What I regularly notice in my interactions with clients is this almost visceral hatred for fat. In a disdainful gesture, patients, both men and women alike, grab a fold of fat with both hands and lift it with horror, expressing their resentment, their disgust for this fat, which sometimes represents a rather graceful natural curve. Other times, however, on the abdomen, the flanks, the inner or outer thigh, this fat becomes truly repulsive and demeaning for the person who has to live with it daily.
Fortunately for the liposculptor and their patients, fatty tissue is very poorly vascularized, meaning there are no major arteries or veins present. Therefore, there is no problem navigating through it with a cannula, provided, of course, that the roof and floor are avoided, i.e., the dermis of the skin above and the muscle below. This is greatly facilitated by tumescence, which, as we will see later, swells the fatty tissue and provides all the necessary space for the cannula.
When we talk about fatty or adipose tissue, we mean a grouping of cells, each filled with a drop of oil. These cells, called adipocytes, are grouped into lobules, which are separated from each other by fibers called “septas.” These fibers can be more or less abundant depending on each person’s constitution and genetics. Athletes generally have more, as do those who have lost weight, but this is relative. The upper back contains a lot, while the inner thigh has very little. The fewer there are, the easier the surgical work, as these fibers are obstacles to the cannula’s movement.
In adults, fat lobules have only one arteriole. Therefore, there is very little bleeding, and thanks to tumescence, we obtain a practically avascular tissue. Fat cells have the ability to multiply until puberty, a process called hyperplasia. After that, they can increase in volume, but their number remains stable, a process called hypertrophy.
Thus, when an adult gains weight, they experience fatty hypertrophy, and atrophy when they lose weight, but the number of fat cells remains the same. Only liposuction can reduce the number of fat cells.
Let us briefly recall the multiple functions of fatty tissue:
an energy reservoir, like a gas can;
a thermal insulator, a kind of mineral wool;
a shock absorber, a sort of cushioning resistant to impacts;
a source of “sex appeal.” It is fat that determines the curve, the line, the beauty of the human body. This line can be altered by too much or too little fat. Both the images of obesity in America and those of cachexia in Biafra stray from the popular standards of beauty represented by Claudia Schiffer or Charlize Theron.
Accepting one’s body is also a notion that changes over time. The first impressions of Rubens’ famous painting, The Three Graces, place us in the gaze of the past. The standards of beauty in 1639 and those of today seem irreconcilable. Has our way of seeing the body changed? One can admire these well-rounded women or judge them as too fat, depending on one’s perspective. Yet, these women are remarkably beautiful. Their posture, their bearing, their smiles, and the apparent self-contentment emanating from them leave no doubt: they feel beautiful and let us know it. So much so that we indeed fall in admiration before these radiant and seductive faces, these maternal bellies, these broad and sturdy thighs.
The distribution of fat, as we will see later, determines a masculine or feminine image. Its acceptability varies over time and leads us to take a more global view of beauty as defined by advertising with its stereotypes or as each person can embody it with their own personality.
On the feminine side, the idealized silhouette, which has varied over the centuries and with fashion, is much more curvaceous and responds to fantasies and an evocative imagination of sensuality, emphasizing slimness. Men retain more fat in the upper body, while women have more in the lower body. However, the “male” valorized by fashion magazines tends to have well-defined muscles, particularly in the abdomen, where a “ladder” is highly sought after, something some have renamed the “six-pack.”
Source: LIPOSUCTION | Everything you need to know before, during, and after – Dr. André Dupuy
