Cheater's Guide to a Better Beach Body

A look at cosmetic procedures that can improve your appearance in time for beach season.

From the WebMD Archives

Forget bikini boot camp -- an arduous six-week cardio-blast designed to get your body beach-ready. Instead, growing numbers of people are nipping, tucking, sucking, and zapping their way to bodacious beach bods.

It may be cheating, but it works -- sometimes and in some people. While there is no substitute to a healthy diet and regular exercise, sometimes we all need a little extra help. Leading plastic surgeons and dermatologists sound off on what you should and should not be doing to get trim and toned for summer.

Breast Implants

They're back -- silicone breast implants, that is. And if anecdotal reports are correct, you will likely be seeing more women sporting these bosom buddies surfside this summer.

"With the approval of silicone implants, we are seeing an increase in interest in breast implantation and seeing more breast enhancement patients getting ready for the summer season," says Julius Few, MD, an associate professor of plastic surgery at Northwestern University in Chicago.

The FDA reapproved silicone breast implants in November 2006, so summer 2007 marks their beach debut. These implants first came on the market in 1962. In 1992, citing safety concerns, the FDA stopped their sale, but now the FDA says the implants are safe.

Few recommends women get the breast surgery about six weeks before they want to see and be seen (in a bikini). "In general, that's when I see the greatest settling of the implants because there is a phase of adjustment and settling, but typically six weeks gives you enough time so it feels comfortable," he says. That's not set in stone, though. "I have definitely had patients who after two weeks have gone on to a warm-weather vacation and have done very well in a bikini."

Losing Those Love Handles

While the name is cute, love handles are anything but. The good news is that there are ways to get rid of that layer (or layers) of pudge around your midsection.

Liposuction has been around for a while, but it's still the best way to get rid of unwanted fat surgically. During liposuction or lipoplasty, a plastic surgeon basically vaccums out pockets of fat using a small, stainless steel cannula. The cannula is inserted into fatty areas between skin and muscle via small incisions where it removes excess fat either using a suction pump or a large syringe.


"Guys come in their 40s to get rid of their little bellies and love handles. And so do women with almost perfect bodies who want some touch-up of love handles, hips, and little tummies," says Lawrence Reed, MD, a New York City-based plastic surgeon. But, he cautions, people who just have skin and muscle and no fat do not make the best candidates for liposuction.

"The biggest complication with liposuction is undesirable cosmetic results," he says. "I have seen ladies who had liposuction and never should have had it because they had no fat, so they are left with dimples and irregularities," he says. The trick? "You have to know when not to do it."

For people who are good candidates, "you should do it at least three weeks before Memorial Day so the bruising will be gone in time for beach season," he says. "You will see a measurable improvement at three weeks, but you don't see final improvements until six months."

Liposuction, like all surgeries, does have its share of risks including infection.

Liposuction Alternatives

Advocates of newer fat-zapping technologies, however, may position the alternatives to liposuction as safer, but the jury is still out on most of them.

There is some buzz about LipoSonix's SonoSculpt and Ultrashape, says Reed. In a nutshell, these technologies use sound waves to break up fat. The fat is then reabsorbed. Neither are FDA-approved or available in the U.S.

"There is no question that Liposonix works," says Reed, who is one of the U.S investigators. "The results I have seen are 30% spectacular; 20% of people have no problems, but nothing that I can see as far as results. And 50% look better, but just OK," he says.

"It will have a role because the technology is good and I think it is safe," he says. "The concern was what happens to the fat. We now know that it doesn't wind up in the heart or vessels because levels of blood fats are not increased, so the safety factor has been good."


In addition, there is no incision with ultrasound procedures. Each session lasts about an hour, and patients can go right back to work after a treatment.

Buyer (or beachgoer) beware, cautions Few. "It is largely under investigation and I don't think we really have a good answer as to what this technology can reliably deliver and who makes the best candidate," he says. "Patients will always want to have a great result and no risk, but it will take time to say who will be best served by this technology."

Fat-Dissolving Treatments

Another technique that's not quite ready for prime time? Fat-dissolving injections, Few says.

If someone could simply give you an injection that would melt away your love handles or thunder thighs, you would be tempted to give it a shot, right? Who wouldn't (especially as beach season approaches)?

Call them fat-dissolving injections, mesotherapy, or Lipodisolve, but don't call them a miracle or a breakthrough. These injections are billed as a simple series of medicated shots which dissolve unwanted, small localized areas of fat. "It is not FDA approved, it's considered investigational, and there is really no good literature to support its use," Few says.

In general, if it sounds too good to be true, it probably is. "The idea of getting something done that offers everything without risks is appealing, but we need to see the studies showing that it works," he says. The American Society of Aesthetic Plastic Surgery (ASAPS) recently released a position statement to its members stating that they do not endorse fat-dissolving injections. "Such therapies not only lack objective proof of safety and efficacy, they also lack Food and Drug Administration approval," the group writes.

"Patients seeking fat-dissolving treatments should be educated about the lack of clinical data supporting these treatments and cautioned to wait until there is reliable information to guide their decision," says Alan H. Gold, MD, president of the Aesthetic Surgery Education and Research Foundation (ASERF) in a news release. "For now, the only proven method for eliminating unwanted fat cells is suction assisted lipoplasty, a procedure that has a long and successful track record for both safety and effectiveness."


Another fat-melting technology generating buzz and headlines is called SmartLipo, but don't believe the hype just yet, cautions Ariel Ostad, MD, a dermatologist in private practice in New York City and a clinical assistant professor of dermatology at the New York University Medical Center.

Basically, Smartlipo adds a laser to traditional liposuction. "The laser generates heat, which helps liquify the fat and then the fat is suctioned out," Ostad explains.

"It's indicated for small areas like the chin and arms, but we can't use it in large areas," he says. "It's a great technology, but it's still too early to say that it is safe or effective," he says. "It's really wait and see."

The bottom line, experts say: if you want to get rid of excess fat, traditional liposuction is still the way to go.

Tucking Your Tummy

Tummy tucks are very popular among moms who are finished having children, says Reed. "There is a marginal scar that is like one-half the size of Cesarean-section scar, there is minimal downtime, it looks good right away," he says. In fact, abdominoplasties or tummy tucks were among the top five cosmetic surgical procedures performed in 2006, according to statistics from the ASAPS. Simply stated, a tummy tuck involves removing excess skin and fat from the abdomen and to tighten the muscles of the abdominal wall. "You can't use your abs for six weeks, but can do everything else," he says.

Dermal Fillers and Botox

If it's your dream to roll out of bed and hit the beach looking your best, you are not alone. "Patients are, in general, clamoring for things that will allow them to feel more comfortable without makeup," Few says. To that end, "we are seeing an increased interest in facial enhancement and injections such as dermal fillers and Botox," he says. The newest kid on the block is Perlane. This filler was FDA-approved in early May 2007. It is useful for moderate to severe facial folds and wrinkles.

Unwanted Bikini Hair

"Laser hair removal for the bikini area is a popular thing," says New York City dermatologist David Colbert, MD. "People come in about a month or two before summer," he says. Sessions last 15 minutes. "You see some results after one session, but you won't see full results until about three sessions."


Vanishing Your Varicose Veins

If large, unsightly varicose veins or tiny spider veins on the thighs, calves, and ankles are your problem, Colbert recommends sclerotherapy. "We inject the veins with a solution to make the veins disappear in a week or two," he says. The solution basically causes these veins to collapse and fade.

Ostad is a fan of endovenous laser for varicose veins. "The cause of these veins is the pooling of blood in the lower leg because your veins don't work properly," he says. Traditionally, doctors used surgery which involves general anesthesia and its related risks. "They would cut out the veins, but people were left with scars. Plus it really doesn't address the problem, so the veins tended to recur," he says.

Endovenous laser technology uses ultrasound to locate thegreat saphenous vein, which runs from the knee to the groin. "Then we insert a laser fiber into the vein and generate heat and seal it," he says. "Once you lose that vein, the varicose veins will get less and less over a course of months," he says.

"There's no pain, no general anesthesia, no hospitalization, and it takes an hour," Ostad says, adding that "endovenous laser treatment has revolutionized the treatment of varicose veins."

Erasing Your Acne

Break-outs on your face or back don't have to put a damper on your fun in the sun this summer, Colbert says. "Lasers are also all the rage for acne. We use blue light lasers on the back and face."

"This is a low energy light source that kills acne-causing bacteria and makes acne go away," Colbert tells WebMD. His prescription: "About one treatment a week for four weeks."

If you really want your skin smooth and supple by summer, opt for a chemical peel about a month before beach season kicks in, Colbert says. Chemical peels can use any of a number of solutions to improve and smooth the texture of the facial or back skin by removing its damaged outer layers.


Good-bye Cellulite?

Unfortunately, not so fast.

"This is really a condition that's waiting for a technology," says Ostad. "There is nothing that has shown to be very effective yet."

"There's endermologie which is basically massaging the fat," he says. Endermologie may work by stimulating skin cells called fibroblasts to increase the production of collagen and elastin, which improve skin tone.

The TriActive laser is also touted as a cellulite cure, Ostad says. "The laser generates heat into the tissue to stimulate collagen production." The hope is that the new collagen will smooth out skin.

Doing Away With Your Comb-Over

While many eager beachgoers are concerned about getting rid of unwanted hair, some have the opposite concern. To the rescue: HairMax LaserComb. "This is the only FDA-approved laser for regrowing and thickening hair," says Mary Wendel, MD, medical director of Women's Hair Loss Center in Worcester, Mass.

"You are out on the beach and everything is much more exposed, so thinning hair in men and women is extremely obvious," she says. "A lot of people avoid going to beach or pools because they are embarrassed about their hair being thin."

Within about six months, HairMax users will see benefit. "Most people will see a benefit even earlier," Wendel says.

What's more, she says, "HairMax will allow you to fight off the abuse of chlorine and sun damage." Researchers are not 100% sure how it works, but HairMax may actually improve blood flow to hair follicles, so growth-fostering nutrients can reach them. The cost? About $545.

Getting a Smile Makeover

You are never fully etched without a smile, saysJonathan Ferencz, DDS, a clinical professor of prosthodontics at New York University College of Dentistry in New York City.

"People take for granted how important teeth are to appearance," he says. "If you see someone who is tan and fit and they smile and you see crooked, stained missing teeth, you just walk right by them."

It doesn't have to be that way, he tells WebMD. From whitening to implants, a healthy smile is within everyone's grasp. "Over-the-counter whitening kits are a great first step and if you get a result that you are happy with, that's great," he says. "If you are still not happy with the outcome, there are whitening products that only a dentist can use that are often done with sources of heat that produce more effective results."


Other options include veneers (thin, custom-made shells made of tooth-colored materials that cover the front side of teeth). They are not cheap, he cautions. "A single veneer can cost up to $1,500."

Depending on the extent of your problem, dental implants (artificial tooth roots placed in the jaw to hold a replacement tooth or bridge or crown) can also overhaul your smile, he says. "They look so natural today," he says. "No one could tell it was artificial."

Whatever you decide to have done this summer, "know the credentials of who is treating you because all surgical procedures have risks and benefits," warns Few.

WebMD Feature Reviewed by Brunilda Nazario, MD on May 18, 2007


SOURCES: Julius Few, MD, associate professor of plastic surgery, Northwestern University, Chicago. Lawrence Reed, MD, plastic surgeon, New York City. News release, American Society for Aesthetic Plastic Surgery. David Colbert, MD, dermatologist, New York City. Jonathan Ferencz, DDS, clinical professor of prosthodontics, New York University College of Dentistry, New York City. Mary Wendel, MD, medical director, women's hair loss center, Worcester, Mass. Ariel Ostad, MD, dermatologist, New York City; clinical assistant professor of dermatology, New York University Medical Center.

© 2007 WebMD, Inc. All rights reserved.


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