Philadelphia Inquirer / Dr. Constantino Mendieta

Chasing shifting body ideals: Homework still a must

February 16, 2011

February 15, 2011

Chasing shifting body ideals: Homework still a must

se_phillyinquirer_logo3

By Stacey Burling, Inquirer Staff Writer

beyonce-buttBlame it on Jennifer Lopez.

She and other entertainers with bodacious backsides – Beyoncé, Nicki Minaj, and Kim Kardashian among them – have helped make many women feel insecure about yet another part of their bodies: their butts.

Once a piece of real estate that almost no woman would want to enlarge, the ideal butt for some now must be round as a balloon, perky, and well-defined. That’s hard to achieve naturally when you’re also striving for the anorexic look or fighting the sags and realignment that age and gravity inevitably bring.

Hence a new demand for butt-enhancing medical procedures – a desire that had tragic consequences last week when an English medical tourist died after black-market butt injections she received in a hotel room near Philadelphia International Airport.

There are legitimate ways to plump up a bottom, but this isn’t one of them. Doctors said there have always been cut-rate cosmetic procedures, and publicity about plastic surgery is lulling more women into thinking it’s no big deal. As last week’s case proved, you’re better off with a pro. A big clue: Board-certified plastic surgeons don’t work in hotel rooms.

“You want to make sure you go to an appropriately trained physician,” said Felmont Eaves, a plastic surgeon in Charlotte, N.C., and president of the American Society for Aesthetic Plastic Surgery.

“A little bit of homework would have saved this woman her life.”

Friends who traveled with the woman who died said she was told she was being injected with silicone, but police do not yet know what substance was used.

Constantino Mendieta, a Miami plastic surgeon who specializes in “gluteal contouring,” said several substances – silicone, PMMA or poly (methyl methacrylate), and hydrogels – may be used by fly-by-night butt enhancers, but patients have no way of knowing what they’re getting. Eaves said practitioners sometimes use industrial silicone, and there have been reports of people using caulk. These are not FDA approved.

Real doctors usually inject patients with their own fat from other parts of their bodies, or they may use silicone implants.

Mendieta said injections of other substances can kill if they get into the bloodstream and cause a clot that blocks an artery. They also can cause infection, and, years later, become lumpy.

Mendieta said he has heard that people who do injections at parties or hotels charge $1,000 to $3,000. What he does, which involves recontouring the whole body and redistributing fat, costs $10,000 to $14,000.

Lyle Back, a plastic surgeon in Cherry Hill and Washington Township, remembers meeting a Brazilian doctor at a conference early in his 25-year career. ” ‘It seems to me that all the American women want are big breasts and small butts,’ ” he remembers the other doctor saying. ” ‘In Brazil, we have the exact opposite. The women want small breasts and big butts.’ ”

As American culture has diversified, Back said, more Americans have embraced the Latin ideal of shapely, sensuous hips. Of course, they also still want big breasts. African Americans have long had an appreciation for more ample backsides, experts said.

James Peterson, an associate professor of English at Bucknell University who studies hip-hop and popular culture, said Americans have seen the deconstruction of what was the predominant beauty ideal: thin, white women. That allowed some African American women to feel good about their ample backsides. But he sees the next step – people who were born with different body types wanting unattainable curves – as destructive.

“You can’t have J.Lo’s butt. That’s the crazy thing,” he said. “She’s an individual.” Plus, she has a lot more time and money than most women to devote to her body.

He sees little hope of influencing his female students to feel more comfortable with the bodies nature gave them. They’re already “beholden by the frat-boy gaze,” he said. “It’s already too late.”

Both Back and Mendieta said they began seeing an increase in women of all races and ages wanting surgical butt enhancement about 10 years ago.

Statistics are imperfect. According to the American Society for Aesthetic Plastic Surgery, there were 5,000 buttocks-augmentation procedures using silicone implants in 2009, compared with 2,100 in 2004. Implants are not popular in this country. Doctors say they can cause scarring and discomfort. Fat injections to the buttocks, a far more common procedure, are recorded along with injections elsewhere in the body. There were 43,000 injections in 2009, up from 38,000 in 1997. Meanwhile buttocks lifts, which are used most often for patients who have had weight-loss surgery, rose from 1,500 in 1997 to 3,000 in 2009.

It would seem that the easiest route to a rounder butt would be to just eat more cheeseburgers, but, as any dieter knows, you can’t make fat go where you want it. Many plastic-surgery patients are striving for a curvy figure with voluptuous breasts and rear and a tiny waist. Nature usually doesn’t do that.

The Internet offers some nonsurgical options to be taken with varying degrees of salt. One ad touts “Big Booty, Small Prices” with padded underwear “as featured on Dr. Oz” for $24 to $37. Buttocks-enhancement pills promise a big butt, wider hips, and a slimmer waist. There’s enhancement cream, too.

What plastic surgeons most often offer is combinations of liposuction to sculpt the body around the butt – giving it a different framework, as Back says – and injections of a patient’s own fat to change the shape of the buttocks themselves. Eaves said he might do a hundred small injections with 200 to 500 ccs of fat per side. Doctors said 50 to 70 percent of the injected cells find a new blood supply and survive.

Mendieta said he sees different shape preferences among ethnic groups. Latin American women like heart-shaped buttocks, he said. African Americans want “junk in the trunk,” a shelf-like butt that’s more prominent, he said, while Asians like a narrower buttock that makes them look longer and taller. Caucasians run the gamut.

Experts on body image say curvaceous celebrities and reality shows such as Extreme Makeover have not only made women think they have more problems to fix, but also made plastic surgery more socially acceptable.

Wendy Lewis, a New York cosmetic surgery consultant who calls herself the Knife Coach, said there was a time when women went to surgeons just to fix the bump on their nose or the wattle at their neck. Now they have “a very low tolerance for imperfection of any kind” and enter the surgeon’s office with a “laundry list of 15 things.”

Ann Kearney-Cooke, a Cincinnati psychologist who specializes in body image and eating disorders, said she’s seeing more women in their 20s and early 30s who want cosmetic surgery. One who was considering butt enhancement told her, “I’m from the boobylicious generation.”

Women think surgery will change more than it does. “I think there’s this huge myth of transformation in our culture,” she said. “You change your body and you change your life.”

Women may miss the fact that Beyoncé and Jennifer Lopez have not only great bottoms, but also beautiful faces and voices. “The whole package is what makes them sexy and appealing to men,” Kearney-Cooke said.

You’d think an expert on attraction between men and women might say that women are wasting their money on butt enhancement. Men surely don’t care that much about butts.

Think again.

While it is true that plenty of men fall madly in love with women who lack shapely butts and that some may even find a good salary or a Ph.D. enticing, men are, in fact, naturally attuned to the waist-to-hip ratio, said Helen Fisher, a biological anthropologist at Rutgers University who has written five books about sex and love. Evolutionarily speaking, shapeliness is a sign of healthiness, which is a sign that a woman is likely to produce healthy children. Men apparently aren’t that good at telling when it’s fake.

On top of that, she said, an upturned butt – the crouched lordosis position – is the universal mammalian sign of sexual readiness. The primitive part of men reacts.

“Men are much more attracted to women with an ugly face and a beautiful body,” Fisher said, “than to women with a beautiful face and an ugly body.”

– http://articles.philly.com/2011-02-14/news/28534181_1_plastic-surgeon-silicone-implants-aesthetic-plastic-surgery

– http://www.constantinomendieta.com/