STATE OF THE ART COSMETIC SURGERY AND ARTISTRY
THE NEW YORK CITY PLASTIC SURGEON, PLLC
Am I Too Thin for Liposuction?

There is a common misconception out there that liposuction, and other fat reducing techniques, are made for patients who are overweight. It would make sense that a surgery that reduces fat would be optimized for patients who have a lot of it, and yet the reality is that these procedures were actually designed for people who have small amounts of extra fat. The key word here is “extra.”

The idea behind liposuction in particular is to target specific problem areas that stand out, and these areas are more likely to stand out when the rest of the person is trim. The other issue here is that the small problem areas on patients who are otherwise at their target in terms of overall size and shape, are usually resistant to diet and exercise, making them almost impossible to get rid of through discipline alone.

Fatty problem areas can occur for a variety of reasons. The first one is genetics. If you have ever observed a large multi-generational family, you will see that things like long legs, broad shoulders, and small feet can be patterned. The same can be said for extra upper eyelid skin, barrel shaped bellies, and double chins. The fat under the chin in particular is often pre-programmed, and it may appear as early as childhood in some people. While that bubble may look right on an older and heavier person, it is noticeably out of place on a young and fit person, and can make them look much older or heavier than they actually are.

The next contributing factor is hormones. Lifelong changes and events such as pregnancy will cause fatty deposits to form and solidify, often on the belly and thighs, and to varying degrees. Rooted in evolution, these deposits are intended to help feed new babies even in times when their mothers have little food. In an era where food is usually not an issue, they go from being purposeful storage units to stubborn unwelcomed bulges hanging over belt buckles, or unsightly side lumps in an otherwise smooth evening gown.

Hormonal changes occur in men as well, but with a different deposit pattern. Men will commonly form fat pockets at the neckline and around their sides. This is one of the reasons why, even in men with stable weight and healthy lifestyles, neck and belt measurements generally trend up over time, and disproportionately to their overall size. This then leads to the neckline overhang and the muffin top effect that force the purchase of larger clothing sizes, and prevent the confident wearing of a fitted T-shirt on a Sunday afternoon.

The last element is a challenging one: nature. The fact remains that the human body is beautiful, but beauty is also culturally and temporally defined, and we have come to a place of airbrushed perfectionism that seems impossible to attain. The truth is that this perfect is not in fact natural. The images we see in magazines and social media of flawless skin and chiseled abs do not occur spontaneously. Yes, those models work hard, eat right, and exercise devoutly. But a lesser known fact is that many of them also avail themselves of aesthetic procedures for the finishing touches. There are unique women who have full breasts and Disney-worthy waistlines, but they could all fit in one elevator. There are men who have washboard bellies and rippled arms, but there are more of them with very strong bodies and a few inches to pinch around the waist. The good news is that there are also simple procedures available that can shape those edges and eliminate those inches, if that is the look you are looking for.

Liposuction was designed to be a body contouring procedure, and it does just that. It sculpts and shapes the lumps and bumps that distract and defeat. And yes, that fat is then gone forever. You may make new fat, but it will preferentially go elsewhere. That is why small amounts of liposuction are very successful, and very large amounts can sometimes lead to imbalances if the patient gains a significant amount of weight afterwards.

Liposuction is safe, controllable, and it produces results. The conversation about less invasive procedures is a long one, but suffice it to say that if any of those techniques could replace liposuction, they would have by now. In the right hands and with the proper support staff, the procedure is reliable, effective, and often touted as “one of the best decisions I ever made.”

Out of all of the patients that I have treated, the happiest by far are those who had breast reductions, upper eyelid blepharoplasties, and small volume liposuction. For the latter, the conversation often starts with them announcing to me that their friends have no idea why they would even consider plastic surgery. “Am I even a candidate for this? No one understands what I am complaining about,” they say. But whether or not anyone else notices it, they do. And they definitely notice it when they wake up one morning and that annoying little bulge is no longer there.

“I look down at my waist and I laugh,” said Mr. S at his postoperative visit. “I mean, I just laugh out loud.”

Sometimes it is the little things that make a big difference.

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