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I am 5'6" and 142 lbs, "pear shaped." I weighed 128-132 prior to having a child at...

Q:

I am 5'6" and 142 lbs, "pear shaped." I weighed 128-132 prior to having a child at 38. I have never been heavy but my metabolism is resistant to weight loss. I have a protruding abdomen from a myomectomy and the c-section. The excess fat "juts out." I am sensitive to epinephrine and other pharmaceuticals. This is of great concern to me in considering elective surgery. I am also considering a reduction of my "saddlebags." First, is there a safe liposuction procedure for me? Will liposuction alone make any improvement to my abdomen? I am seeking a "smoother" as well as flatter profile. Second, I am not "sleek" below the waist. I could use some contouring. Would liposuction of the saddlebags region make a noticeable improvement in my appearance? Can both procedures be performed at the same time?

A:

The problem you describe is a very common one. Lipoplasty (liposuction) is a safe and proven method for body contouring; it is not a method for weight loss. First, an evaluation by your physician or an endocrine evaluation may be helpful to insure there is no medical reason for your appearance. In addition, an exercise program will be helpful to you even if you do not choose to have a surgical procedure. Many people say they are allergic to epinephrine. In reality, epinephrine is a substance that is naturally produced by your body. This "allergic response" may be secondary to some of the medication getting into your bloodstream and causing an increased heart rate following a dental procedure. Other medications can also interfere with anesthesia. It is important to discuss these issues with your plastic surgeon and an anesthesiologist prior to scheduling surgery.

Regarding your abdomen, I feel a combination of lipoplasty with possible mini-abdominoplasty might be the best approach. A mini-abdominoplasty involves smaller incisions than a standard abdominoplasty and is generally used to remove excess skin. Liposuction would help in contouring the saddlebag and leg areas. Both of these procedures are very safe in the proper setting and with proper surgical indications. It may be reasonable to combine both of these procedures at the same time, but this is a decision that will be made following a consultation with a plastic surgeon.

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