๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Female physique
Female physique
What defines a beautiful female body has always been a subject of much debate, and the perception of the ideal body shape has changed over time and still differs between cultures.9 Nowadays a beautiful female body has several curves and chief lines that define it. The chief anterior line extends from the suprasternal notch along the midline of the linea alba to the umbilicus, while the chief posterior line is in the midline of the back between the erector spinae.10 Additionally, in those females that truly desire a more athletic look, lateral rectus definition, hip contouring (anterior superior iliac
spine), and lower sacral dimples can be created or enhanced using superficial liposuction techniques. It is not common for females to have horizontal lines at tendinous insertions of the rectus abdominis (โsix-packโ) as this is a more masculine feature and should be avoided unless the female is truly a candidate for this type of etching (Fig. 60-14A and B).
Excess fat of the thighs also needs to be addressed in females, and is a major problem area and an extreme area of disproportion for most women. In the past, overresection of the inner and outer thigh gave a smaller appearance, but also one that was flat and straight, more masculine, and ultimately unattractive. This area needs to be treated in a 360-degree fashion, keeping lateral curves and some thickness to the anterior and inner thighs so that a proportionate leg shape is maintained. The breast, buttocks, and lateral thighs are frequent areas requiring enhancement or contouring with fat transfer in order to create a smooth transition between the hip and leg. It is common for an HDBC surgeon to add fat volume to the lateral buttock and thigh while removing fat of the upper buttock/lower back and inner thigh. This technique gives the buttock a more round appearance and further enhances the โS-curveโ that is created when sculpting of the abdominals, flanks/sides, and lower back is performed (e.g., improving the hip-to-waist ratio). Even without any leg contouring, the buttock and hips will look more shapely by fat reduction and skin tightening of the lower back and flanks/sides. Additionally, fat removal is more common in places like the calves and ankles in females, but is an uncommon area of expertise for most surgeons.
Early treatment of the neck with sculpting along the jawline/lower face from both a midline (submental) and lateral position (preauricular) will tighten and contour this area and be preventative to early neck aging/sagging. Cellulite can be treated with combination approaches such as motorized subcision (e.g., Cellfina), fat transfer, and/or
internal radiofrequency (e.g., ThermiRF) during the surgical procedure, and maintained with external heating devices (e.g., Exilis, Venus Legacy, Ultherapy) and injectable collagen stimulation with poly-L-lactic acid (e.g., Sculptra).
Ethnic, geographic, and cultural variation in shape in female buttocks
It is important to recognize differences between cultures and ethnicities when preforming an HDBC procedure. Caucasian and Asian patients often desire a lessdefined and curvy thigh, and want it to be as โstick thinโ as possible, with a much less laterally projected buttock. In contrast, Latin/Hispanic and African-American patients desire much more prominent lateral thighs, larger buttocks, and very thin waists, often giving a less proportionate appearance.
Figure 60-14. (A) Female high definition body contouring without tight skin. Same patient in different angles showing results before (left) and 3 months after (right) high definition body contouring of the circumferential torso, arms, and thighs, with fat grafting to the buttock. This patient is not a candidate to get a tight, contouring high definition outcome as she has moderate skin laxity without muscular definition. Nonetheless, you can see the significant bulk reduction in fat and skin tightening and body shape achieved after a VASER sculpting procedure. (B) Female high definition body contouring with tight skin. Same patient in different angles showing results before (left) and 3 months after (right) high definition body contouring of the circumferential torso, arms, and thighs, with fat grafting to the buttock. This patient is a candidate for a high definition outcome as she has almost no skin laxity and adequate underlying muscular definition.