PEER-REVIEW | PREGNANCY AND AESTHETICS | humans6 . Associations have been made by Karine
Clement and others between genetic obesity susceptibility and early postnatal fat and lean mass7 Bariatric surgery represents a powerful tool for morbid
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obesity treatment. It is usually used for patients with a BMI of around 40 or more (extremely obese). However,
■ The ‘pre-baby’ or ‘mating’ body type with fat distribution seen in more ‘normal’ areas of distribution. In this body type, breasts are again used to ‘attract’ a partner rather than being a functional mammary organ. They tend to be ‘firmer’ due to fat distribution. Women prefer this body type as it symbolises health, vitality, and beauty. Men prefer it as it shows a female who is ready to reproduce. The ‘post-baby’ body type with fat now distributed subcutaneously especially in the buttocks and thigh area. There are breast volume changes with sagging, especially if the female has breast fed her infant. Breast volume may increase but usually we get shrinkage. In this physiological state the dermal tissue of the abdomen has been distended and sometimes left with long- term ‘stretch marks’. We shall now look at the problem
encountered by the ‘post-baby’ body type and what a patient can do to correct them. In some instances the tissues have been distended and sheared to such an extent that surgical repair is the best if not the only option. We will first look at excess fat. The author does not put dieting and exercise as a primary option because most patients feel it is not effective.
after the stabilization of weight loss that follows surgical interventions, ex-obese patients face the problem of residual tissues removal. It is unknown whether the characteristics of this residual subcutaneous adipose tissue (SAT) is ‘restored’ with regard to molecular and morphological features8
. One of the more interesting theories Conventional liposuction consists of using large cannulae
under general anaesthesia, largely practiced by plastic surgeons. The whole procedure lasts 2–3 hours. This method is quick, can remove
to explain why female fat deposits are located where they are was made by a Polish researcher called Boguslaw Pawlowski of the University of Wroclaw. To quote from an issue of Current Anthropology ‘the fat deposits may help to meet the balance requirements of two-legged walking during pregnancy and lactation’9 In this publication, Pawlowski notes that both during
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advanced pregnancy and when nursing, a human female has an additional anterior load that moves her centre of gravity forward and upward, making bipedal locomotion more difficult and energetically inefficient. This theorises why we see a lot of the problems we see in the post-natal period. We have a quadruped means of reproduction been carried around in a biped body. Therefore, evolution may have promoted buttocks and thigh fat deposits to compensate for the biomechanical handicap imposed by carrying a baby. Interesting theory but it would probably explain some of the cultural effects of this new shape. We hence have two physiological types:
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large amounts of fat, and saves time for the surgeon. However, it has many disadvantages.
Excess fat Solution: Liposuction (tumescent, ultrasonic-assisted, power-assisted, water-assisted, and laser-assisted) bariatric surgery Liposuction, also known as lipoplasty (‘fat modeling’), liposculpture suction lipectomy (‘suction-assisted fat removal’) or simply lipo, is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs, and buttocks, to the neck, backs of the arms and elsewhere10
. There are many differing
mechanism of liposuction and the procedure has been reported to be associated with
significant morbidity and risk of mortality under general anaesthesia11
. Conventional liposuction consists of using
large cannulae under general anaesthesia, largely practiced by plastic surgeons. The whole procedure lasts 2–3 hours. This method is quick, can remove large amounts of fat, and saves time for the surgeon. It is performed under general anaesthesia and only a small amount of fluid is introduced into the fat. It is possible to remove large amounts of fat, often 8–10 litres (called megaliposuctions), quickly in 1–2 hours, through large cannulae (6 mm-1 cm in diameter). However, it has many disadvantages, including the
fact that the patient has to be hospitalized, which adds significantly to the cost and the possibility of hospital- acquired infections. It goes without saying that general anaesthesia always has its risks. There is a risk of
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