Wednesday, July 12, 2006

Problem Areas

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


PalmTreeChick said...

I love this paragraph:

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.”

Um yeah, she is skinny. If she's getting "Flabby" why doesn't she try working out!! Everyone wants the easy way out, so instead of working out a few times a week, she goes under the knife to take care of the "problem." That drives me insane.

As far as plastic surgery goes...2 words...Joan Rivers!! She may even be looking worse than Michael Jackson these days!

wading through recovery said...

The whole article just made me nauseous.

Um,...and why would it be exactly bad to have arms with something besides skin on them anyway? I just realized the other day (after reading one of the previous posts by the doc) that I actually sort of like that I've developed a chest which feels cozy and soft...

Just the other day one of my roomates (ultrathin and hating it) was asking the rest of us hypothetically if we would have plastic surgery if it was free. I didn't even really have to think about it, "Hell, no"!

I was repeating this anecdote to another pretty conservative, Mormon nontheless, friend of mine who I assumed would have the same reaction as me. I was pretty shocked when her face lit up and she explained excitedly how she would have liposuction.

I was stunned.

drstaceyny said...

PTC--we love a quick fix. Think of surgery and diet pills ("Trimspa, baby!") and other potentially dangerous techniques. If you've never exercised before (and can't imagine spending the time/energy to do so), these may seem to be easier/more realistic options than going to the gym.

WTR--interesting question--I wonder how many people refrain from surgery for financial reasons only.

PalmTreeChick said...

Can't say I haven't wanted to try Trim Spa myself. I've tried my share of other diet aids, but I also workout everyday, so I'm not totally going for that quick fix by itself.

It would be nice if there was a magic pill somewhere. Although, that could cause more harm than good, if it got into the wrong hands and was easily accessable to those who don't need it.

annie said...

Okay, so I had this litle piece of hanging, loose skin on my neck (under my chin), and I came up with the bright idea that it would really give me a "lift" to tighten it up a little. So I went to a plastic surgeon, and right there in his office I had some "minor" surgery. I then passed out, ended up in an ambulance with a siren blaring, and was later told by my friend who is an RN that I came into the hospital in critical condition. I found out that there is really no such thing as minor surgery, and that any time you cut into your body there is a risk.

Beth said...

Unless you've had liposuction, you can't possibly understand the benefits. Most people don't want the risks, but now surgeons are even doing it under much safer local anesthesia. I had it when I was 18 (4yrs ago), at the dismay of my parents. No matter if I weighed 140 as then, or 107 as now, I would have had a potbelly no matter how much cardio I did. Working out can firm you up, but there is NO other way to spot reduce fat. While it didn't change my weight, it made my body more proportional, regardless of size. Before, I rarely wore swimsuits and looked flabby in sports bras. Now, I'm more comfortable and can actually SEE the results when I do my tough ab workouts. Imagine people whose main concern is their looks. True, that's a sad focus, but if this microlipo can help women get over their micro hangups or overexercising, it could be a good option.

littlem said...

Mmmm-hmmm. Wasn't it Ms. Goldsmith who died getting her last facelift on Park Avenue?

Certainly wouldn't assume right off the cuff that quality of care was the problem there. (Of course, there are a lot of assumptions inherent in that assumption, but still ...)

I know it's not a weight-related issue (unless there was some sort of "turkey wattle chin" involved), but when we're talking about the relentless pressure imposed on women to look young, in addition to look thin, aren't we just discussing different facets of the same CZ?

I'm not even going to get into the flappy arms thing. There're these amazing things called hand weights ...

littlem said...

"Imagine people whose main concern is their looks."

Um, Beth, if you're having lipo at 18 ... doing much introspection lately?

Perhaps there's a REASON your parents were -- how did you put it -- dismayed.


littlem said...

And one more thing regarding Sylvie Schiffer and the doctor.

It's the husband who needs the freaking psychiatrist.

What I find really interesting is how much attention is paid to women's heinous body images, and how NO attention is paid to the exacting "standards" of entitlement of the pot-bellied, pock-marked, emotionally and morally bankrupt so-called "life mates" who harangue these women into feeling the way they do, and leave or humiliate them when they gain an ounce or age a nanosecond.

As many books as I've read on body image (Orbach/Roth/Rodin/Wolff/Ryan blah blah blah), I have YET to see a doctor -- or other "professional" brave enough to address that issue set.

How about it, Dr. Stacey?

Beth said...


What is "unbeleivable" is how others can categorize all people together who gets plastic surgery. Perhaps some people get it so that their looks don't become the largest focus in their lives. I've spent much more money on college than surgery, and desire to learn more everyday. My main concern is to be smarter, more enlightened, but this is something not always realized in teenage years, when much of our self identities are linked to our body.

If you want a good example of people whose looks are a sole priority, just check out some of those MTV shows like "Sweet 16" or "Laguna Beach." I guess the older you get, the easier it is to bitterly judge others as one-dimensional.

Anonymous said...

To say that every woman has an eating disorder is absurd. Our society is so fixated on diagnosing people with disorders and making everyone feel sick. As a person who has suffered from anorexia for years and knows what it feels like to cry when you reach eighty pounds because you think you are fat, it is frustrating to have eating disorders marginalized in this way. What the book should say is that most women have body insecurities. To say most women have eating disorders is like saying that most people have ADHD because they can't study for two hours straight. The truth is many people are overweight, and their insecurities should motivate them to work out and eat right. If you ask me, turning to surgical solutions is nothing but a display of laziness (excluding, of course, those people who must do so for medical reasons.) And please don't tell me that many people are genetically doomed to be overweight. While some are, genetics don't change in 30 years. Americans are all about taking the easy way out. Fifty years ago, if you did not like your flabby arms, you would join a gym. Now you spend thousands of dollars on lipo when that money could have fed ten Africans for a lifetime. Anorexia is a serious disease and I hate to see it mainstreamed like this. The less people are told they are sick, the less people will act sick. Telling a woman she is anorexic is likely to make her develop an unhealthy relationship with food, like a self fulfilling prophecy.