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Special to The Times

They are the last people you’d think need liposuction -- personal trainers, runners, gym rats and everyday athletes who spend hours each week trying to sculpt a perfect physique -- yet no matter their routine, that chiseled hard-bodied look has somehow eluded them.

Tito Hernandez is a personal trainer who works out five days a week but was frustrated that no number of crunches could give him the stomach he wanted. “I had just put on a little weight around my belly,” said Hernandez, 35. “I wanted the six-pack abs I had when I was younger.”

So Hernandez spent a recent afternoon in a Los Angeles plastic surgeon’s office, undergoing liposuction. But not just any liposuction. Hernandez experienced a new technique called VASER High-Definition Liposculpture that not only removes fat but, as the name suggests, creates a highly defined and sculpted look.


Nor is Hernandez alone. Plastic surgeons’ offices are fielding inquiries from a growing number of clients, especially men, eager to exchange soft stomachs for six-packs, love handles and saddlebags for a more sleek profile (one local doctor has performed the procedure on 14 patients in the last two months), making VASER High-Def the latest trend in the search for a perfect body -- with the least amount of effort.

“I have marathon runners and triathletes coming in who still have love handles, and those aren’t going away no matter how much they exercise,” said Dr. John Millard, a cosmetic surgeon in private practice who helped develop the Vaser technique.

VASER High-Def (which stands for Vibration Amplification of Sound Energy at Resonance) is not for everyone. The procedure is best suited for those who are close to their ideal body weight, who work out at least three times a week and are already in good shape. VASER uses ultrasound technology to emulsify fat, which is then sucked out through incisions with a long needle called a cannula, exactly as is done during liposuction. Except the cannula, when used for high-def sculpting, is smaller and slimmer, and the suction technique has been modified so that fat can be removed from areas directly beneath the skin, specifically, tracing the natural musculature.

“Instead of simply thinning out the fat on certain parts of the body, the surgeon is attempting to . . . sculpt the fat to match the contours of the underlying muscle,” said Dr. Dan Yamini of Sunset Cosmetic Surgery in Beverly Hills. “It allows for a much more lean and chiseled look that until now could only be achieved through a very aggressive diet and exercise plan.”

The VASER machine has been used for liposuction procedures for around seven years. But in November, Millard and a colleague published a paper in the Aesthetic Surgery Journal outlining how VASER could be used to create the illusion of muscle tone. Since then, the technique has been adopted by cosmetic surgeons around the country who find VASER results more artful than those from liposuction.

“For all these years, our concepts of liposuction have been a little unsophisticated,” said Dr. Roger Friedenthal, a plastic surgeon in private practice in San Francisco and an associate clinical professor at the University of California Medical Center. “We got the idea that waists go in, stomachs are supposed to be flat, love handles should be gone and saddlebags should disappear. That’s not incorrect, but it misses a lot of the aesthetics of the shape.”


Still, surgeons as well as fitness experts caution against the procedure being used in lieu of a fitness program. “This is not a lunchtime procedure,” said Dr. Daniel Mills, a Laguna Beach plastic surgeon, president of the California Society of Plastic Surgeons and spokesman for the American Society of Aesthetic Plastic Surgery. “You’ll get real results, but it’s a real surgery that will take a real recovery.”

Downsides and alternatives

Roland NAHAPETIAN, who owns No Excuses Fitness, a gym in Pasadena, said there are always alternatives to surgery. “Just because people work out hard and are committed doesn’t mean they are doing the right thing. I do have clients who fit that profile -- who are devoted to their workout but can’t lose the little bit they have. I’d rather ask them to change their exercises, fix their diet and lifestyle.”

According to doctors, it typically takes six to eight weeks for swelling associated with the surgery to subside and for the muscle definition to take on a natural appearance. “At four months, the final results are there 24/7,” said Millard.

A month after his surgery, Hernandez says that his results continue to improve. Plus, he is dropping weight as a result of a doctor-prescribed diet. “Everything looks better,” he said. “It looks more natural now -- and it has gotten me more clients.”

VASER is not cheap, averaging around $6,000 per area (liposuction is approximately half that cost). Hernandez spent $18,000 for the work done around his stomach and flank.

Julie Ford, who’s 44 and wears a size-2 jean, spent $13,000 on two procedures, one for her stomach and back, the second under the arms. “It was expensive,” she said, “and it took a lot longer to recover than I thought, but it was worth every penny.”


Although Ford worked out four days a week, she said there was always a “muffin top” at her waistline she couldn’t quite eliminate. “I’ve always been really fit,” she said. “But my body didn’t look as balanced as I’d like. Now I can wear a bikini and not even think about it.”

Dr. David Matlock, a Los Angeles surgeon who’s appeared on E!’s “Dr. 90210,” started using VASER High-Def two months ago. Since then, he has performed the surgery on more than a dozen patients and plans to demonstrate the technique on a couple in an upcoming episode. Other clients include an emerging rap star, who works out two hours a day and wanted a rippled look on his abs, and his girlfriend, a former national boxing champion, who is looking for a six-pack and chiseled flanks.

Doctors say the procedure often motivates patients to spend even more time in the gym to maintain the results. If a patient ever gains more than 15 pounds, “much of the definition goes away,” said Millard, who also claims that the VASER High-Def can withstand some effects of aging.

“Even older people whose skin loses tone but who work out still maintain definition of muscles through looser skin,” he said. “But it takes maintenance. This is not a license to eat ice cream.”