By Kevin Wilson
Illustration by Marco Ventura
Fadil Berisha; hair: Elin Nyberg; makeup: Yuko Takahashi
IMAGINE IT: NAGGING FAT FROM ONE OF YOUR TROUBLE SPOTS, seamlessly redistributed to an area that could use a bit of plumping. An easy tightening of skin that once again appears lustrous and youthful. Access to the ultimate beach body. This fantasy is closer to reality than you would think.
When it comes to our shape, genetics inevitably play a huge role, and many cultural beauty ideals fall into the realm of diminishing returns. They’re just not worth the effort. Take six-pack abs. for example—one must train hard and eat carefully to manage them, and for most of us it’s just not going to happen.
For fit, healthy individuals who are unable to achieve their ideal body shape, a powerful procedure is waiting: High Definition Liposculpture, or Hi Def Lipo. This blend of fat transplantation, liposuction, and energy-assisted lipolysis is the brainchild of plastic surgeon Alfredo Hoyos, MD, of Bogotá, Colombia. The technique is designed to craft and hone the curves, bumps, and bulges that idealize the aesthetic silhouette. “Patients differ greatly in terms of body type, as well as their expectations,” Dr. Hoyos says. “Some people are satisfied with simple reduction and reshaping, but for those who are wanting more, this procedure offers amazing results.”
Doctors using these advanced techniques can create six-pack abs—among other things—even if you can’t get them in the gym. Beyond rippling muscles, it’s about plumping areas where a bit of extra meat would be pleasing. “Many individuals are frustrated because the muscles they are exercising are not visible, and there are places where well-placed fat would be more to their liking, such as in the buttocks or hips, if they are not genetically predisposed to store fat in that manner,” Hoyos adds.
Hi Def Lipo has the ability to use one’s own fat to reshape the muscles themselves, according to Colorado-based plastic surgeon John A. Millard, MD, a former associate of Dr. Hoyos who is advancing body sculpting techniques in the US. “We can actually implant pockets of autologous fat directly into the muscle to build it up, allowing us to create a foundation we can accentuate using finer liposuction and lipolysis techniques,” Dr. Millard says. “The outward appearance and shape depend upon everything from the skin to the fatty tissue to the musculature beneath.”
Dr. Millard has developed tools for high-definition liposculpture that allow more rapid performance of procedures with reductions in discomfort and post-operative side effects. “The layperson would guess that pockets of fat injected into muscle would be used for energy,” he explains. “This isn’t the case with the techniques we use. Once the fat ‘takes,’ it won’t go away. It adds volume, and by its nature it moves so it enhances the natural look. Basically, we’re turning filet mignon into Kobe beef.”
After assessing the patient’s body type and discovering what the patient is looking for, the procedure is tailored accordingly. “Each case requires a different mix of fat grafting, liposuction, and finer liposculpting techniques,” Hoyos says. “Some will have enough underlying musculature that they do not need fat grafting to reshape muscle, and instead require some liposuction and careful, fine lipolysis to bring out the natural shapes.”
The newest version of the technique is known as 4D Lipo. “We have evolved our technique to account for muscular dynamics, and the fact that people’s shapes change as they age,” Hoyos says. “Muscles are in motion all the time, and if we do not sculpt with that in mind the outcome will not be as convincing during movement. Also, as we age and lose volume or gain and lose weight, we wish to maintain the natural look.”
To achieve this additional effect, the body is marked while lying flat and after flexing movement, which further guides the physician. “It takes an artistic eye to understand the dynamics and work within that framework,” insists Hoyos. He has founded a training company for these techniques, and the global list of trained physicians can be found at 4dynamx.com.
The post-operative regimen with 4D and Hi Def Lipo techniques is relatively minimal in comparison to traditional liposuction. “Patients will need differential compression garments, which have more or less elasticity in different places depending on gender and what will benefit the result,” Hoyos says. “Manual massage and ultrasound therapy are also required to promote lymphatic drainage, and we recommend at least ten sessions over the first two weeks. Strict care after treatment reduces bruising and swelling, minimizes recovery time, and maximizes the final result.” Healing and full realization of outcomes will take a few months, but patients may be back to work in as little as a week or less.
Although not for the obese patient or those with extreme skin laxity, the number of potential patients who are good candidates for the technique is surprising. “You can do this kind of thing on anyone who leads a basically healthy lifestyle and works out maybe three or four times a week,” Millard says. “I had a fifty-year-old woman who works out regularly come in and now she has a six-pack, among other things. She tells me that she looks and feels as if she’s in her twenties.”
Results such as these, according to Hoyos, add up to one huge plus: “When a person feels they have the body they always wanted, they tend to work harder to keep it.”
