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What conditions can arm and leg liposuction target?

Liposuction is the most effective way to get rid of loose, saggy skin and stubborn areas of fat in the arms and legs. This procedure is used to treat common arm and leg complaints including saddlebags, bingo wings and fat knees, and create a thigh gap. Although these are the natural results of puberty, ageing or genetics, they can sometimes cause a person mental distress or physical discomfort.

But what are saddlebags, bingo wings, fat knees and thigh gap, and how can arm and leg liposuction at the Cadogan Clinic tackle these problem areas?

Saddlebags

Saddlebags are localised fat pads overlying the greater trochanters, the sharp angle of the femur (thigh bone) where it angles into the hip. These fat pads develop in puberty in response to increased oestrogen levels. The presence of these pads is normal. In some cultures, larger hips are recognised as a sign of fertility, but this shape is so out of fashion this accumulation of fat on the hips is known as the condition trochanteric lipodystrophy. Fat over the hips is usually accompanied by deposits of fat in the buttocks, inner thighs and inner knees.

Body shape is inherited and cannot be changed through diet or exercise. But with celebrities like Kim Kardashian flying the flag for fuller hips and buttocks, there has been increased interest in body sculpting procedures, that is, taking fat from one area and grafting it elsewhere.

The most common treatment is liposuction of the hips/saddlebags through a stab incision hidden under the buttocks. There is a 10 percent skin retraction, which is usually enough to prevent sagging. Older people and those that need a considerable reduction may also benefit from skin excision.

Patients with a hanging bottom, where the buttock folds over the lower buttock (inferior gluteal) fold, would benefit from a buttock reduction, removing the overhang and tightening the buttock skin. This procedure results in an extra scar, which is mostly hidden in the inferior gluteal fold.

For those who are looking for a smaller reduction, or do not want to undergo liposuction with general anaesthesia, here at the Cadogan Clinic we use Total IntraVenous Anaesthesia (TIVA), which helps patients to avoid the unpleasant nausea associated with the usual anaesthetic gases.

Bingo wings

Bingo wings are folds of loose skin and fat that hang from the undersides of the upper arms.

The condition can cause physical discomfort and anxiety. Short sleeves can expose the problem, while long sleeved clothing just doesn’t fit.

Although bingo wings are often thought of as a ‘woman’s problem’, men can also have them and benefit from liposuction.

Bingo wings are most commonly a problem for large or obese individuals, but can persist after weight loss and it is also true that those with skinny arms can experience bingo wings.

Bingo wings are a natural result of ageing, when skin loses elasticity, and can be made worse by sun damage. The skin stretches, and it stretches faster if there is the weight of extra fat hanging from it. At this stage, liposuction will help by reducing the weight of fat and shrinking the skin by perhaps 10 percent.

As time progresses, only liposuction or skin excision (brachioplasty, arm reduction) will effectively reverse this condition.

For patients with slim arms, skin excision will be used on its own, while heavy arms will benefit from extra liposuction as well. The extra skin is in the circumference of the arm, not along its length. The scar will need to be along the length of the arm to the elbow. Our expert surgeons will hide this scar along the back of the arm, so it will not be obvious.

The procedure can be done under local anaesthesia, but most patients prefer to be asleep. Here at the Cadogan Clinic, we use Total IntraVenous Anaesthesia (TIVA). This means the patient will wake up quickly, ready to go home, and will not feel nauseous.

Fat knees

Women can develop fat knees during puberty, although in later life this deteriorates with weight gain and increased skin laxity. Fatty deposits appear primarily at the inner side of the knee. Liposuction will remove these, without leaving any loose skin behind, even in a middle aged patient. If this is the only area which requires treatment, the procedure can be carried out under local anaesthesia. However inner thigh fat is associated with knee fat and may need similar treatment. Another common association is fatty deposits of the hips, inner thighs and knees, under the umbrella term trochanteric lipodystrophy.

Fat and skin at the front of the lower thigh can pose a problem as it tends to fold as a crescent above the knee. This skin is folding over the vastus medialis muscle at the inner side, which is a prominent muscle in a toned thigh. Following an examination and consultation with the patient, a surgeon would make the call as to whether to treat the area with a skin tightening non-surgical laser, gentle liposuction or, in severe cases, direct surgical excision.

Fat above the front of the knee can be treated with liposuction, with a surgeon taking care to preserve a natural symmetrical look. Liposuction would provide a more noticeable improvement than treatment with a non-surgical laser.

Small bulges on the front of the knee are deeper pockets of fat and on occasion can prove inaccessible via liposuction. Our expert surgeons at the Cadogan Clinic have a special technique for this area.

Thigh gap

The thigh gap is the triangular gap between the upper thighs of a slender woman standing with both feet together. The thigh gap has been a standard for measuring thinness in the modelling industry for some time. While some find a thigh gap attractive, others view it as a sign of anorexia and a physical trait of the unhealthy ‘size zero’ model.

So what is the thigh gap and how is it formed? The femur (thigh bone) angles out from the knee towards the hip joint. It is this angle, made by the shape of the femur and the width of the pelvis, that provides the basis for the thigh gap. Overlying the bone are muscles and, in particular, the gracilis and adductor muscles, with an origin on the inner pelvic bone. These make up the side wall of the gap. Then comes the subcutaneous inner thigh fat pad and skin. The Cadogan Clinic’s expert surgeons can sculpt the fat and the skin, but not the muscle or bone.

It is impossible to selectively diet or exercises away particular areas of fat, as fat is lost from all over the body. The gaunt, skeletal look seen on catwalk models is the result of extreme dieting which causes the body to lose muscle as well as fat. We do not advise undergoing such extreme dieting. Exercising and building muscle will not cause the thigh gap to disappear, but nor will it create one.

Here at the Cadogan Clinic, we can create a thigh gap in most people by removing fat surgically with liposuction. The limitation is the underlying muscle and bone. Weight gain and the ageing process can cause fat to build up in this area, resulting in an unsightly bulge squashed against the other side. Liposuction gives gratifying relief and treatment may be extended down the inner thigh to the knee. The surplus skin retracts, but a few patients may also require an inner thigh lift to remove excess skin in order to achieve a smooth result.

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