Modern methods of body contour correction

2021-04-16
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In modern society, people treat their appearance more carefully and scrupulously compared to previous generations. Perhaps the fact is that the era of Instagram has arrived, the era of media, when self-presentation on social networks is extremely important.

Kristina Musikhina , plastic surgeon, specialist in contour plastic surgery, graduate student of the Department of Otolaryngology at the Aleksandrovskaya Clinical Hospital, specialist in the field of aesthetic surgery and cosmetology


Reasons for changing body contours

Under these conditions, patients strive to maintain beauty and youth for as long as possible. Overall, in my opinion, this is a positive trend. Our mothers did not have the opportunity to take good care of themselves and did not have the capabilities of modern medicine. Even just 15 years ago, there was not much demand for body contouring procedures. Now this is one of the most common requests from patients: to remove any local fat deposits on the body or face. It is interesting that today most women are aware of modern methods of solving such problems. Therefore, it is not surprising that many patients come to the appointment knowing exactly what they want, for example: “Give me lipolytics here and there...”. People understand that modern medicine makes it possible to preserve beautiful contours of the face and body, regardless of age or hormonal disorders.

The main reasons for changes in body contours are well known: a sedentary lifestyle and lack of adequate physical activity, unbalanced diet, large amounts of coffee and alcohol, hormonal changes in the body (for example, during pregnancy, lactation, menopause, and also during severe stress), smoking, sudden weight fluctuations.

It is important to remind patients of common truths: a healthy and active lifestyle is important. Not everyone is suitable for sports, but most can take the required number of steps per day. Modern research confirms that 10-15 thousand steps daily provide the necessary physical activity and make it possible not to visit the gym. It is difficult to overestimate the importance of a balanced diet. Although nowadays people take better care of themselves, they do not always pay attention to what they eat and in what quantity: too often they resort to unhealthy snacks on the go. Also, no matter how sorry it is to upset patients, they should be advised to reduce their consumption of coffee and alcohol, and also quit smoking.

However, not every problem can be solved through lifestyle changes. The latest scientific research confirms that a balanced diet does not play a significant role in the fight against local fat deposits in the event of hormonal changes in the body. Pregnancy, lactation, menopause, severe stress (cortisol, the stress hormone, greatly affects weight changes) - this is an incomplete list of hormonal changes that can lead to changes in body contours. In this case, even if the patient manages to return to his previous weight, the problem of the so-called “fat traps” is not solved. These are problem areas of the body that do not regain their previous appearance even after working out in the gym or receiving a massage. Most often this is the stomach, hips (the so-called “breeches zone”), the side of the back, the inner thighs, arms, and chin. 90% of people have such “fat traps”, and after losing excess weight, patients come to surgeons to deal with them. Traditional methods of weight loss - fitness classes, diet correction, massages - in such a situation do not help to the extent that we would like. In this case, in combination with lifestyle changes, more radical methods of therapy work: various types of liposuction.

Liposuction

First of all, it is important to explain to the patient that liposuction is not intended for weight loss; using this method of therapy, we are fighting for aesthetic body contours. Liposuction helps eliminate the patient’s embarrassing “fat traps,” which cause his clothes to fit poorly and make him feel self-conscious about his body. Therefore, if a woman or man comes to a specialist specifically with the goal of losing weight, an adequate surgeon will definitely explain that you first need to return to your stable weight, and then plan the operation. For example, there is no point in removing 5 liters of fat from a very obese patient who does not plan to change his lifestyle. This will only bring unnecessary inconvenience to the person, because he will have to go through a rehabilitation period without getting the desired result.

Lipolytic injections are popular for correcting body contours - this method is also called chemical liposuction. According to the principle of action, these drugs can be divided into direct and indirect. Classical (also mechanical, manual) liposuction, or classical lipoaspiration, is the most effective, although also the most invasive, method of combating fat deposits from my point of view as a surgeon. Increasingly popular in Ukraine is acquiring such a type of invasive liposuction as vibration, or infrasonic, lipoaspiration. A type of invasive liposuction is the water jet method, or Body Jet. In combination with invasive liposuction methods, the method of lipomodeling, or liposculpture, is successfully used to correct body contours. The essence of the technique is to transplant the patient’s own fat tissue, obtained after liposuction, from one area of the body to another, for example, to the buttocks, mammary glands, legs

Given the fears of many patients about invasive procedures, non-invasive and minimally invasive liposuction methods are very popular.

Ultrasonic liposuction, or cavitation, is a non-invasive procedure that uses an ultrasonic lipocavitator.

Cryolipolysis is another non-invasive liposuction technique performed using a machine.

A minimally invasive type of ultrasonic liposuction performed through micropunctures is the so-called weiser liposuction. Unlike non-invasive ultrasonic liposuction, fat tissue is immediately aspirated through a microcannula, so there is no need to wait several weeks for it to metabolize naturally.

Another popular method of minimally invasive liposuction is laser lipolysis. The essence of the method is that a laser probe uses heat to destroy fatty tissue, which is removed through small punctures.

RF is another minimally invasive and low-traumatic type of liposuction, in which the electrode is placed under the skin and the emitter is placed above the skin.

Radio wave energy circulates between these devices, which destroys fat.

It is also worth mentioning some non-invasive weight loss techniques that can be used in combination with other methods, for example, after invasive liposuction. These techniques help restore the condition of the skin after plastic surgery, eliminate swelling, strengthen and tighten the skin.

LPG, or vacuum massage technique, helps get rid of excess fluid in the body and improve skin tone.

Pressotherapy (hardware lymphatic drainage, intermittent pneumatic compression) is another popular non-invasive weight loss technique. The essence of the method is that with the help of compressed air, which is supplied to special cuffs placed on the treated area, the body is exposed.

If necessary, implants can also be used for body contouring. In this way, you can correct the shape of the buttocks, mammary glands, chest in men, lower legs, chin (it is possible to form a “strong-willed” chin in a man or correct a sloping chin in a woman). The implants are filled with shape-stable cohesive silicone gel of varying consistency depending on the requirements placed on it. For example, when performing gluteoplasty, implants are placed under the gluteus maximus muscle or gluteal fascia. This operation is performed on both men and women of different ages. The procedure is used for injuries, deformities, tissue atrophy, small volume of the buttocks and their drooping - this may be a genetic problem that cannot be solved by visiting the gym.

Selecting a method

What method of body contour correction is the most effective? As a practicing surgeon, I believe that to achieve radical results it is necessary to use radical methods of therapy. From this point of view, the most effective is the classical technique, which allows you to get rid of voluminous fat deposits at one time. An additional advantage of this procedure (and to a lesser extent other invasive methods, there is simply a difference in stimulation after a large cannula and after a small puncture) is that the body responds to the puncture by actively producing collagen. Thus, the skin at the surgical site becomes more elastic.

I usually offer patients with voluminous fat deposits who have no contraindications to liposuction the following treatment regimen: return to their stable weight, then undergo classical liposuction. After surgery, a course of LPG massage or pressotherapy for the most effective rehabilitation. Next - just a healthy lifestyle.

However, many patients will never go under the knife, even without contraindications to surgery. In such cases, we can use minimally invasive or non-invasive techniques. But our task is to explain to the patient that when choosing such methods, one procedure is not enough: you need to plan a course, be patient and not expect a super effect right away.

From a financial point of view, it is again more rational to spend money on invasive liposuction once and get a visible result immediately, than to “stretch out the pleasure” for a long time, undergoing a long course of minimally invasive or non-invasive procedures.

If a person is afraid of even minimally invasive techniques, the attending physician’s arsenal of remedies is small, and the patient will have to change literally everything in his life in order to get a visible result. But this is his choice, and the surgeon’s task is to explain to the patient in detail the principle of operation of each method, its pros and cons. It is important that the person himself is ready to adjust his lifestyle. In the case of invasive liposuction, the patient's motivation increases; he does not want to go through the postoperative rehabilitation process again.

Patient mistakes

The main mistake a patient makes in the process of body contour correction is the wrong choice of a specialist. Only a person with a higher medical education can prescribe therapy. It is important to turn to professionals and not trust flashy advertisements from unknown “specialists” promising “getting rid of 15 liters of fat in one session.” This is a question not only of the effectiveness of therapy, but also of patient safety.

The second common mistake is monotherapy combined with inflated expectations. For example, a patient has settled only on LPG massage or lipolytic injections, but at the same time does not adjust his lifestyle and expects a miracle from the attending physician. But to obtain a visible result, a combination of several methods is necessary. Even invasive liposuction must certainly be accompanied by lifestyle changes. In addition, to get a good result from the surgery, the patient must first return to his stable weight. On the other hand, if a person begins to walk a lot, drink enough fluids, and eat a balanced diet, then he will get results even after using one LPG massage or a course of lipolytics.

As I often say at receptions: “If you try half-heartedly, then the result will be half-hearted.” It is necessary to motivate the patient to partner with us in improving his appearance.

Photo 1: Before and after using a course of lipolytics in combination with exercise and diet

It is extremely important to properly build communication with the patient. It is important to adhere to the principle: “If you own the information, you own the world.” The doctor must tell in great detail, and if necessary, explain in detail to the patient any method, including the rehabilitation period and possible complications. It is also necessary to carefully collect an anamnesis so that later it does not come as a surprise to the doctor that this particular patient cannot undergo invasive or even minimally invasive liposuction. For the patient himself, it is important to ask a lot of questions; for the doctor, it is important to give as much information as possible. This is the key to their successful cooperation. Trusting your healthcare provider is extremely important. I always advise patients to find a specialist with whom they can find a common language. It often happens that a client comes with a fashionable name, a “promoted” surgeon, but during the communication process he doesn’t like something - he needs to look for another doctor. Fortunately, in Ukraine today there are enough competent doctors with whom you can build trusting business relationships. When an experienced specialist meets with a positive patient who trusts the doctor, is open to his suggestions and is ready to follow his recommendations, almost any problem can be solved.

Read more about each type of body contour correction in the magazine PRO Cosmetology by “Cosmetologist” No. 2, 2021

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