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Problem Areas

Posted Oct 01 2008 8:21pm
A derivative of liposuction, called micro liposuction, is becoming increasingly popular, as revealed in an article in The New York Times.* According to the article, Dr. Luiz Toledo, a Brazilian plastic surgeon, who brought the procedure to the U.S., calls it “liposuction for skinny people.” What we’re talking about here are little “tune-ups,” aimed at people who are already quite thin or at specific areas of the body not classically targeting during liposuction.

And what areas are we talking about? The Times cites a recent edition of the journal, Dermatologic Surgery, which in an article entitled "Lexicon of Areas Amenable to Liposuction," identifies: “the ‘buffalo hump’ (upper back), ‘wings’ (bulges around the bra area), the ‘doughnut’ (around the belly button), the ‘banana fold’ (below the buttocks), the ‘piano legs’ (calves) and the ‘chubb.’” In case you’re wondering, like I was, “chubb” is defined for us by Dr. William Coleman III, one of the articles authors, as a “. . . Southern term for the kneecap area."

And who is a classic micro liposuction patient? Dr. Howard Sobel, interviewed by the Times discusses a typical micro liposuction patient: “'Some of them are perfect 10's who want to be 10½'s.'" Sobel, who reportedly has treated models and personal trainers, goes on to say: “'These patients' before pictures are what patients in the past wished their after pictures looked like.'"

The article continues: “One of Dr. Sobel's patients is Judy Goss, a former Ford model who works as a model agent. ‘By normal standards, I'm pretty skinny,’ said Ms. Goss, 38. She is 5-foot-10 and weighs 126 pounds, she said. ‘But my arms were getting a little flappy. I could feel it wiggle every time I shook hands.’ Two years ago, Dr. Sobel performed liposuction on her upper arms.”

Micro liposuction carries similar risks to standard liposuction, with side effects ranging from scarring or infection at the site to the low-probability, but still real, and lethal, chance of an adverse reaction to anesthesia. In addition to any physical consequences, though, is the psychological impact of this procedure both for the individual and for our evolving zeitgeist around (largely) women, bodies, and self-esteem.

You may have seen the show Dr. 90210 on E, a reality show which follows people seeking plastic surgery from consultation to after-shots. The show’s promo begs the question, “Can you fix the inside by fixing the outside?”

I’m asking the question, too. Of course, my immediate reaction is “no,” but I’m willing to entertain the alternative—could there be a very circumscribed “problem” that operates more or less in a vacuum and that once removed, improves your body image and allows you to feel better about yourself?

I’m reminded of a fictional exchange I came across from the book Switcheroo, penned by Olivia Goldsmith in 1998. In it, Goldsmith’s character Sylvie Schiffer consults with a plastic surgeon regarding a face lift, in an attempt to mimic the appearance of her husband’s young mistress. When her doctor asks her what’s wrong, Sylvie replies:

“Everything. Bob’s cheating on me. And I saw her. She looks just like me but younger. Just like me, but no crow’s feet. Just like me, but without the second chin.

“Age crept up on me, John. I wasn’t watching. I didn’t know I looked so bad—”

“Are you insane? You need a psychiatrist, not a plastic surgeon.”

Is Goldsmith (via the surgeon’s character) right?

With micro liposuction, where do we draw the line? Most of us have seen the popular talk show guests who’ve had repeated plastic surgeries and speak of procedures in much the same way that an addict would describe a fix. It seems that doing it once opens the door for doing it again. . . and again.

And more, if patients are seeking surgery to remove a barely visible “problem area,” should doctors have an ethical responsibility to say, “I’m sorry, it’s just not worth the risks.” I can’t understand risking your life for a little bit of chubb.

As the Times indicates, medical ethicists are starting to pose these questions, as well as to understand the implications of the procedure. Dr. Sheila Rothman, a professor of sociomedical sciences at Columbia says, “‘Maybe liposuction will become like a gym membership where you pay a doctor $10,000 for the year and you can have as much surgery as you want.’”
*sent in by a dear reader
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