These days the female shape that’s promoted as the one we should all strive for is the boyish, emaciated fashion model-Before the end of the First World War, this amount of leanness and shapelessness would have been considered unhealthy, unwomanly and unattractive.
It is unwomanly to have narrow hips and thighs, and to be underweight. Our genes and hormones dictate that during puberty our hips broaden and our thighs, belly and hips begin to store fat. These developments are nature’s way of ensuring survival of our species: women’s genes do their best to equip women well for pregnancy and childbirth. The stored fat is used if a woman runs into lean times during pregnancy or lactation and the broad hips provide an easy passage for the baby’s birth.
How we feel about our bodies
I’m sure some readers are thinking ‘Why are my hips and thighs bigger than other women’s?’. As a medical journalist I receive many letters from women who hate their inherited body shapes and want to know how they can be changed. But of course it’s impossible to change our basic bone structure and, though dieting and exercise can reduce overweight and increase muscle, we generally remain woman-shaped as nature intended.
It’s very sad that women whose bodies are different from the shape that’s fashionable today feel self-loathing and misery about something that can’t be changed. My advice is not to try to hide your hips, thighs, breasts or whatever it is you don’t like about your shape. Be proud of them! Join my campaign to bring the womanly figure back into style.
Some women who are unhappy with their body contour created by the distribution of adipose tissue resort to its removal by surgery. Though results can be pleasing, they aren’t always satisfactory because the bones underneath are designed to be covered with a certain amount of fat and can look odd without it.
Cosmetic surgery and fat deposits
If the adipose tissue is removed, fat can no longer be stored at that site, resulting in a changed contour of that part of the body. Surgical removal of unwanted fat (lipectomy) has been performed, though not commonly, since the turn of the century. The technique of suction (known as ‘suction-assisted lipectomy’, commonly called liposuction), which assists this procedure, has improved and increased in popularity since the 1960s.
Who is suitable for lipectomy?
When excess type I fat storage is eliminated by diet and exercise, the type II fat pads are clearly defined. If change of body
contour is the aim, removal of type II fat is generally preferred. The thighs are most often treated because they are a common trouble spot, and because good results can often be expected. The procedure may also sometimes be suitable for the chin and neck, breasts, abdomen, upper arms, calves and ankles, and in front of and be sit low the armpit.
Liposuction is more suitable for those whose skin is still elastic, preferably those aged under 35, because the skin is not tightened surgically during the procedure, If the skin is less elastic, surgical lipectomy combined with skin tightening may be preferred, or liposuction followed later by skin tightening.
How to choose a surgeon
This advice applies if you need any type of cosmetic surgery. Recommendation from a friend who has had successful cosmetic surgery is worth following, or your GP may be able to suggest plastic surgeons who are known to be experienced and competent. Otherwise, the Australian Society of Plastic Surgeons will post you a list of its members so that you can choose someone in your district. All members of this society, and of the Society of Aesthetic Plastic Surgeons, have had at least five years post-graduate training in general surgery plus additional training and experience in plastic surgery. A referral from a GP is needed to cover the consultations, but the costs of surgery are not generally refundable by Medicare.
It’s worthwhile to ‘shop around’ until you find a surgeon that you feel you can get on with: someone who listens carefully to what you want, answers all your questions, tells you all the alternatives available, explains clearly the procedure and its possible outcomes, discusses possible complications and doesn’t try to rush you into surgery. Remember to ask for an estimate of the cost of the procedure, anaesthetic, and the stay in hospital.
Surgical removal of fat
Lipectomy and liposuction are usually performed in hospital with general anaesthesia (local sometimes for small areas). Your surgeon will tell you what to expect in the way of discomfort, bruising and swelling, when you can return to work or other activities, and if and for how long you’ll need to wear an elastic support over the site of adipose tissue removal (it is very important to follow advice exactly in this matter).
Remember that lipectomy is not a treatment for overweight. Remember also that it is improvement that is aimed for, not perfection. If you decide to go ahead, cross your fingers and hope that the fashion for women’s body shapes doesn’t soon return to what was considered beautiful and
desirable in the time of the painter Rubens!
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