Love handles, a well known slang term, refers to a layer of fat that develops around one’s midsection, especially apparent on the sides over the abdominal external oblique muscles. I assume they are called love handles because they can be grabbed or rested on while one’s arm is around another person. But I don’t know anyone that really loves them. Love handles are also called a spare tire, midriff bulge and muffin tops. (my personal favorite)
While there is no doubt that diet and exercise are the first line of offense to reduce love handles, this is often not that effective. I have talked to many patients, both men and women, in my Indianapolis plastic surgery practice who have made gallant efforts and are still stuck with love handles. They may have lost it most everywhere else, but the love handle area is often quite resistant. Perhaps they weren’t doing the right exercises or weren’t really trying hard enough, but they remained with love handles nonetheless. I do not believe that most people can lose spot areas of fat by exercise.
The love handles happen to be a particularly good area to be reduced by liposuction. I consider it the most ‘responsive’ area on which to do liposuction because the results are always significant and there is very little risk of contour or shaping problems. It is an area which can be treated very aggressively with liposuction techniques because of the thickness of skin and the acceptance of an overall ‘indentation’. If the side of the waist ends up either straight up and down or becomes more like an hourglass, all patients would consider that a good result. In short, maximal removal of subcutaneous fat around the waistline into the back is the approach for love handle removal.
The newest laser liposuction method, Smartlipo, works particularly well for this waistline problem. It appears that the heat build-up in the love handle area helps to create significant collateral damage to fat, beyond what is liquified and melted, to optimize the results. Suctioning the love handle area traditionally creates very noticeable bruising and pain in the back area around the waistline, but that seems to be reduced with Smartlipo. I didn’t say eliminated but definitely reduced.
I like to leave the small entrance skin sites for the laser probe and suction cannula open to drain after surgery. This drainage is easily caught in dressings that are placed against the skin over which a circumferential abdominal binder is placed. This drainage will stop in 24 to 36 hours. It is better to have this fluid out, rather than in, so there is less blood and fluid for the body to have to clear afterwards. Love handle liposuction results are immediately apparent, even the next day when the dressings are removed. The results continue to improve as swelling and bruising resolves.
Be aware that love handle reduction is only as permanent as the stability of your weight permits. Like the abdomen, it is an area of preferential fat deposition (particularly in men) and treating it with liposuction will not change this biologic predisposition. Keep working on those exercises after surgery!
Dr. Barry Eppley
Indianapolis, Indiana