This is from last Thursday's New York Times. Dr. William P. Coleman III (see last line) has clearly never heard of cankles.
Do My Knees Look Fat to You?
By NATASHA SINGER
Published: June 15, 2006
LOVE handles, saddlebags, turkey wattle. Self-conscious women have been trying to reduce those body areas for years. But now, with more efficient diets and fitness routines, women are turning to more obscure anatomical zones. The newest worries? "Bra fat" and "back fat."
"I had a little roll of fat hanging over the back of my jeans, like a spare bicycle tire in the back," said Dana Conte, a bartender in Manhattan. It was so obvious that her mother constantly came up behind her and pulled her shirt down over it, Ms. Conte said. "When your mother is doing that, it means there's a problem."
Ms. Conte, 34, says she has an hourglass figure that attracts whistles as she walks along the street. To get rid of the back fat, she tried working out "like a lunatic," she said five days a week. Then, she enrolled in Weight Watchers. When neither worked, she turned to plastic surgery.
Last August, she had liposuction on her lower back around her waistline, and in January, she had liposuction again, this time on her mid- and upper-back to eliminate "bra fat," bulges that can occur when "your bra pushes lumps of fat down your back and up over the bra fastening and to the sides right near your arms," Ms. Conte said.
The total fee for both procedures, $10,000, was well worth it, she said.
Last year, Americans had about 455,000 liposuction operations, making fat removal the most popular cosmetic surgery procedure, according to the American Society for Aesthetic Plastic Surgery. But in the last two to three years, liposuction, once used predominantly to reduce the flabby abdomens, hips and thighs of average Americans, has become a tool to enhance the near-perfect body parts of the already fit.
For this designer-body approach, an increasing number of doctors are using a technique known variously as precision, selective or micro liposuction. The goal is to remove an ounce or three of fat from ankles, knees, chins, necks, backs and upper arms, according to some prominent plastic surgeons and dermatologists.
"This is mostly for people who do not need much work done," said Dr. Luiz S. Toledo, a plastic surgeon in São Paulo, Brazil, who has taught the technique to American surgeons at their annual medical meetings. "It's liposuction for skinny people."
But some sociologists and medical ethicists say that using liposuction which can cause complications ranging from infection to death for such tweaks raises profound questions about the increasing risks cosmetic doctors and patients are willing to take in the name of perfection. They say these microprocedures may signal a shift in beauty standards in which people come to regard the body the way they do their cars or kitchens: as an object able to withstand never-ending renewal and modification.
And they worry that the idea of precision liposuction carries an inherent suggestion that everyone should have surgery, even those who are already beautiful.
"The goal posts are changing so rapidly that what was once considered cosmetically unnecessary is now considered helpful," said Victoria Pitts, an associate professor of sociology at the City University of New York, who teaches a course called Sociology of the Body. "As calves, ankles, knees and even genitalia become zones of perfectibility, we will feel more and more pressure to get involved in projects that improve them."
Dozens of experienced American doctors have been performing precision liposuction for more than a decade. But in the last two to three years, hundreds of other doctors have been adding it to their surgical repertory because it seems easier to perform than it used to be and because more patients are asking for it, said Dr. Peter B. Fodor, a plastic surgeon in Los Angeles.
"Because our equipment has gotten better, surgeons who a few years ago would not have touched areas like kneecaps, inner thighs, back rolls, calves and ankles have extended their practices," Dr. Fodor said.
New types of ultrasound machines, which can be used to break up fat before it is extracted, and daintier cannulae, the blunt-tipped hollow tubes used to dislodge and suck out fat, have made it easier for doctors to fine-tune liposuction, Dr. Fodor said.
During liposuction operations, doctors anesthetize patients, inject a numbing solution and suction fat cells out of the body with a tube inserted into incisions in the skin. Patients may be sore and bruised for several days to weeks afterward, but doctors say results are permanent on the treated areas as long as patients maintain stable weight.
Because removing too much fat can be risky, medical societies do not recommend liposuction for the morbidly obese. But it has been widely used to reduce bulges on the merely chubby.
And now, as it has grown more precise, liposuction is attracting a new clientele of body-conscious people who want to improve physiques already honed by diet and regular exercise.
"Some of them are perfect 10's who want to be 10½'s," said Dr. Howard D. Sobel, a dermatologist in Manhattan whose liposuction patients have included models and personal trainers. "These patients' 'before' pictures are what patients in the past wished their 'after' pictures looked like."
One of Dr. Sobel's patients is Judy Goss, a former Ford model who works as a model agent. "By normal standards, I'm pretty skinny," said Ms. Goss, 38. She is 5-foot-10 and weighs 126 pounds, she said. "But my arms were getting a little flappy. I could feel it wiggle every time I shook hands."
Two years ago Dr. Sobel performed liposuction on her upper arms.
Dr. Lawrence S. Reed, the plastic surgeon who operated on Ms. Conte, the bartender, said some patients who choose micro liposuction want to reduce such negligible deposits that doctors can have trouble seeing the problem when the patients are undressed.
To pinpoint the little lumps of fat, Dr. Reed, who is based in Manhattan, asks patients to wear their favorite jeans or bra right before surgery so he can mark the areas with a pen.
Patients have developed their own nicknames for these obscure fat deposits. To help doctors understand the exact locations their patients are describing, the journal Dermatologic Surgery recently published an article titled "Lexicon of Areas Amenable to Liposuction." According to the article, patients are now asking for liposuction of the "buffalo hump" (upper back), the "wings" (bulges around the bra area), the "doughnut" (around the belly button), the "banana fold" (below the buttocks), the "piano legs" (calves) and the "chubb."
"Chubb is a Southern term for the kneecap area," said one of the article's authors, Dr. William P. Coleman III, a clinical professor of dermatology at Tulane University School of Medicine in New Orleans. He has not yet heard a colloquialism for ankle fat.
Click here to read the rest of the article. You'll need to register (it's free). http://www.nytimes.com/2006/06/15/fashion/thursdaystyles/15skin.html?_r=1&8nyh&emc=nyh&oref=login
Do My Knees Look Fat to You?
By NATASHA SINGER
Published: June 15, 2006
LOVE handles, saddlebags, turkey wattle. Self-conscious women have been trying to reduce those body areas for years. But now, with more efficient diets and fitness routines, women are turning to more obscure anatomical zones. The newest worries? "Bra fat" and "back fat."
"I had a little roll of fat hanging over the back of my jeans, like a spare bicycle tire in the back," said Dana Conte, a bartender in Manhattan. It was so obvious that her mother constantly came up behind her and pulled her shirt down over it, Ms. Conte said. "When your mother is doing that, it means there's a problem."
Ms. Conte, 34, says she has an hourglass figure that attracts whistles as she walks along the street. To get rid of the back fat, she tried working out "like a lunatic," she said five days a week. Then, she enrolled in Weight Watchers. When neither worked, she turned to plastic surgery.
Last August, she had liposuction on her lower back around her waistline, and in January, she had liposuction again, this time on her mid- and upper-back to eliminate "bra fat," bulges that can occur when "your bra pushes lumps of fat down your back and up over the bra fastening and to the sides right near your arms," Ms. Conte said.
The total fee for both procedures, $10,000, was well worth it, she said.
Last year, Americans had about 455,000 liposuction operations, making fat removal the most popular cosmetic surgery procedure, according to the American Society for Aesthetic Plastic Surgery. But in the last two to three years, liposuction, once used predominantly to reduce the flabby abdomens, hips and thighs of average Americans, has become a tool to enhance the near-perfect body parts of the already fit.
For this designer-body approach, an increasing number of doctors are using a technique known variously as precision, selective or micro liposuction. The goal is to remove an ounce or three of fat from ankles, knees, chins, necks, backs and upper arms, according to some prominent plastic surgeons and dermatologists.
"This is mostly for people who do not need much work done," said Dr. Luiz S. Toledo, a plastic surgeon in São Paulo, Brazil, who has taught the technique to American surgeons at their annual medical meetings. "It's liposuction for skinny people."
But some sociologists and medical ethicists say that using liposuction which can cause complications ranging from infection to death for such tweaks raises profound questions about the increasing risks cosmetic doctors and patients are willing to take in the name of perfection. They say these microprocedures may signal a shift in beauty standards in which people come to regard the body the way they do their cars or kitchens: as an object able to withstand never-ending renewal and modification.
And they worry that the idea of precision liposuction carries an inherent suggestion that everyone should have surgery, even those who are already beautiful.
"The goal posts are changing so rapidly that what was once considered cosmetically unnecessary is now considered helpful," said Victoria Pitts, an associate professor of sociology at the City University of New York, who teaches a course called Sociology of the Body. "As calves, ankles, knees and even genitalia become zones of perfectibility, we will feel more and more pressure to get involved in projects that improve them."
Dozens of experienced American doctors have been performing precision liposuction for more than a decade. But in the last two to three years, hundreds of other doctors have been adding it to their surgical repertory because it seems easier to perform than it used to be and because more patients are asking for it, said Dr. Peter B. Fodor, a plastic surgeon in Los Angeles.
"Because our equipment has gotten better, surgeons who a few years ago would not have touched areas like kneecaps, inner thighs, back rolls, calves and ankles have extended their practices," Dr. Fodor said.
New types of ultrasound machines, which can be used to break up fat before it is extracted, and daintier cannulae, the blunt-tipped hollow tubes used to dislodge and suck out fat, have made it easier for doctors to fine-tune liposuction, Dr. Fodor said.
During liposuction operations, doctors anesthetize patients, inject a numbing solution and suction fat cells out of the body with a tube inserted into incisions in the skin. Patients may be sore and bruised for several days to weeks afterward, but doctors say results are permanent on the treated areas as long as patients maintain stable weight.
Because removing too much fat can be risky, medical societies do not recommend liposuction for the morbidly obese. But it has been widely used to reduce bulges on the merely chubby.
And now, as it has grown more precise, liposuction is attracting a new clientele of body-conscious people who want to improve physiques already honed by diet and regular exercise.
"Some of them are perfect 10's who want to be 10½'s," said Dr. Howard D. Sobel, a dermatologist in Manhattan whose liposuction patients have included models and personal trainers. "These patients' 'before' pictures are what patients in the past wished their 'after' pictures looked like."
One of Dr. Sobel's patients is Judy Goss, a former Ford model who works as a model agent. "By normal standards, I'm pretty skinny," said Ms. Goss, 38. She is 5-foot-10 and weighs 126 pounds, she said. "But my arms were getting a little flappy. I could feel it wiggle every time I shook hands."
Two years ago Dr. Sobel performed liposuction on her upper arms.
Dr. Lawrence S. Reed, the plastic surgeon who operated on Ms. Conte, the bartender, said some patients who choose micro liposuction want to reduce such negligible deposits that doctors can have trouble seeing the problem when the patients are undressed.
To pinpoint the little lumps of fat, Dr. Reed, who is based in Manhattan, asks patients to wear their favorite jeans or bra right before surgery so he can mark the areas with a pen.
Patients have developed their own nicknames for these obscure fat deposits. To help doctors understand the exact locations their patients are describing, the journal Dermatologic Surgery recently published an article titled "Lexicon of Areas Amenable to Liposuction." According to the article, patients are now asking for liposuction of the "buffalo hump" (upper back), the "wings" (bulges around the bra area), the "doughnut" (around the belly button), the "banana fold" (below the buttocks), the "piano legs" (calves) and the "chubb."
"Chubb is a Southern term for the kneecap area," said one of the article's authors, Dr. William P. Coleman III, a clinical professor of dermatology at Tulane University School of Medicine in New Orleans. He has not yet heard a colloquialism for ankle fat.
Click here to read the rest of the article. You'll need to register (it's free). http://www.nytimes.com/2006/06/15/fashion/thursdaystyles/15skin.html?_r=1&8nyh&emc=nyh&oref=login
