IS THE PATIENT CARRYING FAT DISPROPORTIONATELY THROUGHOUT THEIR BODY?
My commitment to a holistic - whole body - approach means that I consult with every one of my patients, working closely with them to learn about their cosmetic goals, their personal aspirations, and the issues that brought them to my practice in the first place. This enables me to offer a level of procedural customization that sets my results apart from my peers, addressing cosmetic issues with precision and elegance in equal measure.
When I consult with a patient, I am evaluating from a number of different perspectives. I don’t go into my consultation and ask what they would like to treat or what they are here for. Instead I evaluate the entire body from neck down, from all angles and consider the following three factors: disproportion, weight, and laxity.
Twenty years ago I was featured on The Today Show with the perfect candidate for liposuction: an 18 year old, 110 pound patient—sounds unreasonable, but bear with me. The patient's mother was also on the show, and both mother and daughter shared a genetic disproportion of a thin, bony upper body, with large outer thigh “saddlebags” that were significantly disproportionate to the rest of the body. This is an example of the perfect liposuction patient: regardless of weight fluctuations, the areas of disproportion do not change. These are the areas of fat that are stubborn and do not change regardless of diet or exercise.
Twenty years ago I was featured on The Today Show with the perfect candidate for liposuction: an 18 year old, 110 pound patient—sounds unreasonable, but bear with me. The patient's mother was also on the show, and both mother and daughter shared a genetic disproportion of a thin, bony upper body, with large outer thigh “saddlebags” that were significantly disproportionate to the rest of the body. This is an example of the perfect liposuction patient: regardless of weight fluctuations, the areas of disproportion do not change. These are the areas of fat that are stubborn and do not change regardless of diet or exercise.
Patients will grab an area of their body they dislike and wiggle and shake it around, which always leads me to ask what they would call the tissue they are grabbing on to. The first answer is always fat. The second answer is skin—but there is actually something else at play—potential laxity of the skin and underlying muscles.
As we age, muscles can loosen. A good example is diastasis recti in women after childbirth. This is where the muscles of the abdomen have stretched and separated. A patient with this concern may think she needs liposuction but instead requires an abdominoplasty (tummy tuck surgery) to repair the muscle laxity and excess lax skin.
