nevertheless hoping against hope for some help in her struggle. And if anyone deserved help, Lindsay did.
She was relieved to learn that she was not to blame for her problems. She was an excellent candidate for liposuction, since she was in top physical condition because of her previous well-balanced, nutritional diet and her habit of exercising regularly.
Liposuction surgery was successful. Over the course of a single 90-minute procedure, we removed a total of 2200 cc of fat (75 ounces) from her buttocks, hips, abdomen and thighs. For Lindsay, this was the equivalent of losing 15 lbs. by dieting.
With body sculpturing completed, for that is what the surgery really accomplished, Lindsay felt much better about herself. She felt far more confident about advising others about diets and nutrition, now that she herself was satisfied with her shape.
Lindsay no longer needed to fight so furiously against the encroachments of that nemesis of inappropriate fat. She still works out regularly, and she still watches her food intake. But Lindsay's life no longer requires the relentless struggle of her pre-liposuction days.
Lindsay's co-workers were shocked and envious of her "new" appearance. Even her supervisor commented. "You look wonderful," he told her. "I don't know what you've done, but you look great!"
CASE STUDY: BOBBIE W.
Bobbie had been doing battle with bulges of fat in the wrong places for all of her life after adolescence -- nearly 25 years of despair.
When Bobbie first considered liposuction, she weighed a hefty 140 lbs., although she was only 5 feet 4 inches, tall.
Bobbie had a total of 1100 cubic centimeters of fat (just over 37 ounces) removed from her abdomen and buttocks. After liposuction surgery, she continued treatment in our post-liposuction program. Six weeks later, Bobbie weighed in at 127 lbs. Best of all, she looked and felt much better. Before liposuction, Bobbie's abdomen and buttocks were flabby. She looked several months pregnant, even though she wasn't, because of her excess weight and bulges. Afterwards, Bobbie's muscles were tighter and more defined. She had lost the matronly appearance that bothered her so much. Instead, Bobbie looked like the attractive woman she really was..."alive" and glowing, fashionable, and definitely interesting.
IMAGES MISSING
1. Circles outline the bulging buttocksand hips that made this patient so unhappy.
2. After surgery, her body was shapely, and showed smooth and graceful lines.
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3. The patients sagging buttocks and heavy bulging shape was an embarrassment and a concern.
4. After surgery, the buttocks shape was gently rounded, in proportion to thepatient's overall body contours.
"I can't believe it" she told her friends, "I wish I'd done this years ago!"
One of the delightful results of Bobble's liposuction and follow-up program is that she now can do what she never could do before this "miracle" surgery. She can wear designer jeans and bathing suits, knowing she looks attractive.
CASE STUDY: BRUCE M.
Bruce had a lifelong problem that showed itself in a set of pronounced "love handles" (the vivid term that describes the rolls of fat protruding at the side of a man's waist), as well as a very prominent belly.
Even though he was a successful public relations communicator, Bruce felt strongly that his career had been adversely affected by deformation. He was in a highly competitive field, and believed he could be even more successful if he could achieve a more streamlined look. He felt uneasy and self-conscious whenever he had to present his work to his manager, or to prospective clients of his firm. And that made Bruce appear more awkward and less competent than he otherwise might have seemed.
When Bruce showed up at the clinic, he was substantially overweight. He was a moderately tail man (5 feet 10 inches) but at 250 lbs., he was distinctly obese. Tests showed that his body fat ratio was 30 percent-almost double the ideal ratio for men. Bruce's biggest problems were his "love handles" and the protruding abdomen. He felt embarrassed not to be able to wear a light shirt in the summertime, or jeans in his leisure hours without appearing sloppy and unattractive.
IMAGES MISSING
1. Circles outline the bulging buttocks and hips that made this patient so unhappy.
2. After surgery, her body was shapely, and showed smooth and graceful lines.
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3. The patients sagging buttocks and heavy bulging shape was an embarrassment and a concern.
4. After surgery, the buttocks shape was gently rounded, in proportion to the patient's overall body contours.
Bruce had read articles about liposuction, and had come to see if the surgery could help him. He was somewhat skeptical, because many of the articles had talked about women. "Can liposuction really do anything for a man?" he wondered.
After Bruce had considered the surgery carefully, he decided to go ahead with the operation. A total of 1500 cubic centimeters of fat (51 ounces) was removed from his waist and belly. Like almost all of our patients, he decided to take part in our comprehensive post-liposuction program.
Follow-up examinations, repeated at regular intervals, showed Bruce to be in much better condition. In fact, his body fat ratio had dropped to 20 percent --not ideal yet, but certainly well on the way to a much healthier condition.
Within nine months after liposuction, Bruce was promoted to an executive position in his firm. He was able to fulfill his ambitions to be better-looking, and also to compete more effectively in the high-pressured world of public relations. Although no one can say conclusively that the liposuction and Bruce's improved appearance were a factor in his advancement Bruce feels they played a big part. "When you feel better about yourself," he says, "you project a more positive attitude. You're confident about how you look. You spend less time paying attention to how you come across to others, and more on the substance of what you're presenting. And that's got to pay off. I feel it did for me."
CASE STUDY: DOLORES G.
Dolores had always been a very lean, slender woman who delighted in wearing the latest fashions. After her third child was born when she was 32, her slim self simply disappeared. In its place, there was an unattractive, frumpy woman who looked much older than her true age. She longed to return to that earlier body image, and finally at 44, she considered liposuction.
Liposuction on her hips, thighs, and abdomen was successful. Dolores looked and felt better after shedding her premature "matron"image. "This was a lot easier than I thought," she says. "I'd worked and worked at exercising, but those bulges were still there. The surgery wasn't bad at all, and I'm a lot happier about the way I look."
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1. This patient shows typical deposits on upper hips, saddlebag areas, and inner thighs, as well as a heavy abdomen.
2. Same patient from the rear shows heavy deposits at upper hips, saddlebags, and inner thighs.
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4-5. Above show the patient after surgery, from the front and the rear, with the bulges gone, and an overall better-proportioned shape.
CASE STUDY: ERIC S.
Eric S., at 66, was a happily married entrepreneur who enjoyed his business and home life. Although Eric had no great concerns about his appearance, his wife kept insisting that he "do something." Eric was a vigorous man who had remained trim until he was 50 years old. From that time on, he said, even though he took walks and did twenty minutes of calisthenics every day, he had acquired a pot belly and the seemingly inevitable love handles. In addition, Eric had a double chin, fat neck, and sagging jowls.
We explained to Eric how aging, combined with certain genetic tendencies, had resulted in his unwanted fat deposits. Since he was otherwise in good physical condition, Eric was an excellent candidate for liposuction. Age was no barrier to the surgery, which offered a real chance for help with his problems.
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1. Patient's double chin and heavy sagging skin on neck create older-looking, sagging profile.
2. The patient after surgery shows a more youthful profile, with fatty deposits removed and flabby skin tightened.
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1. A patient shows a sagging double chin and flabby neck, which add years to his appearance.
2. The same patient after surgery shows a much more attractive profile and youthful neck and chin.
Liposuction removed a total of 1300 cubic centimeters of fat (nearly 33 ounces) from his abdomen and waist. Eric swears liposuction saved his marriage. "My wife wants to come next," he told us. "She says if it worked this well for me, she should have the surgery too."
CASE STUDY: ANGELA B.
Angela, at 44, claimed that she was the victim of a lifelong injustice. She said that ever since her adolescence, she always had lumps and bulges in her legs, even though she had otherwise been normal in shape and weight. "Piano legs" is how Angela described them, saying her legs always felt heavy and tired. It was hard to believe her, however, because she had been so frustrated with her appearance that she had gotten into some bad eating habits and had put on a good 30 pounds of extra weight.
Angela was so insistent that I made an agreement with her. We would proceed with liposuction of her abdomen--without waiting for her to lose the extra weight--but only if she agreed to go on a reducing diet immediately after the surgery and take off the 30 pounds. Once she had reached that goal, we would then consider liposuction of her thighs, calves, and ankles. Angela agreed. We did the abdominal procedure, removing 900 cubic centimeters of fat (over 31 ounces).
During our post-liposuction program of diet, exercise, counseling, and regular follow-up care, Angela successfully followed the reducing diet we gave her, and lost the 30 pounds of excess weight. That was when I discovered that she had been telling the truth. Her bulging thighs were still there, just as she insisted they would be. We then did the liposuction on her thighs, calves, and ankles, and removed another 1500 cubic centimeters (over 51 ounces) of fat.
IMAGES MISSING
1. Angela had bulging hips and abdomen.
2. After surgery, Angela's appearance was smoother, and her hips, thighs, abdomen, and legs showed a much more normal contour.
Angela was delighted. So was her husband, who said, "It's like having a completely new life and it's like having a completely new wife-and it's legal!"
CASE STUDY: ANNE N.
Anne, an advertising agency executive who had large hips and thighs all her life, wanted to wear high-fashion clothes when she made presentations to clients. She loved the slim skirts, but bulged like a sausage in them. She was embarrassed about the fat deposits in her hips and buttocks, so she always tried to wear loose, dark-colored clothing to hide them.
As a young woman executive, Anne knew the importance her appearance had in determining not only how she came across to clients, but also to her own agency. She was expected to look good and dress well, and she tried. Anne went to aerobics class three times a week. She watched her diet. But nothing helped.
I removed a total of 2200 cubic centimeters of fat (75 ounces) in a single, 90-minute operation, and the result was exactly what she had hoped for. From then on, Anne was able to wear the straight skirts that had up till then been denied her. Because she felt more confident about her appearance, she says, she did a better job of making presentations to clients.
CASE STUDY: HAROLD C.
IMAGES MISSING
1. Harold G. wanted help for his double chin, sagging breast tissue, and pot belly, all of which could be helped by liposuction.
At 38, Harold was a good-looking man who was an officer of a major corporation. At 5 feet 8 inches, weighing 204 lbs., he was a little on the plump side. Harold was ashamed to go to a health club, however, or to undress in front of others, because he had large, hanging, female-type breasts, as well as a fat chin and neck. Harold finally considered liposuction, although he was somewhat skeptical about how much his appearance would improve. We removed 700 cubic centimeters (24 ounces) of fat, and he was astonished. Now he can wear the latest "dress-for-success" clothes. Harold assures everyone he expects to climb up the executive ladder at a faster rate. As an added benefit, he no longer feels embarrassed at pools or beaches-locations he had always avoided.
CASE STUDY: SHIRLEY D.
Shirley was a former teacher who entered the business world to help earn money for her children's college tuition. Despite her late start in corporate life, she was making progress in her new career. Then fate dealt her two blows.
copyright-dr.leon tcheupdjian/liposuction copyright-dr.leon tcheupdjian/liposuction
1. The patient's abdomen and hips showing fat deposits before surgery.
2. The patient after surgery.
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3. The patient's protruding abdomen and buttocks before surgery.
4. The patient after surgery, with normal contours in hips and abdomen.
Shirley's husband became interested in a much younger woman and asked for a divorce. Almost simultaneously, her company was bought by another, larger firm. Shirley found herself having to justify her accomplishments to a new--and extremely critical -- supervisor.
IMAGES MISSING
1. The patient's heavy double chin and neck.
2. The patient after surgery.
These events had happened about a year before she seriously began considering liposuction. Shirley realistically assessed her prospects-both in the dating world, as a mature divorced woman in her mid-forties, and in the business world, where she hoped to change jobs as quickly as possible.
Shirley knew her appearance should be improved if she wanted to compete successfully with younger women. She felt that liposuction might offer her the quickest, and most effective, way to change her image.
I was somewhat startled by her frankness in confessing her ambitions, but examined her as a possible liposuction candidate. As is the case with so many women of a similar age, Shirley had fat deposits around her pelvic and abdominal area, and was developing a pouchy double chin.
Liposuction was performed, and substantial fat was removed from both areas. Shirley felt her appearance was improved, and expected her dating life and career to improve. She called recently to say she'd secured a new position as director of a training center, and to confide that she was seeing a new man. "My life is on the upswing," she told us. "It's a lot more fun to get up in the morning when you've got something to get up for. I'm telling all my friends about liposuction."
The cases described above represent a typical range of liposuction patients with respect to age, gender, and kinds of problems. Most liposuction surgeons feel that there is no set age limit for liposuction. In a very young person, we would want to be sure that growth and maturity had taken place before considering liposuction. However, men and women in their senior years are good candidates for liposuction if they are in good health, and in stable physical condition. These are the same requirements that apply to any elective surgical procedure, including cosmetic surgery.
Most physicians who perform liposuction will use a program that combines diet and exercise, perhaps along with psychological help, as a follow-up to the surgery. I consider such a comprehensive and long-range program essential, if a patient is to receive the greatest benefit and lasting results from liposuction.
I have summarized the cases I described in order to illustrate some of the conditions that lead a patient to consider having liposuction. However, there is far more to successful liposuction than the statement..."We removed a certain amount of fat and now the patient can do...," or "now the patient can wear..." In subsequent chapters, we will look at what I believe are those components. In the next chapter we will consider the surgery itself.
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