Imagine being able to “perfect” your body, making you eligible for a wider range of roles. Mid-snack fantasy? No. It’s a real business decision facing any performer who feels their appearance restricts their appeal. How would you decide if this is a good choice for you?
Proponents of liposuction say it’s a quick, easy way to achieve the figure you want but haven’t been able to achieve naturally. Plastic and reconstructive surgeon Alvin Harris of Manhasset, NY, performs between 100 and 300 liposuction procedures a year and says, “This is just another way to improve one’s appearance. If you approach it intelligently, you can be very happy with the results.”
One vocalist put it this way: “If your motivation is to be prettier so you get more work, what happens if you’re prettier and you still don’t get work? Would it be worth it?”
Because auditioning fosters insecurity, performers can be easy prey for unscrupulous surgeons offering instant beauty. If you’re considering liposuction, the most important thing you can do is to be well informed. Knowing what your real goals and motivations are, and if they can be achieved through surgery, are crucial factors. Here, in a nutshell, is what to expect from liposuction. Please remember that this is ONLY the nutshell. Volumes are written about this procedure, with many more on the pros and cons!
Liposuction, also called a lipectomy, is the surgical vacuuming of fat from the body. Fat cells reside in the area just under the skin layer, laced into and above the muscles and nerve tissue. The most-used method is tumescent liposuction, sometimes done in conjunction with ultrasound. In tumescent liposuction, liquid solution equal to or greater in mass than the amount of fat to be removed is inserted into the area to be reduced. The solution is made up of three parts: wet Ringer’s lactate (a saline solution), lidocaine (an anesthetic), and epinephrine (to shrink blood vessels and slow bleeding). This solution is fed into the area under the skin. The liquid lifts the skin layer up and away from the nerves and blood vessels, which shrink from the epinephrine. This leaves the fat layer, swollen with liquid, floating in between. A thin tube with a flat end called a cannula is inserted through an incision. The cannula is attached to a vacuum suction system. It’s moved around in the fat layer to break apart and vacuum away the fat cells. In an ultrasound-assisted lipectomy, ultrasound is used to liquefy fat cells. This can be done either internally (at the tip of the cannula) or externally (via ultrasound over the area, as used in sonograms). The cannula then sucks out the liquefied cells.
Liposuction costs approximately $2,000 to $10,000, depending on the part of the body involved and the extent of the surgery. It can take anywhere from one to several hours. Common procedures take from 1,000 to 5,000 cc’s of fat (2.5 to 12.5 lbs.). Most liposuctions can be performed with local anesthetic in a doctor’s office, using only lidocaine in the solution, but more extreme cases, removing up to 10,000 cc’s of fat (25 lbs.), are considered riskier and are generally done in a hospital. Risks vary, depending on, among other things, the age and physical health of the patient, the extent and area of the procedure, and the skill of the doctor.
The effects are visible immediately, and patients can resume most regular activities within a week. A tight-fitting compression garment must be worn for many weeks after surgery to aid in reattaching the skin layer to the underlying tissue. Bruising and fluid buildup are common and there can be great discomfort. But many people are choosing this “shortcut” to slimness.
For certain areas of the body, or for extensive procedures, general anesthetic is used. Here, of course, singers have special challenges to consider. General anesthetic is administered one of three ways: via intubation, intravenous injection, or mask. When one famous singer had surgery for gallstones, doctors were unwilling to take the risks of intubation and used mask anesthetic instead. However, administration of general anesthetic without an endotracheal tube has risks as well. Stomach fluids can aspirate, going down the trachea and burning the lungs. A singer’s special considerations should be discussed in detail with the anesthesiologist before surgery.
Plastic surgeons recommend liposuction for people in fairly good shape who have already tried diet and exercise but have problem areas that aren’t responding. When liposuction was first introduced in the early 1980s, it was recommended only for people under 40. In the last 10 years that recommendation has expanded–now liposuction is considered safe for anyone in good shape, with good skin tone. Older persons need to take extra care, since skin elasticity is necessary for good healing. Liposuction may be combined with tucks or lifts (or might be followed by these procedures, if necessary).
Liposuction is criticized on many fronts. Statistics show that complications occur in 5 to 15 percent of all liposuctions. Patients can have adverse reactions to painkillers, and the surgery can cause shock. Infections can occur afterwards, or patients may experience excessive swelling. One New York woman died after her bowel was pierced during surgery. Dr. Harris strongly suggests removing no more than 5,000 cc’s at a time. He cautions, “Pick the right procedure. Don’t go overboard.” Approximately 10 percent of Dr. Harris’s patients are repeats, following up liposuction with more liposuction, or with nips and tucks as needed. He believes that this is safer than taking too much at one time.
Another risk to consider is the skill of the surgeon. Liposuction is usually an outpatient procedure, done in a doctor’s office. While this is generally easier to schedule and less expensive than in-hospital, the drawback is that hospitals have credential committees, whose job is to safe-check the hospital’s reputation and the credentials of those who operate. In-office surgery can be less complicated and less costly, but checking your surgeon’s credentials is left up to you.
Interview doctors before deciding on who you want to perform your surgery. Don’t be intimidated by surgeons! Questions to ask a doctor might include: Is the surgeon board-certified? How often does he or she perform this procedure? Are references available, with permission to contact previous patients? Be prepared to fact-check those references.
Another avenue for information is the State Board of Regents Professional Practices Committee. Many states have records of complaints and actions against surgeons licensed to practice in their state. New York State’s Board of Regents website can be found atwww.health.state.ny.us/nydoh/opmc/main.htm.
There is a danger, especially within the performing community, of rushing into a “quick fix” based on insecurity. One performer, who had liposuction done in the early 90s, cautions, “It didn’t make me happier. It didn’t get me more work. It didn’t make me like myself more. That has to come from inside first.” Voice instructor Bonnie Forgacs says, “Sometimes you have to ask yourself, ‘If I have to go to extraordinary measures for this, is it really what I should be trying to do?’”
Liposuction is currently the single most performed elective surgery in this country. Obviously, its appeal outweighs its detractions for many people. The only way you can make an informed decision is to ask yourself and your surgeon some very honest questions.
