Honey, do I look fat?

A patient undergoes a laser liposuction procedure under board certified plastic surgeon, Dr. Alexander de Leon, left. (Photo courtesy LNI)

Something Like Life
Sept. 28, 2007

HOW many men in this world have felt tortured, rendered catatonic by extreme anxiety, and sweated buckets as they try to answer this question from their girlfriends or their wives with extreme delicateness, knowing full well that even saying “No” would open a long discussion on whether or not they appreciate their sweetie pie?

I pity the men who’ve been put in such an impossible situation by these women who actually know that they are fat but are just looking for extra validation from their men about how they look. Or maybe they’re just trying to escape the inevitability, even the wisdom, of going back on a diet or exercising when their men—hopefully—say, “No sweetheart, you look just fine the way you are.”

Women have a crazy, almost hilarious relationship with their body. We are just never happy with what we have. Either we’re too thin, which would mean we don’t have the boobs, or we’re too obese that we can’t squeeze into the size 0 dresses that all the runway models and magazine covergirls are wearing. And thin or fat, we will always see ourselves differently from how others actually see us. There is never enough problem areas on our bodies. So we turn to quick fixes.

Like many women who’ve had a running battle with their bodies and dress sizes, I, too, have toyed around with the idea of undergoing liposuction primarily because I wanted to suck out the fat from my thighs and hips, and then reinject them into my flat chest.

Thankfully, the upside of my tipping the scales over the years is that my bra cup size has now increased (wohoo!) and I no longer feel self-conscious wearing a low-cut blouse. So I think I’m just gorgeous the way I am right now and a trip to the plastic surgeon will not be on the calendar anytime soon. Still, admittedly, shopping for just the perfect set of jeans can be a frustrating shopping experience. But then there’s sugar-free ice cream, so who cares?!

The lowdown on lipo

SERIOUSLY, while waiting for my turn with my dermatologist, Dr. Reena Corona Rosales, at La Nouvelle Image the other day, I managed to have a friendly chat with her partner, Dr. Alex de Leon, one of the only 60 board-certified plastic/cosmetic surgeons in the country. (For sure, your friendly neighborhood, billboard-advertising, celebrity-endorsed cosmetologist isn’t one of these professionals.) Since he started his practice in 1994, Doc Alex has become famous for the perfectly trimmed noses and gorgeous bodies of his very private clients, many of whom I cannot name, of course.

While no statistics are available from the Philippine Association of Plastic, Aesthetic and Reconstructive Surgeons on the number of lipo procedures done in this country, Dr. de Leon says, in his experience alone, he has done about 1,025 liposuction procedures in his 13 years of practice—or roughly 76 procedures a year. (In the US cosmetic plastic surgery is a $12-billion industry, with about 11 million Americans having undergone procedures last year, according to the American Society of Plastic Surgeons.)

We’re all too familiar with the image of the traditional liposuction, where the surgeon moves his canula back and forth, sucking out the fat from the body of the anesthetized patient. These days, Dr. de Leon also uses the laser-assisted liposuction method, wherein the problem area is exposed to a low-level diode external laser, after being injected with a solution composed of normal saline plus a local anesthetic and epinephrine. This so-called tumescent solution “makes the extraction of the fat less bloody and, of course, less painful because of the anesthetic,” he explains. After injection, the external laser is used to melt the fat without having to insert it into the problem area. After the fat melts, the surgeon then inserts a thin canula, about four centimeters in diameter, in the problem area and easily sucks out the wet soggy fat.

Under laser lipo, according to the doctor, the patient experiences less pain and his or her recovery is shorter, as compared with those who undergo the traditional procedure. “On a scale of 1-10, I think the pain is about a 2 or 3. Of course, pain is very subjective...it varies from person to person, depending on his or her threshold. But with the laser lipo, I’ve observed that my patients take less of the postoperative analgesics. Under the traditional lipo, kulang pa sa kanila ang painkillers and we have to combine several analgesics just to relieve their pain. They’re also up and about faster [with laser lipo], in about two to three days, whereas under the traditional lipo a patient takes about five days to recover.” He adds that with the laser lipo, there is less bruising on the patient’s skin, primarily because there is less trauma to the body as the fat is melted.

Of course, liposuction itself isn’t that cheap to begin with. A traditional lipo on the upper and lower abdomen, for example, generally costs about P80,000. With the laser lipo, it will cost about P15,000 more. (At La Nouvelle Image, it comes with a complimentary overnight stay at Linden Suites with breakfast for two.) But for many patients, the procedure may spell the difference between having a more positive view of their bodies and, ergo, a happier outlook in life, or feeling depressed, alone and isolated.

No change after dieting, exercise

THE ideal candidates for laser lipo, Dr. de Leon says, are persons not more than 20 percent over the ideal body weight, healthy patients who exercise regularly, have good skin tone, firm and elastic (with no cellulite or stretchmarks), have realistic expectations, and are psychologically stable and motivated to get rid of problem areas.

“If the patient is really big, I tell them to go on a diet and exercise first. But I also realize that some patients who come here, honest to goodness, they tried all that already—they spend five hours at the gym to work out, they don’t eat anymore—and yet they’re still big or they still have problem areas that don’t go away.” For women, the most problematic areas are the abdomen or puson, the butt, thighs and arms. “It’s physiologic. It’s something related to the child-bearing function of the female. ’Yung puson pang-cushion sa baby,” he explains.

But lest we misunderstand, Dr. de Leon stresses that liposuction isn’t a weight-reduction procedure. It is the inches that are reduced in the body and not the weight, so it is really more for body sculpting, instead of weight management. And once a patient has undergone the procedure, it is advisable that she observes a properly balanced nutritional diet and exercises to maintain her figure. “If you’re not careful and you start eating again and you lead a sedentary life, then definitely you will gain weight.” Mercifully, the weight gain will not be in areas already lipoed—because the fat cells have already been reduced there—but in the other areas of the body with fatty deposits. I remember a tabloid story years ago which said country singer Kenny Rogers grew boobs after he had liposuction done on his abdomen and love handles. Dr. de Leon says this is very possible.

A patient consults Dr. de Leon on breast implants. (Photo by Rhoy Cobilla)

“But the beauty of liposuction is that you can grow fat but still maintain your shape. In other words, if your figure was straight before and through lipo we were able to create a shape, a thinner waistline, for example, when you grow fat, you will still have the curves. But you must understand that although the remaining fat cells will no longer multiply in number, they can increase in size.”

Have realistic expectations

IN terms of safety, Dr. de Leon says all patients going under general anesthestia are required to have a thorough medical checkup (e.g., chest X-ray, ECG, complete blood count, fasting blood sugar, etc.) first and to secure a cardio-pulmonary clearance from a cardiologist and internist. “Without this clearance, we don’t schedule the patients for general anesthesia.”

Okay, girls, before you start hocking the family jewels or force your husbands to allow you to get a liposuction as a Christmas gift, Dr. de Leon impresses on his patients to have realistic expectations and really understand why they want to undergo the procedure in the first place. If you’re getting a lipo just so that your husband will stop playing around with the sexy brainless slut in his office, then lipo may not be the answer to your problem. “Maling motivation ’yan. You don’t want to promise [your patient] na ’pag successful ’yung operation, guaranteed na babalik asawa mo. If the husband doesn’t come back to her, then the operation would be deemed a failure even if it was successful.”

Most of the time, it really isn’t the body weight that is the issue in problem marriages. I’ve known reed-thin or sexy fabulous women whose husbands still leave them. The issues in the marriage are deeper and complex than the sexy wife just being a jealous nagging bitch, the husband just a serial philanderer/sex addict, or either one being a fat slob.

If you’re serious about undergoing liposuction, do it for the right reasons. Because you want to be sexy for yourself, perhaps jump-start your diet and exercise routine, and generally just be healthy. Isn’t that a better Christmas gift for yourself?

Dr. Alex de Leon may be reached at La Nouvelle Image, 7th floor, Linden Suites, 37 San Miguel Avenue, Ortigas Center, Pasig City. Call 637-7841.

(My column, Something Like Life, is published every Friday in the Life section of the BusinessMirror.)