24 May, 2008

Conquering Cellulite

Table of Contents
Introduction To Cellulite
What Is Cellulite?
Cures & Treatments
Drugs or Cosmetics?
Topical Treatment
Body Wrapping
Electric Muscle Stimulation
Liposuction
Glossary
Resources

Introduction To Cellulite

In our never ending search for the illusive “Fountain of Youth,” nothing strikes a chord like the term “cellulite.” Interestingly, the term “cellulite” was first introduced to us by a fashion magazine. That fact is sufficient to generate speculation among opposing sides to this controversial subject.
What we endeavor to present here is an overview of the facts surrounding “cellulite” with an eye toward education. We make no recommendations nor endorsements as to the efficacy of any products that may be mentioned, nor do we recommend or endorse any particular treatments that we might discuss.
We hope to present the pros and cons of the arguments and allow you to make your own determination and course of action.
It is interesting to note that nearly two decades ago, The Journal of the American Medical Association (JAMA) stated that "there is no medical condition known or described as cellulite in this country.”
Because there is no official medical term for the conditions, does that mean that there can be a “cure?” Apparently so, as evidenced by the thousands of products and procedures available to combat the condition.
What Is Cellulite?
Cellulite is a term that is used to describe fat deposits under the skin that outwardly give the skin a dimpled, or orange-peel like appearance. Cellulite is most often seen in women because the fat is arranged in large chambers separated by columns of collagen fibers.
Fibrous strands of tissue connect your skin to deeper tissue layers, creating compartments of ordinary fat cells. When the fat cells increase in size, the compartments bulge and produce the dimpling appearance on your skin.
In overweight people excess fat is stuffed in these compartments causing them to bulge out. On the surface of the skin the bulging provides the dimply appearance of cellulite, especially in areas such as the hips, buttocks or thighs.
Oddly enough, cellulite is predetermined by genetics so even thin women can develop the appearance. Factors such as hormones, pregnancy, and aging may all attribute to the weakening of the collagen fibers to give the cellulite appearance.
Even people diagonosed as the “morbidly obese” are not necessarily genetically pre-disposed to cellulite and may display no symptoms at all.
It is important to note that even though it is unsightly, cellulite is normal for many women and some men as well. The dimpling appears to be less obvious when the subject has thicker skin which further enforces the genetic predisposition. As the body ages, the skin becomes thinner and there is nothing that can be done for that natural aging process.
Cures –& Treatment Options
If our research indicates that cellulite is not recognized as a disease, is there no such thing as a “cure?” We aren’t here to make that determination. That is something the reader should pursue for him or herself. Whether there is or is not a “cure,” there are various methods of treatment and we will endeavor to review them for you with an eye toward “Conquering Cellulite.”
All you need to do is begin a search for information about cellulite and you will find yourself bombarded with commercial messages. There are hundreds of sources all claiming to reduce or eliminate the ravages of cellulite, and “for only $xxxxx you too can rid yourself of this condition.”
The most widely advertised methods we have found are topical creams and/or ointments, body wrapping, electronic muscle stimulation and liposuction. Let’s review them beginning with topicals.
Topical Treatments
Numerous products are available to consumers that are promoted in the area of “skin care products” and/or “thigh creams.” Some of the claims are:
§ Increased collagen production
§ Strengthening collagen and elastin fibers
§ Cellulite reduction through cellular stimulation to release stored fat
§ Weight reduction through appetite suppression, increased metabolism, and fat burning
§ Reduced water retention.
When is a topical considered a drug or a cosmetic? That’s a difficult question.
According to the government drugs, unlike cosmetics, alter the structure or function of the body. Here’s where it gets really confusing. If the manufacturers claim that thigh creams or other topical treatments eliminate cellulite, is that considered as “altering the structure or function of the body?”
We don’t have the answer to that question nor are we in a position to present a plausible argument either way.
What we do know, is that many people have hidden allergies. These allergies only surface when the individual comes in contact with a “new” trigger. Some of the thigh creams and other topical products contain an ingredient that can be potentially harmful for certain individuals. We will discuss that in just a moment.
Before you use any new topical treatment, you should “test” the product on a small area of skin and give yourself sufficient time to observe any reactions.
You should also carefully read product labels and follow directions. If it contains an allergen that you already know affects you, obviously you won’t want to use that particular product.
Persons who suffer from asthma need to pay particular attention. “Aminophylline,” an approved prescription drug used in the treatment of asthma, is an ingredient used in many thigh cream products that marketers claim will dissolve the fat and smooth the skin.
Since some individuals suffer from allergic reactions to ethylenediamine, a component of aminophylline, there is some concern and these people may wish to avoid these products so that they don't develop a sensitization (become allergic) to aminophylline.
For these and other reasons the government argues that the majority of “topical agents and thigh creams” should be regulated as drugs. They further dispute the efficacy of these creams. As we said earlier, that isn’t our determination to make.
Some dermatologists and clinicians have a differing point of view. One such practice conducted an abstract study wherein they used a “double-blinded randomized trial.” This means that neither the clinicians conducting the test nor the subjects, knew which of a particular topical agent they were testing.
Twenty women with a moderate degree of cellulite on the buttocks and/or thighs were entered into a four-week, double-blinded, randomized trial where an anti-cellulite cream was applied to the affected sites on a nightly basis.
Some of them were randomly selected to use a neoprene garment on either leg. High quality digital photography was used to photograph them from different angles before and after four weeks of treatment.
17 of the subjects actually completed the study. Of those 17, 76% saw overall improvement in their cellulite. 54% reported even greater improvement on the thigh that used the special garment.
The dermatological evaluators found an improvement in 65% of treated legs with the garment and 59% of treated legs without the garment.
Further, the evaluators found the thighs using the garment showed greater improvement than those that did not in 65% of subjects. The topical agent used in this study was found to be effective in reducing the appearance of cellulite and the neoprene garment enhanced the effect of this topical agent in cellulite reduction.
The dermatological evaluators claim that the success of this study validates the garment used to enhance the topical agent used.
Your writer makes no claims as to the validity of the above test or the arguments set forth by the government. Both present valid points of view.
Also take note that we have no idea of the “brand names” of the products involved. Again, you might want to check the contents of any product you may be considering.
Body Wrapping
Many spas and salons offer a process called “body wrapping.” This procedure claims to remove inches from the waist, thighs, hips or other parts of the body. The process includes the use of special wraps or clothing and can sometimes be used with special lotions or creams that are applied to the skin.
Customers are usually told that they can lose “inches” as opposed to pounds and that fat will melt away bringing about a loss of inches in about an hour. One of the claims is that wrapping will work because cellulite is “water logged fatty tissue.”
What overweight person wouldn’t love to find a product that will render them slim and trim while they sleep?
Unfortunately, many people think that body wrapping is a relatively “new” procedure and jump on the bandwagon quickly. The truth is that the body wrapping craze has been around for some time.
Over two decades ago, government “watchdogs” reported:
Who can blame the fretfully flabby for being lured by the promise of losing inches without doing anything more strenuous than popping a pill or wrapping up the offending flesh? Who can resist ads for body wraps that promise ‘to burn away fat even while you sleep,’ to ‘lose 4-6 inches the first day?"
What do these wraps consist of?
Some are plastic or rubber garments worn around the waist, some cover the waist, hips and thighs, and others cover nearly the entire body.
Some are to be worn while carrying out routine activities, others while exercising, and some while sleeping. One is inflated with air from a vacuum cleaner. Another uses an electric hair dryer to blow in warm air. Some are used after a cream, gel or lotion is applied or after the wrap is soaked in a solution.
The garments and wraps, with or without lotions and creams, say that they reduce body dimensions by removing fluids. Most medical experts agree that such treatment will cause a loss of inches and perhaps pounds due to profuse perspiration. But the reductions are temporary. The fluid is soon replaced by drinking or eating.
Remember, rapid and excessive fluid loss is potentially dangerous because it can bring on severe dehydration and can upset the balance of important electrolytes in the body. Reputable spas are aware of any potential hazards such as this, so do your homework and select a spa with a good reputation.
Some people have tried using “plastic wrap” as body wrap material. In fact, that was a very popular practice several decades ago.
Body wrapping has evolved since those days, becoming much more sophisticated. Prices for a body wrap range anywhere from $40 an hour up to as much as several thousand dollars at some of the upscale spas.
Some advertising claims that body wrapping will eliminate, or at the least reduce, cellulite but we’ll leave that up to you to determine. What we can tell you is that visiting a spa or salon for body wrapping may be a wonderfully rejuvenating experience, leaving you rested, relaxed and refreshed.
And who wouldn’t like to have a few hours being pampered and fussed over in a relaxing environment regardless if it helps the cellulite problem.
Some spas advertise herbal and other natural wraps. In fact, the methods and products applied are widely varied. Let’s explore some of the components that make up a good “wrap” experience.
Herbal wraps. Some of the higher end spas go so far as to grow their own “herbs” for use in their body wraps, but that isn’t necessary for a good body wrap experience. Herbs can be fresh, or dried and usually organically grown is best.
Each herb has a specific effect. Some increase circulation, another may soothe the skin and so on.
The herbs are steeped in very hot water (almost boiling) then special muslin sheets are soaked in the solution. It is these herb-infused sheets along with other insulating layers that wrap around the body.
How the treatments work is interesting. The goal is to create a condition not unlike your body when you have a fever. We all know that when we have a fever, our body eliminates toxins by sweating.
It’s the same principle with body wraps. The results vary. Some people report a very intense detoxification while for others it might be mild.
Methods of application and content vary as well. Seaweed, mud and salt are popular body wraps. Most often, the subject is wrapped from neck to toe with the arms set close to the sides of the body. This can be uncomfortable for someone who suffers from claustrophobia.
The easiest correction for this is to keep the arms free from the wrap. Most people who are claustrophobic find the works and that all they need to be able to feel free to remove themselves if they choose.
Whatever type of body wrap you select make certain that you feel comfortable with the spa and that a technician is always close at hand.
Care should be taken when selecting a salon or spa. Some things to consider:
§ How long have they been offering body wraps?
§ Do they have a licensed clinician whose sole purpose is massage and/or body wraps?
§ Where do their herbs and other contents come from?
§ Do they offer any special pricing for new clients?
§ Will they allow a tour of their facilities prior to purchase?
§ Have they had any unresolved complaints reported by the Better Business Bureau?
§ Do they have any package pricing for multiple visits?
Watch your local publications for coupon offers. This can be a good way to try out a service at a bargain. Ask your friends if they have had a body wrapping experience and whether they enjoyed it and what kind of results did they experience. You may even want to check for “two for one” specials and try it out with a friend!
Whether the experience reduces your cellulite or not, if you follow the guidelines you are in for a pleasant experience. Who knows, you might just like it enough to include it in your long term personal care budget!
Electric Muscle Stimulation (EMS)
We will discuss two different types of EMS equipment. The first is a procedure that sends electrical current to muscle and fatty tissue. The second is the use of a “massage like” piece of equipment.
Physicians have used electrical muscle stimulation using approved devices for some time. They are a legitimate process approved for specific conditions. Some of those conditions are
§ Increase blood circulation
§ Prevent blood clots
§ Relax muscle spasms
§ And rehabilitate muscle function after a stroke
Providers of EMS equipment for consumer use will tell you that the process will:
§ Reduce breast size
§ Remove wrinkles
§ Do face lifts
§ Reduce bellies
§ Remove cellulite
There is no clinical evidence that proves such claims, but we will endeavor to briefly explain how this process works according to the providers.
The premise is that using EMS, the brain sends a nerve impulse to the “motor point” of the muscle you desire to change. This signal is a message to the muscle to expand and contract.
Electrodes are placed on specific motor points of the muscle group(s) to be exercised. When the electrical stimulation is applied through the electrodes using a mild current the muscle will expand and contract. The theory is that this makes it possible to duplicate regular exercise without the effort using conventional means.
During your conventional exercise, your brain is sending messages down the spinal cord through the nerves with the muscles you are using, causing them to relax and contract. Your brain is controlling the muscle using what is called voluntary muscle action.
EMS uses the outside electrical source to stimulate the nerves and send signals to your muscle to expand and contract. It send an electrical current through adhesive electrodes creating the expansion and contraction. This would be considered involuntary muscle action.
It is believed by some that EMS stimulates large nerve axons, or long outgrowths of a nerve cell body. Some of these cannot be stimulated voluntarily so the logic is that EMS might allow for increased development of tissue by enlarging it without multiplying cells.
The second piece of equipment is a “massage like” device. We will not mention the name as it is trademarked and it is not our intent to provide advertising for any specific method of equipment.
They claim to have the first FDA approved device for temporarily reducing the appearance of cellulite. The process is what they term a “subdermal” approach for temporarily reducing the appearance of cellulite.
It consists of a hand held motorized device with two adjustable rollers and suction which creates a symmetrical skin-fold. They state that, “the skin gently folds and unfolds under the continuous action of the rollers allowing for smooth and regulated deep tissue mobilization.
As the viscosity of the subcutaneous fat layer decreases, blood flow and lymphatic drainage increase, facilitating the elimination of excess fluid and metabolites, while improving overall cellular function.”
This is supposed to help you to reduce cellulite and probably brew your morning coffee!
All joking aside, if not used properly these devices can produce harmful effects. Because they border on “snake oil salesman” techniques in their advertising and claims, our suggestion is to go ahead and research them but buyer beware.
Liposuction

Finally we arrive at the granddaddy of all procedures – liposuction.

What is Liposuction?

Liposuction is a surgical procedure intended to remove fat deposits and shape the body. Fat is removed from under the skin with the use of a vacuum-suction canula (a hollow pen-like instrument) or using an ultrasonic probe that emulfsies (breaks up into small pieces) the fat and then removes it with suction.
Persons with localized fat may decide to have liposuction to remove fat from just one specific area. Liposuction is a procedure for shaping the body and is not recommended for weight loss.
Liposuction may be performed on the abdomen, hips, thighs, calves, arms, buttocks, back, neck, or face. A liposuction procedure may include more than one site, for instance, the abdomen, back, and thighs all on the same day.

Who performs liposuction and where is it performed?

Most liposuction procedures are performed by plastic surgeons or dermatologists. However, all that is required to perform liposuction is a medical degree, so any licensed physician may perform liposuction.
This can be a bit discomforting because it means that even a “podiatrist” can legally perform liposuction procedures without any specialty training.
It’s a good idea to find out all you can about a particular physician before considering him or her to perform your procedure. Check with your local licensing board, ask your physician how many procedures like yours has he/she done and can you see before and after photographs.
Don’t be afraid to ask your physician probing questions. Remember, you are paying for a service and you deserve to know the answers to any questions. Ask him for in depth explanations of what your procedure consists of and what your prognosis is for healing.
Don’t have unrealistic expectations. The recent “make over” craze on television gives the impression that anyone and everyone is a candidate for a make over. Don’t enter into a decision based on what you see on television.
The patients you see on television are the very best candidates in terms of health and other factors. They are selected based on the fact that their “before” and “after” will show drastic results. That just isn’t true for the average person.
If you expect to come out of liposuction looking like Britney Spears, you will be very disappointed. That is not to say that you can’t expect results. More than likely you will and the end result will give you a younger look. Just don’t expect unrealistic results.
Some professional medical organizations recommend special training for physicians, it isn’t required by law. So the more information you can determine, the safer you can feel about your procedure.
Liposuction is a surgical procedure, so remember even the best screened patients under the care of the best trained and experienced physicians may experience complications as a result of liposuction.
Liposuction may be performed in a
§ Doctors office
§ Surgical center
§ Hospital
Because liposuction is a surgical procedure, it is important that it be performed in a clean environment. Emergencies may arise during any surgery and access to emergency medical equipment and/or a nearby hospital emergency room is important. These are things that you should ask your physician before the liposuction procedure.
Be wary of advertisements that say or imply that you will have a perfect appearance after liposuction. Yes, back to those realistic expectations. Remember that advertisements are meant to sell you a product or service, not to inform you of all the potential problems with that service.
Don't base your decision simply on cost and remember that you don't have to settle for the first doctor or procedure you investigate. The decision you make about liposuction surgery is an important one but not one that you must make right away.
You should learn as much as you can about liposuction. It is important for you to read the patient information that your doctor provides.
Do not feel that because you speak to a physician about this procedure that you must go through with it. Take your time to decide whether liposuction is right for you and whether you are willing to take the risks of undergoing liposuction for its benefits.
Visit several physicians if it will help you make the right decision. Initial consultations are generally free and it can be helpful and enlightening to have several different opinions. It can also help you to make an intelligent decision based on all the facts. Selecting a physician that you feel comfortable with should be a main concern.

When is Liposuction not for me?

It may not be for you if you are not accustomed to taking risks. Complications can arise and are unavoidable in a percentage of all patients.
Cost is a huge factor to take under consideration. Since liposuction is primarily considered “cosmetic,” most medical insurance companies will not pay for the procedure placing the burden directly on you.
If you are considering liposuction as a means to lose weight, then liposuction is not for you. This is a procedure designed to shape the body and is not recommended for losing weight.
If you are on certain medications that affect healing this may not be a procedure you should risk. Some of the considerations are:
§ Current infection
§ History of bleeding
§ Heart disease
§ Edema
§ Blood clotting medications
§ Anti-inflammatory agents
§ Anti-coagulants
§ Any medications that may interact with the drugs used during liposuction.
Your skin elasticity may not be adequate. Your doctor will evaluate the skin at the site where you are considering liposuction to determine if skin is elastic enough to shrink after liposuction.
If it is not, it will be baggy after liposuction. This may cause you to have to consider plastic surgery to eliminate the excess skin.
Our analysis of liposuction would not be complete without pointing out some of the risks involved.
As a general rule, most patients are pleased with the outcome of their liposuction surgery. However, like any other medical procedure, there are risks involved. That's why it is important for you to understand the limitations and possible complications of liposuction surgery.
Before you have liposuction, you should be aware of these risks and should weigh the risks and benefits based on your own personal value system. Try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so. Decide for yourself whether you are willing to take the risks involved in liposuction.
Take your time deciding if you are willing to accept the risks inherent in liposuction. Because it is usually a cosmetic procedure, and not medically necessary, there is no reason to rush.
Gather as much information as you can so that you make an informed decision about whether liposuction is right for you. Don't believe that complications "only happen to other people." It is important for you to understand what the risks are and decide if you are willing to accept the possibility that it might happen to you.
What are some possible complications?
Infections may happen after any surgery and may occur after liposuction. Some physicians prescribe an antibiotic to all patients undergoing liposuction but other physicians do not. It is important to keep the wound(s) clean but even if you do, infections may sometimes occur from the surgery.
Sometimes, infections may be serious or life threatening such as in cases of necrotizing fasciitis (bacteria eat away at the tissue) or with toxic shock syndrome, a serious, sometimes fatal infection caused by a bacteria, that is associated with surgery (you may have heard of toxic shock syndrome occurring in women using tampons, also).
Embolism may occur when fat is loosened and enters the blood through blood vessels ruptured (broken) during liposuction. Pieces of fat get trapped in the blood vessels, gather in the lungs, or travel to the brain.
The signs of pulmonary emboli (fat clots in the lungs) may be shortness of breath or difficulty breathing. If you have the signs or symptoms of fat emboli after liposuction, it is important for you to seek emergency medical care at once. Fat emboli may cause permanent disability or, in some cases, be fatal.
Puncture wounds to the organs. During liposuction, the physician is unable to see where the canula or probe is.
It is possible to puncture or damage internal organs during liposuction. This may happen, for instance, if the intestines are punctured during abdominal liposuction. When organs are damaged, surgery may be required to repair them. Visceral perforations may also be fatal.
After liposuction, there may be a pooling of serum, the straw colored liquid from your blood, in areas where tissue has been removed.
You may experience "paresthesias" which is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain) in the area, or the loss of any feeling (numbness) in the area. If these changes in sensation persist for a long period of time (weeks or months) you should inform your physician. In some cases, these changes in sensation may be permanent.
Swelling may occur after liposuction. In some cases, swelling may persist for weeks or months after liposuction.
The skin above the liposuction site may become necrotic or "die." When this happens, skin may change color and be sloughed (fall) off. Large areas of skin necrosis may become infected with bacteria or microorganisms.
During ultrasound assisted liposuction, the ultrasound probe may become very hot and can cause burns.
Fat tissue, which contains a lot of liquid, is removed during liposuction. Also, physicians may inject large amounts of fluids during liposuction. This may result in a fluid imbalance.
While you are in the physician's office, surgical center or hospital, the staff will be watching you for signs of fluid imbalance. However, this may happen after you go home and can result in serious conditions such as heart problems, excess fluid collecting in the lungs, or kidney problems as your kidneys try to maintain fluid balance.
Toxicity from anesthesia is a risk factor. Lidocaine, a drug that numbs the skin, is frequently used as a local anesthetic during liposuction. You may have had a similar drug, novocaine, to numb your mouth at the dentist.
Large volumes of liquid with lidocaine may be injected during liposuction. This may result in very high doses of lidocaine. The signs of this are lightheadedness, restlessness, drowsiness, tinnitis (a ringing in the ears), slurred speech, metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions.
Lidocaine toxicity may cause the heart to stop. Of course, this can be fatal. In general, any type of anesthesia may cause complications and is always considered a risk during any surgery.
There are numerous reports of deaths related to the liposuction procedure. Although it is difficult to be sure how often death from liposuction happens, there are several studies that estimate how often patients undergoing liposuction die during the procedure or as a result of it. None of the studies is perfect so the results are just estimates.
Some of the studies indicate that the risk of death due to liposuction is as low as 3 deaths for every 100,000 liposuction operations performed. However, other studies indicate that the risk of death is between 20 and 100 deaths per 100,000 liposuction procedures.
One study suggests that the death rate is higher in liposuction surgeries in which other surgical procedures are also performed at the same time. In order to understand the size of the risk, one paper compares the deaths from liposuction to that for deaths from car accidents (16 per 100,000).
It is important to remember that liposuction is a surgical procedure and that there may be serious complications, including death.
Before you undergo liposuction, you should have a complete physical exam so that your doctor can determine if you are an acceptable candidate for liposuction.
It is important for you to discuss any medical conditions that you have and to tell your doctor about any medications that you are taking including any herbal or other non-prescription ones. If your doctor decides that you can have liposuction, discuss the procedure thoroughly with him or her before deciding if you want to go through with the procedure.
Just because a physician says that you may have liposuction does not mean that you must decide to have liposuction. You may still change your mind even after discussing the procedure with a physician.
Your physician should be able to answer any questions that you have about liposuction including questions about what to expect during and after liposuction and the complications or problems that sometimes occur with liposuction. Some physicians will provide written information about liposuction. You may also take information from this website to your appointment to discuss with your physician.
You may want to have someone drive you to your appointment for liposuction. You may be tired or uncomfortable after liposuction and unable to drive yourself home. Discuss this with your physician before the day of your procedure.
Your physician may prescribe an antibiotic drug for you to take before and after the surgery. This is to prevent infections.
On the day of the liposuction surgery, the physician will mark your body with a pen to indicate where the fat is to be removed. Then you will receive anesthesia, that is medicine that prevents you from feeling pain. Some physicians use only local anesthesia, that is, anesthesia that they inject with a syringe or pump into the area where they will do the liposuction.
The anesthesia medicine is injected along with a lot of fluid, usually buffered salt water and epinephrine, a drug to reduce bleeding. Large volumes of liquid may be injected, until the skin is very firm. If your physician uses only this kind of local anesthesia, also sometimes called tumescent anesthesia, then you will be awake during the procedure. Other physicians use local anesthesia and a sedative that can be taken by mouth or injected from a syringe. Still others prefer to use general anesthesia, that is to use anesthesia that will put you to sleep during the procedure. This is usually done in a hospital.
Once the anesthesia is working, the physician will make an incision (cut) in the area where the liposuction will be performed. A canula, a hollow tube that is about the size and shape of a skinny pen, will be inserted into the incision. The physician moves this canula back and forth to suction out the fat. The fat, and liquid that has been injected, are collected in a flask.
The physician will monitor the amount of fluid and fat that are removed. Because you will be losing liquid and fat from your body, it may be necessary to replace some of that fluid. This is done with an intravenous (i.v.) line for the replacement of fluid.
Depending upon the amount of fat removed and the location of the surgery (doctor's office, surgical center, hospital), you may leave the doctor's office soon after the surgery or you may spend the night in the surgical center or hospital. Ask your doctor how long it will be before you should be able to return to your normal level of activity or if you will need to miss work after liposuction.
The cuts where the doctor inserted the canula may be leaky or drain fluids for several days. In some cases, the doctor may insert a drainage tube to drain fluid away from the wound.
You will wear special tight garments to keep your skin compressed after the liposuction procedure. Your doctor will tell you how long to wear these, usually for weeks. Some doctors provide these garments but others will tell you where to purchase them before your surgery.
Your doctor will also probably give you some after-surgery instructions. This will include information about wearing compression garments, taking an antibiotic if that has been prescribed, and the level of activity that is safe for you after your liposuction procedure. You should also have information about signs of problems that you should be aware of, for instance the signs of infections or other problems that you need to know about.
When the anesthesia wears off, you may have some pain. If the pain is extreme or of a long duration, you should contact your physician. You will also have some swelling after the surgery. In some cases, this swelling will remain for weeks or even months. If you have pain and swelling, this may be the sign of infection and you should contact your physician.
You will have scars, usually small, where the physician cuts your skin and inserts the canula to remove fat tissue.
While medical complications are important, the reason that people have liposuction surgery is for cosmetic reasons. The cosmetic effect after liposuction may be very good and many patients report being satisfied.
However, it is possible that the cosmetic effect will not be what you expected. In other words, your appearance after liposuction may not be what you expected or wanted.
Some physicians counsel their patients that reasonable expectations are important. It may be difficult to have reasonable expectations after reading advertisements and looking at pictures of women and men who have had liposuction.
We discussed this earlier, but remember that advertising is made to make you want to purchase a product or service. Advertisements do not usually tell you about problems or shortcomings of the product or service.
Some cosmetic shortcomings after liposuction include:
§ There may be scars at the site where the doctor made the cut to insert the liposuction canula. These scars are usually small and fade with time but in some people, scars may be larger or more prominent.
§ The liposuction site may have a wavy or bumpy appearance after liposuction.
§ Liposuction results may not be permanent. If you gain weight after liposuction surgery, the fat may return to sites where you had liposuction or to other sites.
§ Results may be less dramatic than what you were expecting and this can be disappointing.
What Are Some Of The Alternatives
Are there alternatives to liposuction for cellulite reduction? With the occasional rare exception, liposuction is usually considered cosmetic surgery. Therefore it is not considered medically necessary.
Because of this, the decision is up to you whether or not to undergo this procedure. You may decide that it is not right for you. And you can make that determination right up to the point of actually having the procedure.
Some of the alternatives to liposuction are:
§ Change diet to lose some excess body fat.
§ Exercise.
§ Accept your body and appearance as it is.
§ Use clothing or makeup to downplay or emphasize body or facial features.
§ Try some of the other methods that we discussed such as topicals or body wrapping.
Whatever method you select to deal with cellulite, make certain that you have done your due diligence and select the most appropriate method with the least amount of risk to obtain the results you desire.
There really is no substitute for good, old-fashioned, healthy nutrition and exercise. The tried and true methods do work:
1. Watch your diet.
2. Incorporate fresh and natural foods into your diet.
3. Drink plenty of water to avoid dehydration.
4. Limit the consumption of caffeine and alcohol
5. Avoid high fat foods.
6. Get plenty of fiber.
7. Quit or cut down on smoking.
8. Avoid medications not necessary to health and well being.
9. Get plenty of exercise.
Following a regimen of good health, nutrition and exercise will rid your body of excess toxins and promote a general state of health that is optimum for pursuing any program for dealing with cellulite.
We have spent a great deal of time discussing the various options for Conquering Cellulite. The bottom line is that you may not be able to do that!
You have learned that genetics dictate whether you have a predisposition for the condition. If you do, there is no amount of money or procedures that can prevent it from happening to you.
Some of the treatments we presented may help in reducing the problem but they certainly won’t eliminate it totally if you carry the gene.
By all means do your own research to determine if any of the treatments or methods we’ve mentioned here might help you. Again, all we recommend is that you have realistic expectations.
We have used terminology that might be somewhat new and unfamiliar. For that reason we are including a Glossary of Terms and we hope you find that helpful in addition to our recommended resources.
Lastly, think twice or three times before investing huge amounts of cash for so-called treatments or cures. You are now armed with the most important tool you need on your journey to Conquering Cellulite. That tool is knowledge! Use it wisely!
Glossary
Aminophylline – an approved prescription drug for the treatment of asthma.
Anesthetic - drugs that cause the loss of feeling or sensation.
Canula (or cannula) - a hollow pen-like instrument or tube used to draw off fluid.
Cellulite - Fat deposits under the skin that outwardly give the skin a dimpled, or orange-peel like appearance.
Cosmetic(s)-a toiletry designed to beautify the body; decorative rather than functional.
Edema - swelling caused by large amount of fluid in cells or tissues.
Emboli - something that blocks a blood vessel. See embolism.
Embolism - the blocking of a blood vessel or organ by pieces of matter such as fat.
EMS – Electrical Muscle Stimulator
Emulsify - to break up into small pieces.
Epinephrine - a drug injected before liposuction to reduce bleeding during the procedure.
Ethylenediamine – an ingredient in the approved prescription drug Aminophylline.
Genetics - The study of heredity and how traits are passed on through generations; the branch of biology that studies heredity and variation in organisms.
Infection - invasion by and multiplication of bacteria or microorganisms that can produce tissue injury.
Morbidly Obese – Persons who are 50-100% or 100 pounds above their ideal body weight.
Lidocaine - an anesthetic that may be injected in large amounts of liquid during liposuction.
Lipoplasty - another name for liposuction.
Liposuction - a usually cosmetic surgical procedure in which fat is removed from a specific area of the body, by means of suction.
Necrotizing Faciitis - a bacterial infection in which bacteria infect and kill the skin and underlying tissues.

Paresthesia - a change in feelings or sensation. May be an increase in feeling (pain) or a decrease in feeling (numbness).
Pulmonary embolism - pieces of fat may find their way into the blood stream and get stuck in the lungs during liposuction. This causes shortness of breath or trouble breathing.
Probe - see canula.
Sedative - a drug which helps a person to relax and may make them feel sleepy.
Seroma - a collection of fluid from the blood that has pooled at the liposuction site.
Skin necrosis - skin or underlying tissue dies and falls off.
Subcutaneous – beneath the skin as in subcutaneous injection.
Subdermal – another term for beneath the skin.
Suction assisted liposuction - see liposuction.
Thrombophlebitis - inflammation of a vein caused by a blood clot.
Topical - logical application; as, a topical remedy.
Toxic Shock Syndrome - an infection caused by bacteria that release toxins into the body. This type of infection can occur after surgery if bacteria are accidentally introduced during the surgery.
Ultrasound assisted liposuction - a type of liposuction in which fat is first loosened by using an ultrasonic probe and then removed by means of suction.
Visceral perforations - organs may be punctured accidentally with the liposuction probe or canula during liposuction.
Resources
American Academy of Dermatology
1350 I St. NW, Suite 870
Washington, DC 20005-4355
(202) 842-3555
American Society for Dermatologic Surgery
5550 Meadowbrook Dr. Suite 120
Rolling Meadows, IL 60008
Phone: 847-956-0900
Fax 847-956-0999

American Association of Plastic Surgeons
900 Cummings Center Suite 221-U
Beverly, MA 01915
Phone: 978-927-8330
Fax: 978-524-8890


DISCLAIMER: This information is not presented by a medical practitioner and is for
educational and informational purposes only. The content is not intended to be a
substitute for professional medical advice, diagnosis, or treatment. Always seek
the advice of your physician or other qualified health provider with any questions
you may have regarding a medical condition. Never disregard professional medical
advice or delay in seeking it because of something you have read.
Since natural and/or dietary supplements are not FDA approved they must be
accompanied by a two-part disclaimer on the product label: that the statement
has not been evaluated by FDA and that the product is not intended to "diagnose,
treat, cure or prevent any disease."
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06 May, 2008

INTERVIEW WITH A WEIGHT LOSS EXPERT & MORE!


Table of Contents
Introduction
Goal Setting
Age and Sex
Plan of Action
Joining a Gym
Exercise
Equipment
Nutrition and Supplements





Introduction
We will approach this interview as if we have someone who wants to lose weight. Our guest expert has a diverse background. His credentials include personal trainer certification, 26 years of fitness experience as well as several awards as a body builder and owner of his own gym. Using the experience and expertise of our guest, we are going to explore the different things that our client needs to do to get started. We will use a Q (Question) and A (Answer) format.

Goal Setting
Q - What is the average weight that people want to lose in your health club?
A -For most people it’s anywhere from 10 to 50 pounds.

Q - How important is the reason or motivation when someone decides to lose weight?
A - The reason or motivation could be their health or their health situation or just the way they feel.

Q - I guess what I am asking is that the reason that will get them to start with a weight loss plan and stick to it?
A - I would say so.

Q - What do you think our client should do to set realistic goals?
A - Well the first thing, you have to do is what I say. That is really the bottom line they have to stick to good nutritional guidelines.

Q - Do you find that clients set unrealistic goals based on a certain time frame?
A - Not really, they are pretty realistic weight loss because that is one of the questions that I have on the data acquisition form that I use to evaluate my client.

Q - Would you share some of those questions?
A – Well, one of them would be how much weight do you want to lose and in a certain amount of time and I have them write that down. Most of them put down 10 pounds in like 6 months. If I see that what they put down is unrealistic I will let them know.

Age and Sex

Q - Is age a factor when considering a weight loss program and if so, what should be taken into consideration?
A - Yes age would be a factor because metabolism slows down, as you get older.

Q - Is there any such thing as too old?
A – No, especially with older women.

Q - Is there a difference in weight loss plans between male and females?
A - Men can build more muscle mass and women carry more body fat. Women don’t carry as much lean muscle mass and so it can be a little harder for them to lose body fat.

Q - Is there anything such as being too young? There are a lot of obese children in the country today and a lot of that has to do with nutrition? How do you feel about children losing weight and what would the youngest age you would recommend?
A - Well with today’s hype and my readings and such you can train any individual of any age as long as they understand what you are talking about. They can go to the workouts but it will be sometime before they can work with the heavy equipment.

Plan of Action

Q - What about a plan of action for a new client? Should they fly solo or is it wise to have a formal plan of action?

A - I think that everyone should have a fitness assessment even because a lot of people don’t even know where they are now concerning progression.

Q - Is that something that should be done in a physician’s office or is that something that can be done at the health club or gym?
A - Most health clubs don’t though I do; I have them go through 5 different tests.

Q - Would you share that with us?
A - Sure, I go through:
Blood pressure, resting heart rate, body composition which is body fat and lean muscle mass, I also try to find out what their cardiovascular ability is and I go through a strength ability test. I also go through strength as far as how many pushups they can do and I give them a whole printout that targets what is normal for your age as far as are you normal or below normal and your blood pressure and your cardiovascular ability and strength ability. It will show you everything. Then you can do it 60-90 days from the start and see the improvement. I think that is the reason why a lot of people end up quitting. Because they don’t know where they are and this helps them see the improvement.

Q - That goes back to that motivation we were talking about. If they can see some progress they are more likely to continue, wouldn’t you agree?
A - Yes.

Q - What about people who approach weight loss through a self help standpoint? What are some of the pros and cons of trying to do it on their own?
A - Well motivation is one of them. Do they have the motivation to do it? Are they eating the right calories for their body type? It may mean they need less or they may need more calories. The exercising is okay, but the bottom line is good nutrition.

Joining a Gym

Q - Do you recommend that someone joins a gym or a health club?
A - As beginners yes I do, because they don’t know what exercises to do or how to do the exercises properly. As far as nutrition as they getting enough calories or too many, are they getting enough cardiovascular activity and are they getting in the target zone that they need to be at? There are a lot of variables in that and they don’t know if they are making any progress.

Q - Can you tell me how do you recommend that someone go about selecting a health club or gym? Are there certain things they should look for?
A - I would say they need to look for how much help they are going to get besides a personal trainer. If they walk into the gym are they going to put them on a program? Will there be someone to help them with the workout. This is where the personal trainer comes in. You don’t want to go somewhere that just shows you what to do and moves on. You need to have your progression checked and help with when to go heavier on the weights.
Q - What should a person expect from a membership?
A - A beginning program and people who will be there to show the equipment and how to use it and to know where they are going. It is important to have skilled staff on hand that knows what they are talking about. When I owned my gym it wasn’t once or twice I was taking people through. I was always watching and if they were doing something wrong I would have to go over there and correct them. Because once they develop a habit it is really hard to break. You know what they can end up getting hurt if they are doing something wrong. Most people won’t ask for help so you just have to watch.

Q - So what you are saying is it is probably easier to train women than men?
A - Oh yeah, you know what, the majority of the people I’ve trained I would say that 90% of them are women. When I train them they are looking around going to some people who aren’t good at all and have very little experience to draw from.

Q - Are their ground rules that a patron should adhere to or certain etiquette?
A - They are usually pretty specific like not taking off their shirt. A lot of people won’t know that in the beginning and they won’t look at the rules. When you are taking them through the beginning program you have to explain any rules. If someone wants to jump in and train with you, you let him or her do it.

Q - What about some of these instructional videos people can get? Are they helpful or harmful?
A - They’re helpful, it helps to see it and then go through the motions. It’s really hard to see something on tape and then do it and see the progression. You have to be really motivated.

Exercise
Q - Are there any warnings our client should heed before undertaking a weight loss program?
A – Yes, their physical health. It’s important just to make sure that they are healthy enough for physical activity. I would recommend a physical. Had I known that when I owned a gym, I would have recommended it to almost every member.

Q - If they go to the doctor what might come up that indicates a weight loss program would not be advisable at that time?
A – Heart problems.
Q - What can you tell us about muscle and weight loss?
A - If they just want to decrease body fat and tone muscles then you have to put them on a program. You don’t want to train them like a bodybuilder. It’s more of a conditioning training. This way they won’t kill the muscle also you wouldn’t have them train like 4 or 5 times a week or isolating body parts. You would have them just training basically everything in one day.

Q - Where would you recommend that they begin?
A - First I would get them on the floor. It doesn’t really matter if they want to build muscle or decrease body fat. They are beginners and they are untrained I’d take them a conditioning facility tour. Depending on what they want.

Q - What would that conditioning process consists of?
A - Well I have them do one chest workout and back workout and a little bit of legs for about 30 seconds depending on what kind of condition they are in and wait to see how long it takes for their heart rate to drop. Then I move on to their legs and have them do a leg press and everything is like a push pull movement.

Q - Does the length of time increase as they become more conditioned?
A - Yes, it depends on how conditioned they are. If they are really deep conditioned it won’t last that long. Most of my client can handle it especially the beginners.

Q - What other types of exercises do you use, especially aerobics?
A - Well aerobic exercise is going to help burn more body fat. It takes more oxygen to do more work. The more oxygen you can take in the more work you can do. That can help with daily activities as well.

Q - Is that done by running or walking or other sports they are involved in?
A - I would say walking would have to be increased. Just like weight training the progression would have to be stepped up because if you just walk the same your body gets used to it.

Q - So it would be safe to say that aerobics is more geared toward improving the cardiovascular system?
A - Yes that’s the bottom line . . . that is exactly what it is.

Equipment
Q - Do you recommend that anyone who begins a weight loss plan purchase any equipment to use at home?
A - If they don’t have any time to do any kind of cardiovascular workout at the gym then yes I would. Then if they don’t have time to come back to the gym 2-3 times a week. Then they don’t have the motivation. If they don’t have that kind of motivation it isn’t going to work.

Q - If someone is really serious what is the single most important piece of equipment you recommend they have?
A - That’s kind of a hard question. It depends on what they prefer. Something that you can use for upper body and legs a treadmill is good. You’re moving your arms and legs. The elliptical machine is good as well. They are basically like a treadmill but you don’t have a belt. You use your arms it has some kind of an arm attachment and you push and pull. A good treadmill or something like that would cost about $1000.

Nutrition
Q - What is the importance of a good nutrition plan to weight loss?
A - Really it’s the only way you can lose weight as far as a good nutritional diet. You want to go low fat and a good 3-course meal. You need both carbohydrates and protein.

Q - I know to lose weight you have to lose body fat, but isn’t some body fat good?
A - Well everyone should have a certain amount of body fat. Nobody that I have trained is competitive but the majority they just want to lose weight and feel good. The majority of them they only go half way of what I give them.

Q - What can you tell us about some of these fad diets?
A - Well a lot of them are just high protein and low carb.

Q - There is so much out there like the Atkins and the South Beach. What do you think about the places like Jenny Craig who sell you the food?
A - Well I don’t really know much about it but it’s mainly just a moneymaking opportunity that I’ve seen.

There was a guy that I had not seen for some time and he just kept getting thinner and thinner. He was doing Atkins and he didn’t think he was getting thinner he thought he was getting leaner. He said that he wasn’t eating carbs and just protein. I told him to pick up the carbs and you will see it in the metabolism. I think that is what is happening with the low carb diets. Sure, they are bringing down the calories but that in turn slows down the metabolism.
Cutting calories is not the whole answer to losing weight. You can actually eat more and lose weight. The key is what you are eating. Cutting carbs totally out of your diet is a mistake. You need carbs to provide the sugar to give you the energy, as long as you are eating the right carbs. Those are the natural ones like rice, potatoes and popcorn.

Q - What specific nutritional plan do you put people on?
A - I am not a nutritionist so I don’t put them on an exact plan but I do give them a food composition and tell them all of the good lean proteins. It has all the low fat proteins and the good carbs. It has the amounts on it. The bottom line is when it comes down to weight loss is that most people can’t do it 100% all the time. I tell people when they start not to do it 100% because they burn out and they aren’t going to continue. I tell them do it little by little.
Stay with a good 3-course meal that includes lean proteins and good natural carbohydrates.

Q - What about people who are diagnosed as morbidly obese? Have you had any experience with people like that that have had the lap band or stapling?
A - Not really. I’ve had some very obese people come in and work out in the gym. But, our skin only has so much elasticity.

Q - What about supplements? Do you recommend any supplements?
A - I do when they start getting into it; I tell them they need to take something mid-morning and mid-afternoon.

Q - Thank you for your helpful insight. I’m sure our readers will benefit from what you have shared.
A – It’s been my pleasure!

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DISCLAIMER: This information is not presented by a medical practitioner and is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read.

Since natural and/or dietary supplements are not FDA approved they must be accompanied by a two-part disclaimer on the product label: that the statement has not been evaluated by FDA and that the product is not intended to "diagnose, treat, cure or prevent any disease."
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