liposuction cosmetic surgery institute
Liposuction: New Hope For A New Figure Through The Art Of Body Contouring
By Dr. Leon Forrester Tcheupdjian, M.D.
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Chapter XIV

Liposuction of the Flanks, Sides, and "Love Handles"

In medical language, the flank is the side of the body between the ribs and the hip. The flanks can easily develop unattractive, difficult-to-deal-with bulges. in women, the problem area is technically known as the "iliac area," and is found below the waistline. In men, it is above the waistline.

You may have heard different terms for the fat found in this area. The most commonly heard lay person's term for these deposits is "love handles." Sometimes the men's fat deposits in this area are referred to as "spare tires," for obvious reasons.

Some men and women develop fat deposits on the outer sides of their upper backs, called "costal fat," because it occurs in the back rib area.

Most people know the flanks as the part of the body with "love handles"-those rolls of fat that stick out at the waist, making people who are really not very fat look unattractive and sloppy. Such people, usually men, try to get rid of their love handles by diet and exercise. Often nothing helps, however, because they are dealing with a genetic problem.

Natalie, a 34-year-old secretary, was embarrassed and distressed about her condition. She usually chose dark slacks or skirts to minimize her bulges. When I examined her during her first visit to the Liposuction Institute, I found she was not exaggerating. Natalie's fat deposits made her body extremely unattractive.

1. Markings indicate the locations of fat deposits on thi spatient's torso.

Another woman, Janet, had costal fat pads that made it hard for her to dress attractively. She wore a B cup bra, because her breasts essentially were of average size. Her side fat, however, protruded so much that she needed a size 38 brassiere to fit comfortably around her chest. Consequently, she had difficulty in finding suitable lingerie and clothing.


1. This male patient's torso was thickened by love handles in this photo.

2. After liposuction the same patient's body.

Don, a reporter on a suburban newspaper, came to The Liposuction Institute asking if liposuction of his flanks could help his condition. Don was sensitive about the large, sagging bulges-"rubber tires," he called them. The striking thing about him was that he had athletically-developed arms and legs. When I questioned him about his history of body development, he said he had been bothered by "love handles" ever since puberty. Despite his extensive jogging, swimming, body building, and even basketball this playing, he could never get rid of them. Liposuction seemed to be the last resort, he said.


1. This back view of a female patient shows fat deposits on both hips.

2. After liposuction the patient's hips are much reduced.

Patients with this Problem can often have really remarkable transformations as a result of liposuction. Usually it is men who suffer from fatty deposits in the flanks, although occasionally women display them also. Physicians generally agree that the accumulation of fat in the flanks is influenced by hormones.


1. A front view of a female patient shows abdominal and hip deposits.

2. Following lioposuction the patient's contours are more appealing.

Before liposuction entered the picture, traditional treatment for "love handles" usually was unsatisfactory. The incisions made in order to remove fat by older techniques frequently resulted in prominent scars. Now, however, many physicians who do liposuction report success in removing "love handles." The operation permits the skilled surgeon to contour the body for attractive results.

1. Before, photograph of patient shows heavy deposits on hips.

2. After, the patient shows normally smooth shape.

3. Before, the patient has fat pads on both hips.

4. After, with bulges gone, the patient's figure is much improved.

Either local or general anesthesia can be used. The operation is done on an outpatient basis, and the patient goes home the same day.

While still on the operating table, the patient is bandaged, using specially-designed tape that helps pull the skin together. Next, the surgeon puts a specially-designed elastic garment on the patient. At The Liposuction Institute, we use an elastic dot garment approximately six to eight inches wide. It looks and feels somewhat like a waistband. The garment is comfortable. Its purpose is to compress the skin during healing, binding it tightly to tissues underneath.


1. Male patient shows love handles before liposuction.

2. After, the patient's torso is smoothly contoured.

Unless your doctor has given you other specific instructions, you probably will be told to wear the tape for one week after surgery. Then you will be allowed to shower. The water helps to loosen the tape, and it can be easily removed.

Your doctor will probably ask you to wear the elastic garment for two to three weeks. You must keep it on constantly during the first week after surgery, removing it only long enough to go to the bathroom. For the second or third week (your doctor will give you specific instructions) you can usually wear the garment during the day, and remove it to sleep.

In the first week or so after surgery, you will, of course, notice a small amount of swelling and tissue discoloration when you take the garment off, but you should not be alarmed. That is normal. During your first post-surgical visit, the doctor will remove the garment to check the progress of healing and advise you how much longer to wear it.

You will probably remain resting at home, or engaged in light activity (lying on couch, watching television, etc.) for a day or two after surgery. If you feel comfortable sitting in a chair, you can work at a desk for short periods, stopping if you feel fatigued. Remember that you have had surgery, and the combination of trauma to your tissue plus anesthesia can tire you quickly. Each day, you will find yourself a little stronger until you are yourself again.

You will, of course, follow your surgeon's specific advice about how soon to return to work. That will b determined, in part, by the requirements of your job. If your job calls for you to handle heavy boxes or stay on your feet for much of your workday, you will be slower at getting back to work than a computer systems analyst who sits in front of a terminal.

You should not engage in any strenuous activity for two to three weeks after liposuction-no sports, for example, until your doctor specifically permits them. The chances are that he or she will encourage you to resume moderate activity, such as walking around the block or driving a car, after your post-surgical checkup.

Sex, especially for male patients, may not be as comfortable as usual until healing is more complete, as the tissues have been bruised and are quite sensitive. Follow your surgeon's advice, and do not feel embarrassed about asking specific questions.

Although we make no promises, many patients have reported that their long-range love life has improved dramatically. Don puts it this way: "I look and feel better without the love handles. My girl friend seems to like the 'new' me."

Natalie, another patient with fat in the iliac area, looks and feels much better since her successful liposuction surgery. I removed a total of 600 cc of fat (approximately 20 oz.)

In Janet's successful liposuction, I removed 400 cc of fat (about 14 oz.). Now she reports shopping for clothing is much easier. Her brassiere size is now 34B instead of 38B, giving her a much wider choice of fashions. Janet is happy with the physical changes liposuction has brought about. "I tried to scratch my side pads, and they weren't there," she says. And she likes the opportunity to wear sweaters. "I felt embarrassed before," she says, "since I looked bulging and unattractive. Now my new boyfriend tells me I look great!"

Two or three days after surgery, you can begin massage. You may find it easier to use the palms of your hands. Gently stroke the area in which liposuction has been performed, using a circular motion, until you have covered all of it. The massage should last one or two minutes at time. Repeat this massage so you do it three times a day.

2. Below, after liposuction surgery, the patient's arm shows a much smoother contour.

Sally was pleased with her liposuction results from her arm operations. "I'm not embarrassed at the health club any more," she says. "I even go into the whirlpool. And I'm going to the beach next weekend with a man I met at the club. I bought a new bathing suit and a sundress to wear. I don't feel self-conscious any more."

You will want to follow your surgeon's advice on when to begin exercising, since liposuction of the iliac area, costal fat, flanks, and "love handles" takes slightly longer to heal than some other body areas.

However, unless your surgeon specifically advises you against it, you can begin the following exercises at home one week after surgery.

Home Exercises

1. Stretching rotation. Stand with your feet and arms slightly apart. Now rotate your upper body all the way to the right till you cannot go any more. Now turn all the way to the left. Keep your lower body as stationary as possible. Twelve of these circles equal one set. Do one set three times a day.

2. Side bends. Stand with your feet apart. Raise your right hand high in the air. At the same time, put your left hand on your waist. Then bend to your left. Go as far as you can. Hold the position for a few seconds. Then straighten up. Next, switch hands, bending to your right. Do 10 of these. Ten of this exercise equals one set. Do one set two times a day.

3. Twist with broomstick. Stand with your feet slightly apart. Hold a broomstick behind your neck, resting it on your shoulders. Use both hands to hold the broomstick.

Gently twist your upper body to the left and return, right and return. Try to keep your legs, knees, and lower body as stationary as possible. Ten left-and-right repetitions equal one set. Do one set two times a day.

4. Side bends with broomstick. Stand with your feet slightly apart, and grasp the broomstick behind your neck with both hands. Let the weight of the broomstick rest on your shoulders. Bend to your left as far as you can comfortably go. Hold the position for a few seconds; then straighten up. Bend to your right...hold...and straighten. Ten left-and-right bends equal one set. Do one set two times a day. Two weeks after surgery you can add the following exercises at home:

5. Wearing two- to three-pound wrist weights, or using dumbbells, do the stretching rotation exercise, as in #I. Ten repetitions equal one set. Do one set two times a day.

6. Wearing wrist weights or using dumbbells, do side bends as in exercise #2. Ten left side bends plus 10 right side bends equal one set. Do one set two times a day.

Exercise for Health Club/Gym

Two weeks after surgery, unless your doctor has given you different instructions, you may do the following exercises in a health club or gym. They can be done by men or women.

Warm up first with stretching rotation, as in home exercise #1 above. Then:

1. Dumbbell double side bends. Stand with your legs slightly apart. Hold a dumbbell in each hand. Hold your arms down at your sides. Keeping your feet and legs straight, bend sideways, so that your right hand reaches as far down your right leg as you can go. Straighten, then shift your weight, so that your left hand reaches as far down your left leg as possible. Repeat, until you have done the exercise a total of 20 times.

2. Free bar side bends. Pick up the free bar. Hold it behind your neck, so that it rests on your shoulders. Keep your body straight You will find it easier to keep your balance if your feet are slightly apart. Now, bend towards one side, while keeping your body as straight as possible. Bend towards the other side. Fifteen times equal one set. Do two sets.

3. Free bar rotation. Hold the free bar behind your neck, so that its weight rests on your shoulders. Keep your legs slightly apart, and your hands at the ends of the bar. Twist your body left as far as you can go. Your feet should remain in a fixed position, while you twist from the waist up. Now, still while holding the bar, twist to the right as far as possible. Do this 20 times for one set. Do two sets.

4. Hyperextension. Place yourself on the hyperextension bench, locking your ankles. You will be lying on your stomach, with your face looking at the floor. Bend forward from the waist. Now straighten up as far as you can go-not just to a horizontal position, but beyond, extending your spine up as far as you comfortably can. Do this 10 times for one set. Do two sets.

5. Hyperextension, with weights. Do the above exercise, while wearing two- to three-pound wrist weights.

6. Pulley side bends. Use the low pulley. Turn sideways to the machine, standing with your legs apart, and your left side facing the machine. Grasp the low pulley with left hand-the hand that is closest to the machine. Bend your side towards the machine. Pull up the pulley with your hand, while you straighten your body, then bend towards the other side. Your knees should remain straight during this exercise. So should your arm. Do 10 repetitions with your left arm. Then switch sides and do 10 repetitions with your right arm. This equals one set. Do two sets.

1-4. Photos show a male patient during liposuction surgery to remove fatty deposits on the flanks, or love handles.

1. The doctor shows the amount of accumulation.

2-3. The patient's left side shows the improvement following surgery.

4. Both sides of the patient's body smooth and normally contoured.

5-6. Photos show a male patient's flank before and after surgery.

7-8. The front view of this patient's torso shows bulging flanks (before surgery), which are greatly reduced after liposuction.
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Liposuction: New Hope For A New Figure Through The Art Of Body Contouring - By Dr. Leon Forrester Tcheupdjian, M.D.
ISBN 0-9621284-1-4 | Library of Congress registration #: 2-414-199
copyright © 1988-2006 Dr. Leon Forrester Tcheupdjian M.D.
Published by Dr. Leon Forrester Tcheupdjian M.D. 875 Rush Street Chicago, IL 60611

All rights reserved. No part of this book may be reproduced in any medium whatsoever, including photocopy or other electronic medium, without the express written permission of Dr. Leon Forrester Tcheupdjian M.D..