Middle Eastern Ancestry
While Middle Eastern women encompass multiple racial types, there may be some general patterns. Certain individuals have larger lower legs, from the knee to the ankle; these can be successfully liposuctioned, although skin contraction may not be perfect. The goal is to produce a smaller more shapely leg. Smaller cannulas are useful here, and these procedures may take several hours. Repeated pre-surgical counseling may be useful before surgery for optimal understanding and to appropriately shape the patient's expectations.
Another group we treat is of course women of European genetics, such as Germans. They may have a more boxy torso. Their fat is sometimes behind the abdominal wall where it cannot be reached. The rule is: what can be pinched can usually be removed. If the fat is in front of the abdominal wall however, these patients may have spectacular results.
Another important issue: in contrast to African-Americans, most Caucasian women want very thin outer thighs. Generally, a liposuctionist who removes most of the fat in this area will produce a satisfied patient. The goal is to smooth the double-bump of the hip and outer thigh into a single attractive curve.
The lightest-skinned individuals that we deal with are redheads, who have an occasional tendency of their skin to mottle or have a slightly irregular color pattern. This looks much like skin that has been exposed to cold. Treatment with massage, ultrasound, or Accuscope microcurrent (a noninvasive physical therapy) can sometimes be helpful, but often many months (or even occasionally years) elapse before the mottling improves. Light blondes also occasionally have this problem. Rarely, color changes are permanent.
Aside from ethnic influence, gender is important. Men sometimes have less fat deposition above the muscular layers, and so may be inappropriate candidates for liposuction. If the surgeon can't pinch fat on top of a bulging abdomen, the fat is inside the muscle, and the patient must be warned that his improvement will be modest. Sometimes just the lower abdomen has external fat, which we can remove. And some men desire only "love handle" removal, and are satisfied even if the front of the abdomen remains bulgy.
These stereotypes, rather than being discriminatory, are instead important considerations for the surgeon and patient. Patients must be counseled carefully as to their understanding of what is possible in light of their expectations. If a patient does not fully understand the procedure, or is unrealistic about the result, of course surgery must be refused until the time when the patient can comprehend the whole situation and the risks. These genetic factors will also impact the surgeon's approach; he must keep in mind that a figure he may personally consider less than optimal might be just right for a given ethnic individual. The surgeon's pre-existing ideas as to what constitutes satisfactory results may have to be modified to meet patient expectation and that which is attainable.
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