Fat can deposit pretty much anywhere, but there are areas that are known for this. In particular, the belly and the thighs tend to gather more bulk and resist more methods for being removed. Most cosmetic procedures focus on these areas when it comes to contouring, and most fitness models prove themselves with those awesome abs and smooth hips. But there are areas that are less known for their heft, and they can creep in over time and surprisingly alter the contours of everything else.
When I perform liposuction, often the fat that I am targeting is easy to spot. But there is always other fat that needs to be “found” in order to get all the right shapes. The first time that a patient asked me to go after the fat on her ribs, I thought that she must be confused, and she must mean the fat on her upper belly. But when I examined her, I found that she was right. Right over each side of her rib cage, sitting smack on top of her ribs, was a thick layer of fat. Some of it was covered by her breasts, and the skin was pretty taught, so it did not hang, but it was unmistakable. When I went to remove it, there was a lot more there than I would have thought.
Another patient came in once who was overall very thin, and she asked me to remove “all of the fat on my knees.” I looked at her size 2 shape and considered that she might be overestimating what was actually there. I examined her and found that she was actually narrower than she even seemed, and there was in fact fat on her knees and lower thighs. When I went looking for it, I ended up shocked at the amount that came out.
The third place I have found that hides fat, and seriously alters your contour, is the lower back. Patients spend a lot of time focused on bellies and hips, because they see them when they look in the mirror. But the waistline is highly dependent on the small of your back, an area that, when properly contoured, can really maximize that outline. I like to call it the “swoop,” and both men and women benefit from it. Even more interestingly, you can see the shape that is makes from the front, because it has such an effect on the sides of the waist and the overall position of the hips. This is the spot that, when tightened, makes everything on your midsection just look good.
It has been many years since those two patients came to see me, and I have learned well that fat hides in mysterious places. Ten years ago I would have never thought to name the knees as a common fat problem area, but this is in fact the case. Not only does fat hover here, it becomes very slowly worse with age. An area like this is also challenging to treat because the skin is thin and can get loose, and there are few procedures to tighten it if you empty it too much with suction. But the good news is that there is something you can do, and if you get to it early, you can head it off at the pass.
After years of hunting for fat, I have learned a few lessons. For one, fat can live anywhere, and the less obvious it is, the more gratifying it is to remove it. I have also learned to appreciate the fact that skinny people have fat problems too, and anyone can benefit from contouring. Sticking with the principles of aesthetics and rejuvenation, and tailoring that to patient identity and goals, it is with this comprehensive perspective that you will get the optimal results. After all, small moves make for big impact in sculpture, and fixing the hidden problems allows the job to be complete.
