Liposuction pre-op: Be specific about what you want!

Is Liposuction to the hips for everybody?

Recently, a patient came to me for a second opinion. She was an attractive, dark skin Hispanic female who had had Liposuction to the saddlebag area along with a tummy tuck and a breast lift. The result was great, but the patient was unhappy. She had a small waist, and a nicely defined hourglass figure. Her hips were curvy. Now why would a patient be unhappy with a ‘good’ result?

Because, it depends on whose opinion of ‘good’ we are relying on.

In this case, both the original surgeon and I saw a very successfully accomplished and shapely reduction of the saddlebag area. The problem is that the patient herself did not want her saddlebags reduced, but ‘shaped’. To her, a reduction of the saddlebag area was not a good thing. They had briefly discussed prior to surgery that there would be some ‘shaping of the hips’. How could there have been such a lack of understanding between the patient’s goals and the surgeon’s goals?

Cultural differences in what ‘looks good’ for Liposuction

In my opinion, both patient and surgeon were expressing their thoughts clearly, but misunderstood each other because of cultural differences. It has been my experience that Hispanic and African American patients generally like full hips, including the saddlebag area. In these patients, it is not uncommon to do Liposuction of the abdomen, waist area and inner thighs, but not the outer thighs.

In contrast, Americans of European descent (except, of course Hispanics) want all ‘bulging areas’ to be smoothed out. This is more ‘in sync’ with the plastic surgeon’s training in Liposuction, which tends to focus on ‘unsightly bulges’ that can be smoothed out by Liposuction. There are always individuals of either grouping that defy generalization, but I think it that in general, when a Hispanic (and there are Hispanics of many races) or African American speaks of a nicely shaped hip, they mean a full, rounded contour. On the other hand, when an American of European descent requests a ‘nicely shaped hip’ she is most likely thinking of a sleeker, more streamlined profile.

So, given that surgeons can’t read patients minds, how can patient and doctor avoid misunderstandings?

Be specific in your Liposuction consultation

The patient should be very specific when he/she talks to the doctor. Rather than saying “I want better looking hips”, or ‘nicely shaped hips’ she should specify “I want you to take fat from here, but not there”. Computer imaging is very helpful in these cases. But not every surgeon is set up to do computer imaging. Quite simply, there is no substitute for spending time with the patient to get to know what he/she wants. Beware of surgeons who are so ‘busy and successful’ that they spend little time with you and you find yourself spending a lot of time with his assistant or patient liaison. The surgeon may do great work, but not the work you were looking for.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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