My Body and That Special Little Dress
By Robert J. Davis, M.D.

One of the most frequent requests we receive as plastic surgeons is to help women achieve the body shape they desire. More specifically, the request is framed around their desire to look good in their "favorite little black dress". We can't make you look like Heather Locklear or Cindy Crawford, but we can make some suggestions to help you appear shapelier in your clothes. But, plastic surgery is often not the first step towards the more shapely you. First, try exercise and diet. Begin with walking and cutting back on the carbohydrates. If you can't get motivated to work out on your own, join a gym or try Curves. Take a nutrition class to learn which foods to eat and which to avoid. In most cases, even with moderate diet and exercise you will see significant toning and notice that your clothes are fitting a little looser.

Once you feel that you have reached your maximum improvement with diet and exercise, and then we can help with those stubborn problem areas. The number one area of complaint is the lower tummy bulge. Most women tell me that they would like their dress to fall from their breasts to their knees without having that lower abdominal protrusion - the one that wouldn't go away even after a million sit ups and three pieces of abdominal fitness equipment purchased on the shopping network. Well, that little tummy protrusion is usually due to the residual effects of pregnancies and because the fat stored in that area is metabolically different than most of the other fat in your body.' It is a type of fat that is meant to be a reserve in ,.the event of starvation conditions. This was a useful idea when we lived in caves and had to survive long cold winters - but as long as there are Boardwalk french fries, this fat is never going to go away. In order to eliminate that bulge we need to tighten the supportive tissue surrounding the abdominal muscles that were stretched with pregnancy. This requires an incision placed
just above the public hairline.

The fat in this area is then removed with a suction device and the lax abdominal wall tissue is tightened using specially placed sutures. If there is extra skin, that too is removed at this time. Some cases, especially in younger women, only two or three tiny (1/4 inch) incisions are made and the excess fat is removed with a suction tube alone. This same technique can be used
to get rid of those thigh bags that won't go away, even after you finished a running program that got you ready to run a marathon.

Another approach is to change the shape of the breasts. For breasts that are too small to accentuate that dress, breast enlargement is a solution. Salt water filled implants are used to safely enlarge the shape and size of the breasts. Some breasts may have lost their tone after having
children and their fallen position not only make their tops look smaller, but also add to the appearance of having a fuller appearing abdomen. For these women the breasts can be lifted and reshaped to give a more youthful, and enhanced appearance. The ladies who are over endowed with breasts complain most about wanting to buy clothes that fit, look stylish, and to be able to wear a dress that looks like something other than a tent. Having such large breasts makes exercise very difficult and jogging impossible, because it hurts to run! Believe me, these ladies would love to be able to jog, but they can't because it hurts. It hurts their necks, backs, and shoulders and it hurts their breasts too. Breast reduction surgery can significantly change the size and weight of the breasts. Women who have had this surgery can buy clothes that they never before thought of wearing. They can now buy bras in a normal department store or Victoria's Secret. They can run and exercise and move around a lot more, and as a result, many experience significant weight loss and feel healthier.

After considering the size and shape of the breasts and flattening the tummy, the last area of complaint, especially for those ladies who like to wear their skirts and dresses above the knee, is that small bulge just inside and above the knee. This area can be removed as a short, local anesthesia procedure using the suction devices to give more shapely appearing knees.

SO ... try diet and exercise first, then try on that special dress. If there is something about your shape that you are unhappy with, then we can help!!!

MAGGIE MEMO: ROBERT J. DAVIS, M.D., is a Board Certified Member of the American Society of Plastic and Reconstructive Surgeons. In private practice on the Eastern Shore for MD than 17 years, he specializes in facial, hand and breast surgery. DR. DAVIS is a member of the Division of Plastic Surgery at Peninsula Regional Medical Center and Chief
of the Medical Staff of Atlantic General Hospital.