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.
the patient did not want the saddlebags reduced, but only shaped
In this case, both the original surgeon and I saw a successful reduction of the saddlebag area. The problem is that the patient did not want her saddlebags reduced, but only shaped. To her, a reduction of the saddlebag area was not a good thing. Prior to surgery they had briefly discussed that there would be some ‘shaping of the hips’. To the patient a ‘shaping’ was different than a ‘reduction’. 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. However, they 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. However, in general I believe that Hispanics and African American women prefer full, rounded contours. 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 remove fat from here, but not there”.
“I want you to remove fat from here, but not there”.
Beware of surgeons who are so ‘busy and successful’ that they spend little time with you. You should have enough time with him to communicate specifically about each area that you are having liposuction. His assistant will not be performing the surgery!
(originally published on April 12, 2007)
