Town&Style

Little Problems, Big Results

We’ve all got little things we’d like to change about ourselves. Cellulite, excess back fat, less-than-luminous skin—the list could go on and on.  For a lot of these issues, undergoing a major surgical procedure may not be an option, or it simply might not feel worth it. With that in mind, we asked local experts how to address these little issues and get a big payoff.

hips, thighs and back
The hips, thighs and back can be problem areas when it comes to excess fat. “My female patients often complain about the disproportionate size of their hips and thighs,” says Dr. Michele Koo, a plastic surgeon in private practice. “They also complain about fat that bulges out from under their bras. They hate the lumpiness of their figures in and out of clothes.” These problems, coupled with cellulite that can dimple the thighs, paint a less than flattering picture. Luckily, there are options for smoothing over these imperfections.

cool sculpting
Cool sculpting hyper-cools an area of localized fat. “Skin, bones and other bodily tissue like muscle aren’t as sensitive to the cold as fat cells,” says Dr. Terence Myckatyn, a Washington University plastic and reconstructive surgeon. “It can be uncomfortable for the first 5 to 10 minutes, but the process injures fat cells and is designed to remove discrete areas of fat.” Myckatyn says the big benefit of Cool sculpting is that there is no surgery, and treatment only takes 35 minutes. There also is little to no post-procedure downtime. “The treated area may be uncomfortable to the touch for three to four days, but people can return to normal activities that day,” he notes.

Myckatyn says another advantage is that it can be done on most areas of the body, including the flanks, thighs and back. “Whatever fits into an applicator can be treated, and more than one machine can be used at once,” he explains. “The process treats about 15 to 20 percent of the fat per session.” Koo notes that back fat is particularly dense and is not ideal for fat removal through freezing. “If you have a small amount of fat on the hips or thighs, cryotherapy can diminish it,” she says.

Both Koo and Myckatyn note that Coolsculpting and other freezing treatments are not weight loss solutions. “The options for significant deposits of fat in the thigh, hip and back areas are limited,” Koo says. “Body shape and weight are determined 70 percent by food intake and 30 percent by exercise. People have to make healthy lifestyle changes.” Myckatyn adds that the procedure is ideal for patients at a desirable weight who eat a good diet and are active but need help with a problem area.

cellfina
Hail damage, cottage cheese—the nicknames we give cellulite reflect what an unsightly problem it can be. These dimples and buckles occur when fat pushes through the connective tissue under the skin, and the condition affects more than 90 percent of women, according to Myckatyn. Cellfina is a treatment that addresses the dimpling cellulite can cause, common in the thigh area. “The procedure uses a device that cleaves the connective tissue that tethers down the skin and causes dimples,” he explains. “First, we photograph and map the area of the cellulite. Then, we numb the area and use a suction-cup device to lift the dimples up. We take a tiny needle and cut the little bands under the skin.”

He suggests thinking of it like a sofa cushion with a divot. If you cut the thread creating the divot, the cushion naturally pops back up. “Patient satisfaction rates have been more than 90 percent,” he adds. “For what it does, it’s by far the most effective treatment.” Myckatyn says the only real downside to Cellfina is its limited number of candidates. “Patients may have wavy or loose skin and call it cellulite, but it’s not,” he says. “The procedure is very specifically for dimpling cellulite. It doesn’t remove any fat.”

fat grafting
Who wouldn’t want to take extra fat and redistribute it to more desirable areas? Fat grafting is a natural treatment that does just that. During the procedure, fat tissue is removed from one part of the body, processed and injected into a different part. “A lot of people think you need to travel to Miami for this kind of procedure, but you can stay right here,” says Dr. Richard Moore of The Lifestyle Center.

» From Head to Toe: Fat grafting can be done virtually anywhere on the body, according to Dr. Sumesh Kaswan, a SLUCare plastic surgeon. “Fat even can be grafted onto the feet of runners who are experiencing pain. It all depends on what you are trying to achieve and the issue you are addressing,” he says.

» Put Your Best Face Forward: The procedure often is used to address some of the changes to the face that come with aging. “As we age, we not only lose elasticity in the skin, we also lose fat in key areas like the cheeks and upper lip,” Kaswan says. “It’s not uncommon to inject fat into those areas to get a more youthful appearance.” He adds that fat grafting often is used to supplement face-lifts and other procedures. Moore notes that the procedure also can stimulate hair growth and improve the quality and texture of the skin because the fat is rich in regenerative cells.

» (Re)construction Zone: Fat grafting in the face requires a small amount, but larger quantities can be used in areas like the breasts and buttocks. Kaswan adds that it often is used in breast reconstruction to create a better contour and address problems with implants.

» All Natural: “The biggest benefit is that it’s natural and comes from your body,” Moore says. “You are not putting something foreign into your body like a dermal filler or breast implant.”

» Bounce Back: Moore says recovery time varies from patient to patient. For larger areas, people are usually back to work in three to five days and back in the gym after four weeks. Recovery time for the face is generally less, but Kaswan says patients may experience swelling and bruising for the first week to 10 days.

» Survival of the Fittest: Both Kaswan and Moore say patients should be aware that not all the fat survives after it is transferred. “Around half may be absorbed over the next nine to 12 months,” Kaswan notes. “If that’s the case, the long-term results won’t be as good as immediately after the procedure.” To increase the odds of the fat surviving, Moore says removing it with Tickle liposuction causes less damage. “After the fat is removed, we also filter and micronize it,” he says. “This strips away mature fat cells that wouldn’t survive and leaves stem cell-rich material for injecting.”

» Crunch the Numbers: Moore says fat grafting is often cost-effective, especially when compared with dermal fillers for the face. But since not all of the fat will survive, Kaswan notes some patients may require a second round, upping the potential cost.

maintaining a beautiful you
We often go to great lengths for beauty, but there are plenty of simple steps you can take to improve the health and appearance of your skin. Here are simple ways to give it a radiant boost and address changes that come with age.

eat:
What you put in your mouth can have just as big an impact on your skin as the cleansers, moisturizers and toners you use. A proper diet will give you vitamins, minerals and amino acids to make your skin healthy and beautiful. Add foods that contain beauty-boosting properties like omega-3 fatty acids, vitamin C, vitamin E, selenium and lycopene found in salmon, walnuts, kiwi, kale, avocado, sweet potatoes, tomatoes, Brazil nuts, watermelon and spinach.

drink:
Your skin is your body’s largest organ, and like all organs, its cells are made up of water. If your skin is not properly hydrated, it can turn dry, tight and flaky. Dry skin is also more prone to wrinkles. Drink eight glasses of water a day to properly hydrate the skin and help rid the body of toxins.

moisturize:
Your face sheds skin cells more rapidly than other parts of the body, and it needs moisture to repair itself, allowing younger cells to rise to the surface. Moisturizing also can help prevent extreme dryness, oiliness and acne. Choose a product that includes vitamins A and B5 to increase firmness, vitamins C and E to fight damage, and a sunscreen to protect your skin during the day. The optimal time to moisturize is after a bath or shower because hot water strips your skin of moisture and oils.

exfoliate:
As we age, the process of cell regeneration slows down, meaning our bodies don’t shed skin cells and generate new ones as quickly. Buildup of old cells can make the skin look dull, rough and dry and can clog pores, leading to acne and other blemishes. Exfoliation removes the barrier of dead skin cells and uncovers the fresh ones beneath.

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