Transform Gracefully: A JOURNEY TO A HEALTHIER BODY

Dr Medha Bhave shares how a 47-year-old achieves remarkable body transformation through liposuction, showcasing the power of determination and cosmetic surgery.

The concept of ‘transform gracefully’ as an additional tagline for Laser Cosmesis, in addition to ‘giving shape to your confidence’, sprouted from patient transformations that happened after the Covid-19 pandemic lockdown. Our society is grappling with a new meaning of life after the lockdown and has definitely zeroed down on health and travel. The families have understood the importance of achieving and maintaining health goals for themselves and their family members. We see the family rallying around our patients not only in the peri-operative period but also through the sequence of surgeries, in the maintenance of diet and exercise, and in extended supervision for us during cheat times. This boosts our confidence in sustained long-term positive outcomes.

One such transformation was of a 47-year-old woman, a professional, who had gained inches of flab around her lower body and arms during pregnancy and lactation. She did not lose those inches despite rigorous exercise and a strict, scientific diet prescribed by qualified professionals. She was a slim hiker before marriage. Her husband, a fellow hiker, did not gain an extra inch on a similar diet. But our patient’s pregnancy hormones – like most women – were the real culprit in the deposition of the stubborn fat around the pelvis. The breasts enlarged and she also developed lumps in the underarms – the axillary breasts.

After trying her best for about 20 years post-pregnancy, she decided to go under the knife – come what may! The patient weighed 105 kg when she came to the clinic. As I always do, I discussed bariatric surgery as the first option because her BMI was nearly 37. She was already prepared for this and narrated her fears about invasive surgery and the need for nutritional support after the treatment. In effect, she turned down bariatric surgery and told me that she chose body transformation with liposuction – to which we are not new. We asked her to carry out our special abdominal fat-mapping sonography, which is developed by us in collaboration with radiologists. In this test, we measure the thickness of the fat deposits under the skin, and the amount of fat deposited around the intestines, kidneys, and in liver. If the internal fat – called visceral fat – is minimal, we can consider liposuction and other body-shaping procedures in our wellequipped set-up that includes ICU. This is done with due risk and thorough counselling about potential complications.

The patient was there within a week with favourable reports, which was a testimony to her sincere efforts to lose fat. She had minimal visceral fat and was given the diet challenge for three months. She lost 2 kg every month, and her weight was reduced to about 100 kg after three months. Despite her ongoing regimen, she had experienced that the scale would not tip to two digits. Yet, we were happy that she was comfortable with the diet and exercise routine and vouched to continue to maintain the results of the surgery.

We decided to offer a new procedure called TULUA, which allows safe abdominoplasty where a good and thorough liposuction can be done. In regular tummy tucks, certain areas like the upper abdomen are often not liposuctioned aggressively to avoid complications related to wound healing. This procedure was introduced to Indian plastic surgeons by our clinic. We not only performed the first TULUA in India but we also improvised it into a drainless procedure. We have published an article about how drains can be avoided in a tummy tuck. The same principles were applied. Dr Villegas, the innovator, uses drains but we managed to avoid them. The unique features of TULUA are the removal of all fat and skin up to the umbilicus, a 360° liposuction, horizontal application of the rectus sheath (as opposed to vertical in routine abdominoplasty), and a skin graft umbilicus at a desirable position.

Here is the result after one year of abdominoplasty

It is difficult to give such contouring to an abdomen with such heavy fat deposits.

Three months later, the patient weighed 86 kg, looking leaner and toned, yet unable to lose fat on the arms and back. She underwent arm and back liposuction with facial contouring for a double chin. Following three months of the session, the patient’s weight dropped to 80 kg, and flaunted a good waist and upper body. The last session was thigh liposuction with an arm lift. We have the latest Embrace Radiofrequency (RF) liposuction, which brings about skin tightening and ultrasound liposuction, which causes selective fat targeting. Thus, thigh skin removal could be averted. Even though an arm lift was required, it was a short scar lift, thanks to Embrace RF and Liposaver.

The whole transformation took nearly nine months of patience and perseverance by both the patient and the doctor. There were no major complications, thanks to intense monitoring at the hospital and strict adherence to pre- and peri-operative safety protocol. She had a drop in haemoglobin, which was corrected with IV and oral iron therapy. Throughout the procedure, she was under close supervision of our physician; completely conversant and experienced in managing the medical aspects of major cosmetic surgery. They surely are a rare species because routine physicians do not get to see the results after they give fitness to cosmetic surgery patients. At our set-up, the plastic surgeon seeks regular assessment of patients for safety and continuing fat loss.

Overcoming the post-op pain and bouncing back to exercises, proper diet, and having a good personal gym trainer are all contributors to her success story. But what really won us was her willpower, faith in the surgeon, and breaking every barrier patiently.

At Laser Cosmesis, we see more and more patients seeking graceful transformation. The dedication and commitment of these patients to health and fitness is an outstanding example of how one can resurrect themself with determination, willpower, and judicious use of cosmetic surgery. This transformation has multiple health benefits because of the loss of inches, bulk, and drag. This is what makes it worth the effort.

About the author: Dr Medha Bhave is an accomplished plastic surgeon specialising in cosmetic surgery. With multiple degrees (MS, DNB, MCh, DNB) and a position as APSI Visiting Professor in Cosmetic Surgery, she brings expertise to her practice at Laser Cosmesis and Param Hospital and ICU in Thane.