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Getting well-rounded through plastic surgery

The Baltimore Sun

In the midst of the obesity epidemic, is it true that some people are having surgery to increase the size of their derrieres?

It's not only true, but the practice is booming! According to the American Society of Plastic Surgeons, the number of "buttock lifts" increased nationwide 283 percent between 2000 and 2005, from 1,356 to 5,193.

An American pioneer of the so-called "Brazilian Butt Lift," Dr. Anthony Griffin, a Beverly Hills, Calif., plastic surgeon, said the most popular form of buttock enhancement, or gluteal augmentation, is "autologous fat transfer."

Just as the name implies, the fat transfer process works by taking fat from the abdomen via liposuction, then injecting it into the muscles of the rear end.

And it's not just West Coast women, or women from South American or African cultures that value curvy bottoms, who are embracing the trend.

"We are getting more and more demand for fat injections," said Dr. Richard Ehrlichman, a consultant in plastic surgery at Massachusetts General Hospital.

The survival rate of the transplanted fat tissue can be low, about 10 percent to 30 percent over one year, which means the procedure may have to be repeated, Ehrlichman said. If the fat tissue dies, it is absorbed by the body.

But Griffin said his transplants last on average 10 years. Making sure to inject fat into muscles, which have a good blood supply, boosts survival of fat tissue, he said.

The curvy look doesn't come cheaply, though, and it's not covered by insurance. Depending on how long the surgery takes, it can cost $12,000 to $18,000.

In addition to creating curvier behinds with fat, plastic surgeons can put in silicone implants, although they tend to shift around and may become quite hard.

Further boosting the demand for plastic surgery on the derriere is the boom in gastric bypass surgery. When a person loses huge amounts of weight, the skin on the derriere sags. Plastic surgeons can correct this by pulling up the skin and cutting off the excess. Some surgeons combine this with a tummy tuck.

But before you leap, remember that plastic surgery is real surgery -- with all the risks that accompany other surgical procedures.

I hear there's a new pill that suppresses menstruation for at least a year. Is this a good idea?

That depends on whom you ask. There are several birth control pills on the market that enable women to have short, infrequent bleeding.

The newest of these, Lybrel -- recently approved by the Food and Drug Administration -- stops periods entirely as long as a woman takes it. In clinical studies, women have taken Lybrel for one to two years, according to Dr. Amy Marren, director of clinical affairs for the manufacturer, Wyeth Pharmaceuticals.

As soon as a woman stops taking Lybrel, a combination of estrogen and progestin, she gets a "withdrawal bleed," which is not a true period because no ovulation has occurred.

While advocates of menstrual suppression claim that birth control pills that reduce periods to once every three months or once a year are a welcome lifestyle choice, critics worry about safety.

In particular, said Judy Norsigian, executive director of Our Bodies, Ourselves, the Boston-based health advocacy group, is the fact that "there are no long-term safety data."

Moreover, some women are ambivalent about losing periods. Two studies by nurse-researcher Linda C. Andrist, an associate professor at the MGH Institute of Health Professions, suggest that slightly more than half of women would choose not to menstruate every month.

But many others see their monthly periods as symbols of fertility, normalcy and health, Andrist wrote in an e-mail.

As with all birth control pills, the period-stopping pills may lower levels of available testosterone, diminishing libido. The long-term pills also trigger considerable breakthrough bleeding, said Dr. Alan Altman, a menopause specialist in Brookline, Mass. "This pill doesn't add much to existing birth control options," he said.

The package insert cautions that "because regular monthly bleeding does not occur on Lybrel, an unexpected pregnancy may be difficult to recognize."

Studies show that Lybrel is comparable to other low-dose contraceptives at preventing pregnancy.

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