InHealth: Straight Talk about Curves

By Alissa Shulman, M.D, F.A.C.S

I consider down-to-earth, frank information to be the best kind.

Regardless of whether the interest in a procedure is for reconstructive or for a cosmetic surgery, it is always necessary to assess the patient’s general “shape” (both bone structure and soft tissue). It is important to truly understand the limitations of one’s shape. Some people are “long waisted” and some are “short waisted.”

There are many options to create the illusion of the desired body shape. Adding fat (fat grafting) or subtracting fat (liposuction) can actually alter your shape. A breast reduction or lift (mastopexy) can create the look of a longer torso.

With regard to padding (fat), the doctor needs to define it as either subcutaneous (under the skin) or visceral (around your internal organs). Both types of fat influence your overall shape and appearance. What most people don’t realize is that your doctor can only influence subcutaneous fat either surgically with liposuction or possibly non-surgically with Coolsculpt.

The more visceral fat you have, the rounder (apple body) the shape. The more external fat, the curvier the shape (pear shape). Diet and exercise help reduce all fat, but they are the only way to reduce visceral fat.

Some prospective patients do the “grab test” to explain what they want. They grab a “chunk” of what they believe is excess fat; however, in reality, it is mostly skin. Excess skin can only be removed with surgery. In fact, if you can grab it and there is little fat, non-surgical techniques are unlikely to be effective.

Of course, with any skin excision, there will be a scar. A scar is permanent, but will become less visible with time. Your best option is to speak with your plastic surgeon, who should be Board Certified, and be open to multiple options and opinions. Plastic surgery is as much an art as it is a science.

Alissa Shulman, M.D., F.A.C.S

Sovereign Plastic Surgery

1950 Arlington St., Suite 112

Sarasota, FL 34239

941.366.5476

www.sovereignps.com