Body shaping: A touchy issue

Body shaping: A touchy issue

Reshaping the body through liposculpting is gaining popularity
among the urban wealthy unhappy with their physical appearance.
The Jakarta Post's Maria Endah Hulupi discusses this hot new
trend.

JAKARTA (JP): Long slim legs, a sexy back and full breasts are
the ideal physical characteristics for women according to the
traditional concept of beauty.

Many women going to cosmetic surgeons say they envy Marilyn
Monroe for her naturally sensuous body.

Today, thanks to technology, those women, and men as well,
whose bodies do not conform with the idealized image of beauty,
have a choice of cosmetic surgeries to correct their perceived
faults.

Among the most popular cosmetic procedures is liposculpting,
which includes liposuction and lipoinjection. Liposuction became
available in Indonesia in the 1980s, but the popularity of the
procedure sank in the late 1990s following the death of a
patient.

Many celebrities are rumored to have undergone liposculpting,
though none admit to it publicly. Surgeons report more and more
people are coming in for the treatment.

A teenager, Rina (not her real name), went to a beauty center
in Jakarta to have her cheeks injected with fat taken from her
own buttocks. And a housewife, Martha, had the backs of her hands
injected with fat to her veins and bones would not be so
prominent.

A middle-aged man went to a clinic to have the fat from his
neck removed. And many other people go in to have liposuction
performed on their inner thighs and stomachs, traditional problem
areas for many people.

Over the past few years, liposuction and lipoinjection have
become the cosmetic surgery of choice in the capital, as the
procedures are considered safe, relatively painless and do not
leave noticeable marks.

However, despite the assumption by many people that
liposculpting is the quick way to a more beautiful body, the
Jakarta Skin Center's medical director, Edwin Djuanda, cautioned
that the procedure should only be performed by credible beauty
centers that meet all safety standards and are well-versed in the
procedure.

Edwin also pointed out that liposuction was not complicated
but liposculpting was difficult. "The person performing the
procedure must have the 'artistic skill' to define the best body
shape for different people," Edwin said during a seminar
organized by the Study Group of the Indonesian Skin Surgery and
Jakarta Skin Center.

Edwin also stressed the importance for hygiene during the
procedure, particularly in regard to the cannula (blunt syringe),
because a failure to maintain hygiene can expose patients to
various health risks.

"It's dangerous because it's like injecting bacteria into a
person's body," he stressed, saying the mark made on the outer
skin during the procedure may look insignificant but there is the
danger of infection under the subcutaneous layer, which can be
serious.

Such an incident occurred in the United States, where a
patient had to have a large section of skin on her stomach
removed to allow treatment for a serious infection in the
subcutaneous gap from which excess fat was removed. The infection
was the result of an unhygienic cannula.

"That's why making sure the tools and the surrounding are
hygienic is very important," Edwin said.

Unlike surgery which requires making a large incision to
remove body fat, liposuction is performed by pushing a blunt
syringe through a small cut in the target area to administer
anesthesia and tumescent liquid, both of which are used in the
wet liposuction procedure.

After 15 minutes to 30 minutes, the doctors push a blunt
cannula (a tube-like syringe with holes) attached to a vacuum
machine through the incision and move it in a back-and-forth
pattern to withdraw excess body fat.

Following the procedure, patients are required to wear tight
clothes to close the gap in the subcutaneous layer.

The patients' skin retracts naturally after liposuction, but
the downside of the procedure is that the skin may look uneven
after the removal of fat.

The body parts on which liposuction is most commonly performed
are the abdomen, legs, inner thighs, breasts, upper arms and back
for women, and the waist and neck for men.

Data from the skin center shows that patients as young as 14
and as old as 86 have undergone the procedure. Most patients
receive the treatment twice but there have been some who have
undergone 11 procedures on different body parts.

There is a limit

However, there is a limit to liposuction and doctors will
maintain a normal-ideal body shape with an adequate fat level. So
if a patient demands an unrealistic result, doctors will usually
turn the patient away.

"It's for the good of the patients," Edwin said.

Doctors will generally refuse to treat patients who have a
mental illnesses or depression, or those whose expectations for
the cosmetic procedure are too high.

Currently, there is no available data on the liposuction-
related fatality rate in Indonesia, with just one fatality in the
1980s on record. In the U.S., data from the American Society of
Plastic and Reconstructive Surgeons shows that the fatality rate
is one out of 5,000 patients, while the American Academy of
Cosmetic Surgery revealed that the use of tumescent liquid in the
wet liposuction procedure was able to cut the fatality rate to
one out of 40,000 patients.

Another liposuction procedure called the dry technique, which
does not use tumescent liquid but uses a general anesthetic, has
begun to fade in popularity among doctors and patients because it
often leads to bleeding and severe pain during and after the
procedure.

Liposuction is also performed for noncosmetic purposes, such
as for lymphoma, angiolymphoma, hyperhidrosis axillaris, hematoma
and lymphedema. The tumescent liquid is also used to diffuse
anticancer drugs.

Mega-liposuction is performed to treat obesity. Ten liters to
15 liters of fat are removed per procedure.

People with fatal systemic health problems such as heart and
lung disease and those taking aspirin or acetosalicilate acid are
advised against undergoing liposuction. In the case of those
taking aspirin, liposuction is a risk because aspirin can thin
the blood and increase the risk of bleeding.

Common complications that may follow fat removal surgery are
bleeding, infection and thromboembolism due to prolonged
immobilization following the surgery.

Liposuction has its own risks, including hematoma (a swelling
that contains blood), intravenous fluid overload (pulmonary
edema), lidocain toximatose which lead to dizziness and fat
embolism, which is rare but can occur when the procedure is
combined with lipectomy.

According to the adage, losing weight is easy but keeping it
off is difficult.

The only way to maintain your body shape following liposuction
is with a proper and balanced diet and regular exercise. If
patients fail to engage in regular exercise and eat a low-fat
diet, the body fat will return.

But the procedure often has a positive psychological effect on
patients, encouraging them to begin living healthy lives.

"Most patients develop the motivation to make the results of
the procedure last," Edwin said.

As for lipoinjection, this procedure is performed by injecting
fat taken from another part of body (usually the buttock) to
enhance the shape of other body parts.

Most often the fat is injected into a person's cheeks, smile-
lines, chin, breasts, back of the hands or penis. The procedure
is also performed to fill large acne scars in order to smoothen
the facial skin.

More information can be obtained at Study Group of the
Indonesian Skin Surgery: www.geocities.com/bedahkulit, Jakarta
Skin Center: www.skinjsc.com.