Go for the burn? Fat chance. These days, it’s just as likely to be … go for the epidural.
Personal trainers, as a golden rule, have fearsomely perfect physiques and tend to reel off their minuscule body-fat percentages as eagerly as if they were peddling low-interest mortgages. After all, their bodies are their calling cards. So if, after you’ve spent several months pumping up and working out under their tutelage, your handles are still lovey and your thighs still have dimples, the thinking goes, you have only yourself to blame.
At least, I always thought so. Until the other day, when I was moaning to my trainer during my umpteenth set of crunches. Every time I sat up, I was treated to the sight of another trainer across the room inspecting/admiring his six-pack in the mirror. “Why can’t I have abs like that?” I growled. My trainer looked around furtively, then made a sucking sound, as though taking a long sip from an imaginary straw.
“What’s that?” I asked, slow on the uptake. “Some wonder steroid drink?”
He rolled his eyes at my naïveté, leaned forward conspiratorially, and murmured the magic word.
Let’s assume, then, that your trainer has no qualms about baring her supple thighs or his rippling stomach. That doesn’t mean she or he isn’t hiding something: a teeny, tiny liposuction scar.
You already see dermatologists who have offices in gyms,” says Dr. Wilder, predicting that in the future, gyms will have affiliations with plastic surgeons. “It’s hard to achieve society’s idea of perfection without surgical intervention – or airbrushing.”
You heard it here first. Prominent Manhattan plastic surgeons report that liposuction is regularly performed on personal trainers, aerobics instructors, and sundry other fitness pros, athletes, and bodybuilders. Official stats don’t exist, but one surgeon, Dr. Helen Colen, says that such fit-for-life types make up nearly 20 percent of her business.
“I always thought great athletes had great bodies,” recalls the ultracritical Colen. (Within minutes of meeting me, she told me that the only way I was getting rid of my love handles was lipo – and I had all my clothes on.) “But the truth is that you can be in extremely good physical shape, and still have all the fat in your body concentrated in your thighs and nowhere else.
“Trainers are people who are obsessed with their bodies,” she adds. “Obsessed! So you better believe that they’re going to want to have liposuction.”
Dr. Todd Wider, another Manhattan plastic surgeon, whose near-perfect clientele includes a closely guarded list of models and actresses, also does a brisk business in personal trainers and fitness instructors. “Trainers have a hyperacute sense of their body image, which I guess is an occupational hazard,” says Wider. “They make very interesting patients. They’re appreciative but at the same time very demanding, because they’re so concerned with their appearance, and they know what they want. It’s a nice challenge.”
So it was three weeks ago that Lia Sanfilippo, a personal trainer at the Trainer’s Place in Manhattan and a physical-education teacher in the New York City public-school system, went to the cushy Fifth Avenue offices of Dr. John Sherman and permitted him to draw all over her with a magic marker. Making himself a map, Sherman would soon go where no exercise regime or diet had gone before: into her saddlebags and love handles.
“I trained like crazy,” Sanfilippo said before the surgery. “I did everything – teaching classes, taking classes, dieting – and those areas never went away.”
Sherman was only too happy to help. In little more than an hour, he suctioned out two pounds of fat, fore and aft, on the trainer. And then all there was to do was wait. “It takes about a month for you to see the results, and about three months for everything to look really perfect,” says Sherman. (If you’re gearing up for the beach, in other words, you’re too late for this summer.)
Doctors say trainers are among the best candidates for liposuction – since usually they have good cardiovascular health, need the least fat extraction, and recover most quickly. And plastic surgeons love them as clients, since they’re the most likely to maintain their bodies. All too many clients, says Colen, come back to her in a year to complain. “They say, ‘Look where the fat went!,’ ” she says with a laugh. “I tell them, ‘The fat didn’t just go there – you have to eat it first.’ And you know, you take it personally if they ruin your work.”
But whether trainers are good candidates or not, the fact that more and more of them are indulging in liposuction underscores the dramatic shift that the procedure has undergone in the popular consciousness. Only five years ago it would have been sacrilege: Liposuction was seen as a cop-out for people who didn’t care about physical fitness. And in the workout world, the predominant thinking was that if you still have fat on your thighs or around your middle, well, you’re just not dancing fast enough.
But the Great American Athleticism has been tarnished by reports of widespread steroid, supplement, and drug use. And those proud athletes who once looked down on plastic surgery as the refuge for the cowardly now have to concede defeat: Not only can you not get perfect thighs in 30 days, but you can’t get them in 30 years either.
You can get them in 30 minutes, though. That plastic surgery should be the slimming method of choice for paragons of health like personal trainers and aerobics instructors must come as a delicious irony to plastic surgeons, who have been under continual fire for providing an easy way out for the vain, indolent, and wealthy.
There is even an argument being made that in some instances, lipo is the healthiest way to go. As Dr. Wider puts it, “Which is safer, dieting for years and depriving yourself of food or having liposuction?”
Good question. Dr. Barbara J. Moore, the president of Shape Up America!, the C. Everett Koop-founded education group that promotes fitness and nutrition, considers liposuction (and even love handles) an issue of cosmetics, not health, since you can be quite fit and still have some extra thigh insulation. But, she says, “if your strategy is one of restricting and restricting and restricting, that is not likely to be successful or healthy.”
This is not to say, however, that patients should be treating the OR as a Stairmaster surrogate – and neither should doctors, especially those without sufficient training in the operation. “Liposuction is not a trivial procedure, because it has the potential to kill otherwise healthy persons,” wrote three New York City doctors in The New England Journal of Medicine last year, reporting on the cases of five local patients who had died from complications of liposuction operations. “Deaths due to cosmetic surgery should be a matter for serious public concern.”
Plastic surgeons themselves, like Dr. Colen, chalk up the risk and accompanying bad press to underqualified doctors. “A lot of people who are doing it are not trained to do it, and as a result they’re not equipped to deal with shock or electrolyte changes,” Colen points out. “A doctor may under- or overhydrate a person – you can give someone heart failure. It seems simple – you go in and you get vacuum-cleaned – but it’s not. If you take too much fat, then you’ll throw the person into imbalance.
“But there’s nothing wrong with the procedure,” she continues. “It’s fine if it’s done on the right person for the right reason in the correct way. This is really not an operation for the overweight. It’s for bulges.”
In fact, recent advances like the introduction of a fluid process, called tumescent liposuction, and ultrasound equipment both make fat cells easier to suction out and reduce the extraction of nonfat tissue. “With ultrasound, it’s pure yellow fat,” says Colen, with her characteristic flair for the gory. And, she adds, “there are no lumps afterward, because the ultrasound breaks them down.” The cannula – the magic suction wand – is much smaller, so liposuction scars can now be no bigger than a bad mosquito bite.
These advances have meant good news for all liposuction patients: less trauma, faster recovery time, less risk of infections or complications, and so on. But they mean even better news for the super-body-conscious. “They care about every little blemish,” Colen says. “When the process became more dainty, they became more brave.”
“It’s the best decision I’ve ever made,” says Lisa Crisano, a personal trainer who went to Colen for liposuction on her thighs two years ago. Crisano began working out as a teenager and a few years ago did a bodybuilding show on a dare; she won both that one and the next one she did. “I did them without lipo,” she says, but it wasn’t a pleasant experience, because all too much of her prep work was focused not on her form but on keeping the fat in her thighs to the absolute minimum. “In order to get onto the stage,” she says, “I had to destroy myself with dieting.” Post-lipo, she eats and works out like a human being, albeit a very fit one, “instead of knocking my head against a wall.” She even weighs more than she did. In high school, she says, “I was five-five and 138 pounds. I was a chunker. Now I’m 142 and look thinner.”
Another trainer (who declined to be named) admits that the cachet of being a workout fanatic has lost some of its luster for trainers as well as for their clients. More and more people, she says, want to spend less time working out and more time on other pursuits – a mind-set that she believes is healthy. “I see these people who come into the gym twice a day now, and I think, What do you do? How much of your life are you going to devote to this?”
So perhaps this heralds a new synergy: a trainer and a surgeon who collaborate on perfecting your body. Dr. Wider, for one, believes that fine-tuning the athletic physique will be increasingly the province of doctors. “You already see dermatologists who have offices in gyms,” he says, predicting that in the future, gyms will have affiliations with plastic surgeons. “Rock-hard abs might take you five years to achieve in a gym, and it can be done in an hour and a half through liposuction.”
Wider’s parting shot might also be his motto: “It’s hard to achieve society’s idea of perfection without surgical intervention – or airbrushing.”
But trainers aren’t about to be liposuction poster children, given how few of them are liable to own up to having it. “Most of them would never admit to getting liposuction,” says Colen of her trainer patients. “They might get fired if they did. They’re supposed to be promoting their club, not their doctor.”
Case in point: another trainer in her early thirties who’s a columnist for a prominent fitness magazine. She was ready to have liposuction on her legs and be interviewed for this article. Then her editor got wind of it. If she talked to me, or went through with the liposuction, the editor said, she would never write for the magazine again. That was the end of that. (Not the liposuction, necessarily. Just talking about it.)
Or take the trainer who gave a glowing account of her liposuction but declined to give her real name, and says she doesn’t generally tell her clients she had it. “I don’t gain from it – in fact, I could stand to lose a client,” she says. But she doesn’t feel as though she’s being dishonest in keeping it secret. For her, liposuction was a last resort to get at a stubborn reserve, and she argues that it’s in her clients’ best interests that they not think of surgery as an option until they absolutely need – or want – to. That is, after they get fit and develop decent eating habits. “I like to get them to have a relationship with food, get the bad stuff out of their diet, and not be so obsessed with being skinny.”
As of the three-week mark, Sanfilippo is reluctant to wholeheartedly endorse the surgery. “It’s a high price for vanity,” she says now. “I wasn’t prepared for how much everything would hurt afterward.” But, she says, “if those spots are gone, it will be worth it. I keep telling myself it’s like being pregnant. When you finally get the results, suddenly you forget the pain.”
And hey – as you’ve heard your trainer say so many times: No pain, no gain.