ASPS President Associate Professor Rodney Cooter warns that “cosmetic surgery is no holiday. Cosmetic surgery packages sold as holidays downplay the importance of the post-operative period. Any kind of major surgery, cosmetic or otherwise, requires a high level of post-operative care.” He adds, “Infections are the most common complications including unsightly scars, hematomas and unsatisfactory results.”

Highlighting the dangers associated with cosmetic tourism, the survey found that:

• 72% of plastic surgeons conducting revisions on cosmetic tourism patients have had cases they were unable to completely correct
• Almost 50% say they have seen cases that would have been life threatening without corrective treatment
• 62% have seen cases which have involved permanent disfigurement despite the surgeon’s best efforts because some complications can result in irreversible damage
• A similar number have seen cases where the patient has been severely psychologically impacted as a result of their experience.

Thailand, Malaysia and South America are amongst the most popular places for Australians to travel to for their procedures. While some of the surgeons in these areas are highly skilled professionals, the concern is that the appropriate post-operative care and monitoring is not being undertaken. “Ask yourself what follow-up care will I get back in Australia after my operation? Who will help me if something goes wrong?” says Associate Professor Cooter.

The survey revealed that the most common kind of overseas cosmetic surgery requiring corrective treatment was breast surgery (representing 68% of all revision procedures required by local plastic surgeons), followed by facial surgery (15%), abdomen revisions (8%), body contouring (5%) and ear revisions (0.5%).

So why are Australians travelling overseas to get their cosmetic procedures? The cost. While the original treatment may seem more affordable, if you experience complications post-treatment the ASPS has found that the average cost of cosmetic tourism revision treatment to the patient is an additional $5,754, plus an average two weeks recovery time.

Before you plan your overseas surgery trip, read Associate Professor Cooter’s checklist:

• Is your surgeon a member of the International Society of Aesthetic Plastic Surgery?  This at least means they have some form of recognised qualification.
• Have you got the right information and had enough time to give informed consent? (Cooter recommends waiting two weeks between appointments)
• Are the medical standards of care and quality control requirements at least as good as those in Australia?
• Do you know whether or not devices and products used in overseas hospitals meet Australian standards?  An implant used in Australia must meet strict standards of safety and effectiveness, a process regulated by the TGA.  Other countries may not have similar regulations.
• Have you got a plan for what you will do in the case of post-operative problems?
• Check out the person promoting the surgery.  Are they medically trained?  Do they accept any liability or provide any help if problems arise or are they simply a ‘travel agent’ or ‘broker’?

* ASPS is a not-for-profit membership organisation for specialists in plastic and reconstructive surgery. Members of ASPS are fully trained and qualified in plastic surgery, operate only in accredited surgical facilities, adhere to a strict code of ethics, and regularly attend continuing medical education courses.

Non-invasive body contouring systems have flourished in Australia over the past few years. While it’s early days, CoolSculpting is different, according to Dr Daniel Fleming, of Brisbane’s Cosmetic Surgery Institute of Australia, “because it does exactly what it says it will do – reduce fat by 20 per cent with each treatment. And when these fat cells have been frozen off they’re gone forever.”

The science behind CoolSculpting was discovered by dermatologists affiliated with Harvard Medical School in the US and has been studied over the past four years. As legend would have it, the professors happened on the idea when they realised that babies given “ice pops” over a prolonged period lost fat cells in their cheeks.

They subsequently found that fat cells are much more sensitive than any other body tissue to cold. When enough cooling is achieved, a natural “cascade” of fat destruction – crypolipolysis – begins, the body eliminating the damaged cells over a two to four-month period.

US cosmetic physician Dr Jay Burns, on the board of Zeltiq (the company behind CoolSculpting), claims it fundamentally differs from other non-invasive body sculpting technologies because it triggers a natural body response as opposed to “exploding” fat cells, releasing cholesterol and triglycerides into the bloodstream.

Each CoolSculpting treatment takes between 45 minutes and an hour. A gel patch is placed on the target area, then a special applicator gently pulls tissue in between two cooling plates. Described as being like a very strong vacuum containing a refrigeration unit, the machine reduces the temperature of the fat in that area.

“It extracts heat out of the fat cell and in doing so causes the fat to change from a liquid to a solid state just like refrigerated butter, “ explains cosmetic physician Dr Joseph Ajaka, of Sydney’s Cosmos Clinic. “This causes the fat cell to die over a three-month period. It speeds up the metabolism in the area treated.”

During treatment the patient feels a tingly pins-and-needle sensation for the first 10 minutes, followed by a mild cooling sensation after the area becomes numb. Patients can read, sleep, or watch TV and, when the treatment is finished, immediately resume normal activities. There is no down time.

“It is is a very safe procedure,” says Dr Ajaka.” Some patients may experience temporary redness or numbness in the treated area.”

Dr Ajaka has been using the system for more than a month and has treated about 70 patients – including himself.

“This is the only non-invasive treatment that really works in my experience – we have trialled others with disappointing results,” he says. “There is a greater than 20 per cent reduction in the fat layer of the treated area.

“Our patients won’t see the final outcome for around three months but I was the first to try the machine and saw results on my lower abdomen after three weeks.” (Click here for video of Drs Fleming and Ajaka treating patients with CoolSculpting.)

Patient selection is one of the most important factors in achieving optimum results, adds Daniel Fleming. “CoolScuplting is not for overweight people – it is for those of a normal weight who have excess fat in areas that they can’t lose by the normal means of diet and exercise.

“Patients might see excellent results with one cycle [a single treatment period] or they may have several.”

CoolSculpting patient before treatment (left) and six weeks later: Courtesy Dr Daniel Fleming

CoolSculpting is recommended for the abdomen, love handles, back, arms, inner thighs and male chest (in the near future the neck will be able to be treated). There is no applicator for the outer thigh.

Costs for a single treatment can range between $500-$1100 depending on individual practitioners. Some patients achieve their desired result after just one treatment but others may need two or more. Each “cycle” (hour) targets one area so where your problem comes in pairs (for instance, love handles), again you would need two or more treatments.

1. PROBLEM: BACK ROLLS

You look great from the front, but those viewing you from the back will see rolls of fat on your back. You may have to buy larger shirts or tops to cover these rolls, but often these look baggy and unflattering, so you may opt for tighter clothes that only emphasise these folds. Sexy, backless numbers are forbidden.

SOLUTION: LIPOSCUTION, OR “BACK SCOOPING”

Rumour is that Heidi Montag has had “back scooping”, which basically uses liposuction to get rid of unwanted fat, carving a concave in the back. According to Dr Sarojini Nair, of The Ashbrooke Cosmetic Surgery clinic in Mosman, Sydney, “back roll fat is very fibrous” so it responds well to Vaser Lipo, a refined form of liposuction. Smaller diameter probes are inserted into the body through tiny incisions, and the ultra-sonic vaser probe is effective in shaking loose fat cells, which are then sucked out leaving tissue and blood vessels unharmed. Local anaesthetic is used on this area, which Dr Nair says is great for “loose skin”. She says the treatment on the back usually takes one hour, with a two-day recovery period. “Best results are seen after four to six weeks and the cost is $3000 all-inclusive.”

2. PROBLEM : BRA STRAP FAT

An ill-fitting bra can always cut into your shoulders and back, leaving fat seeping over the straps, but if you have surplus pudge in these areas, you’ll see an overhang of fat in these areas, even with well-fitting bras and tops.

SOLUTION: LIPOLYSIS OR LIPOSCULPTURE

“It is very common to accumulate fat that then bulges as a “roll” under the bra strap, which is a very unflattering look,” says Dr Tony Prochazka, of Sydney’s International Centre for Cosmetic Medicine. “Eventually the skin stretches and sags due to the weight of the underlying fat.” He says both lipotherapy and liposculpture work to remove this fat, “but I generally advise liposculpture as there is significant swelling and discomfort following lipotherapy, which needs to be repeated several times. ”

(Lipotherapy is a method of localised spot fat reduction performed by injectiong phosphatidylcholine (PC) and sodium deoxycholate (DC) into the treatment areas. It works by causing emulsification and lysis, or dissolution, of fat cells. The fatty acids are then slowly reabsorbed and flushed from the body over a period of weeks. Each treatment can cost around $400 and not everyone is a “responder”.)

Liposculpture is performed under mild twilight anaesthesia, then local anaesthetic is infiltrated through the area, via a small skin incision. “Gentle suction of the excess fatty tissue is performed using micro-cannulas with a diameter or 2mm or 3mm.” This stand-alone treatment takes about 30 to 45 minutes, but when combined with other liposculpture may only take 15 to 20 minutes. There may be some swelling for three to four weeks, and skin tightening usually takes three to four months. “For many women there is a very satisfactory cosmetic improvement as well as reduced discomfort from the ‘digging in’ of bra-straps,” says Dr Prochazka.

He adds it must be understood that skin may not snap back as easily in older patients. Expect to pay about $1000 for the treatment when performed along with larger liposculpture, which has its own cost.

3. PROBLEM:  PUDGY KNEES

You may be quite svelte, but often women’s legs are marred by unsightly knees. They may have fat and fluid gathering on top of the knee to cause legs to look pudgy. The knees are often resistant to exercise or diet, so you need a specific remedy to allow you to wear shorts, shorter dresses and swimsuits.

SOLUTION: HYPOXI

Hypoxi is designed to boost fat-burning, particularly in the legs. Its regular program using the L250 Trainer is great for streamlining bulbous knees.  Squeeze into a neoprene mini-skirt and then cycle in a reclined position, while this vacuum-pressured treatment, stimulates blood supply to the fat tissue. You’ll lay back, often watching DVDs, and pedal away for 30 minutes. To get best results, three 30-minute sessions are required each week. You’ll also need to watch carbs, drink plenty of water during the day, limit alcohol, sugar and fat intake, and continue for 12 sessions. But if your knees are ultra-stubborn, try HypoxiDermology (HD), in conjunction with the L250. The HD is modelled on Chinese cupping. Wearing a plastic full body suit, you lie down as 400 integrated pressure chambers are activated by suction and compression. This is a passive treatment, but it stimulates blood circulation, and afterwards you cycle on the other machine for 30 minutes. “Doing both treatments accelerates results and works wonderfully at moving hard-to-shift fat,” comments Patricia Rogers, National Marketing and Commercial Co-ordinator for Hypoxi.  Cost is around $69 for each single session of the L250 Trainer, and if you opt for the combination of the HD and L250 Trainer, expect to pay double. Blocks of 12 sessions can be purchased for $690, giving you two sessions for free. Call 1300 497 694 for details.

4. PROBLEM: BATWING ARMS

As you get older it seems harder to shift excess fat on the arms. Even when showing muscle mass after losing weight, you may have swinging flab when you lift your arms. Likewise you may have lost a lot of weight and now have skin laxity in this area. Sleeveless tops are a no-no, but long-sleeved ones can be hard to buy when your arms are too big.

SOLUTION: BRACHIOPLASTY (ARM LIFT)

To get rid of unwanted excess fat and skin between the armpit and elbow, Dr Benjamin Norris, plastic surgeon at Sydney’s Silkwood Medical Clinic, recommends brachioplasty, but says that patients with excess fat only, as well as good quality,  elastic skin in this area will get a great improvement with liposculpture alone. Dr Norris says most patients start with liposculpture to remove excess fat and determine the true extent of their excess skin. He explains: “Skin is then removed through a variable length of wound along the inner aspect of the arm, from armpit to elbow. In some cases the amount and location of the excess skin may be small enough to allow the wound and the subsequent scar to be limited to just the armpit or the inner part of the arm.” Dr Norris says the operation takes about one and a half hours and is “not particularly painful”. Bruising and swelling settles by day five or six and although most patients can use their arms relatively comfortably for necessities straight after the procedure, they can’t do upper body exercise such as weights or tennis for four weeks. A support garment is worn for six weeks, at which time scars are beginning to fade. Scarring is probably the worst aspect of this procedure. The all-inclusive costs are about $9000.

5. PROBLEM: CANKLES

Many women have no definition in their lower legs, with the calves being the same width as the ankles. Legs usually ache and when touching the “cankles” you’ll leave a dent in the flesh that takes ages to return to normal. Exercise does nothing to relieve the problem and may make the odema worse. Strappy sandals are out of the question and you probably end up wearing trousers to cover your lumbering legs, instead of jaunty skirts and dresses.

SOLUTION:  SORISA PRESOR-3

Increase circulation and decrease fluid retention with the Sorisa Presor-3treatment. Pneumatic massage is used with controlled compression to the areas of the body that most need treating. You’ll slip into boot-like body sleeve, covering the feet, hips, legs, buttocks and abdomen. Divided into compartments into which air is continually pumped at varying dosage rates, you’ll feel like you’re having your blood pressure taken, all over. By delivering interim pressure to different parts of the body, it helps activate circulation while assisting lymphatic drainage, and getting rid of clumpy ankles. Cost is $75 for a 25-minute session. Call 1 800 554 545 for details.

Choose a flattering hair colour
Hair that’s too dark can leave your complexion looking sallow while over-bleached hair will draw attention to damaged tresses. Stay within two tones lighter or darker than your natural hair colour for your most flattering look. A natural-looking colour will also soften your features. Try Wella’s 3D Color Effects, it’s an in-salon hair colouring technique that gives the illusion of depth and dimension by layering hair with similar yet graduated colours that go from dark to light.

Brighten your entire face with concealer
Your concealer can do more than hide dark circles under the eyes. Use it over your lids as a neutral base to counteract discolouration. Also dab it on the outer corners of your eyes, around the nostrils and at the corners of the mouth for a lifted effect in these age-evident areas. We recommend The Body Shop Lightening Touch, $20.95, which disguises dark shadows with its light diffusing particles while instantly brightening the skin.

Disguise drooping eye lids
Eye contouring will help perk up the appearance of your lids. Use a light-coloured shadow near the lash line and a deeper shade in an arc above the crease where the lid is dropping to make it appear receded. Too Faced Eye Shadow Duo in Totally Toasted, $34.95, will help you lift the eye area.

Leave lips looking fuller
Just because your lips aren’t looking as naturally full as they used to, that doesn’t mean you can’t fake it. A pink lip gloss with plenty of sheen will help lips appear fuller.

For more lip plumping tips, read Pucker Up

Bring lustre back to your hair
After years of chemical, heat and environmental damage it’s no surprise your hair is struggling to keep up a healthy sheen. Intense hydrating hair masks will help repair damage while a shine spray or serum will give your hair a glossy finish.  Try Moroccanoil Glimmer Shine Spray, $34.50.

Skip drying makeup formulas
Drying makeup can highlight lines and gives skin a crepey finish. Since mature skin produces less oil you should seek comfort in hydrating formulas and luminising products which reflect light and give skin a youthful glow. We love Bobbi Brown Moisture Rich Foundation SPF 15, $75, and Avon True Luminous Moisturising Makeup Base, $12.99.

Lift and plump your cheeks
Reverse the look of sagging, undefined cheeks with a well-placed application of blush. A bright pink shade with an illuminating finish swept over the cheekbones will give your face a lifted appearance. Try Maybelline NY Fit Me Blush in Medium Pink, $14.95.

Curl your lashes
By using a lash curler before you apply mascara will open up your eyes and give the overall area a lifted look. Follow with a curling mascara for a really bold effect. We love Utowa Eyelash Curler, $45.

Big or small, the key to a beautiful bottom is pertness and an harmonious ratio with the rest of your body.

If nature hasn’t gifted you with a great cheeks, or a sedentary lifestyle, extreme weight loss or ageing has seen your butt balloon and bust towards your knees, all is not lost.

A healthy diet and keeping active – regular walking, running, swimming, cycling … whatever your preference – is core to keeping in shape.

But for toning trouble spots, such as the bottom, you may need more targeted assistance. Younger You asked the experts and here, in no particular order, are some suggested solutions, from exercise and spa treatments to non-surgical procedures and surgery.

If you need more inspiration, click here for our Top Of The Bots celebrity photo gallery.

LIPOSUCTION – SURGICAL

Anyone experiencing disproportionate deposits of fatty tissue in the buttocks and thighs is suited to liposuction (barring, of course, contra-indicating health conditions).

It may also be useful in minimising the appearance of cellulite and dimpled skin.

Before and after liposuction by Dr Steve Merten, Pure Aesthetics

A major area of concern is at the top of the, where excess tissue produces a squarish shape, rather than a feminine curve.

The 90-minute procedure is performed under either general anaesthetic or twilight sedation in a sterile environment in a doctor’s rooms.

The latter allows the patent to move around and gives the surgeon greater access to the areas being treated.

A fluid is injected to dissolve the fat, which is then sucked out through tubing connected to a cannula.

Patients will need to take up to one week off work and will be required to wear compression garments day and night for a few weeks to assist with swelling and bruising. Any pain and discomfort can be managed with prescription or over-the-counter oral pain relief.

Within a few weeks the areas will take on a more sculpted and shapely silhouette, which will last as long as a healthy lifestyle incorporating sensible diet and an exercise program is maintained.

Ballpark Cost: From $4000.

IONITHERMIE – SPA TREATMENT

Ionithermie treatments are suited to anyone wishing to reduce the appearance of cellulite and improve skin and muscle tone, with the added benefits of slimming and detoxification.

“It is great for sculpting the thighs, hips and bottom,” says Claudia Calisto, director of Body Elite, and who brought the French system to Australia.

Before and after Ionithermie treatments

“The results are measurable with the first treatment and by the third the results are so noticeable that most women will receive compliments from their friends!”

Ionithermie can also be great for kick-starting a weight loss program, or for people who’ve lost weight but have stubborn fat deposits clinging on.

The spa-only treatment works by using two kinds of electrical stimuli, with topical application of algae and thermal clay containing active ingredients derived from plant extracts.

Without using any injections, Ionithermie penetrates deep into the cellular level, providing an effective total-body cellulite and sculpting treatment.

There is no downtime and results of up to 20cm reduction in measurements have been reported, with a marked reduction in the appearance of cellulite.

The benefits should be maintained with daily body-brushing and application of specialised at-home products.

Ballpark Cost: A package of 5 treatments, with home care products and a nutritional consultation, costs around $1200. Home care kits start at $195 and refills are available.

BUTTOCK LIFTING – SURGICAL

“Many people find that after significant weight loss their skin has lost elasticity and the ability to shrink back,” says plastic surgeon Dr Robert Drielsma, of Sydney Cosmetic Plastic Surgery in Bondi Junction.

“Excess skin is an unwanted by-product of weight loss but the good news is body contouring surgery can improve the way your look and feel.”

Dr Drielsma says that ideal candidates for buttock lift surgery are people who:

• Have loss of skin elasticity in the buttock area due to extreme weight loss or ageing
• A saggy appearance in the buttock area due to weight fluctuations, extreme weight loss or ageing
• Buttocks that appear asymmetrical

You are ready for surgery if:

• Your weight has now stabilised
• You are healthy and activE
• You have a realistic expectation of what buttock lift surgery can do for you.

“An outer thigh and buttock lift can be done as part of a body lift procedure or as a single procedure to improve the contour of the buttock and make it look more rejuvenated and perkier,” says Dr Drielsma.

“A buttock lift raises and tightens the skin over the buttocks. Other buttock contouring procedures include buttock implants which, just like breast implants, add volume to the backside, and liposuction to shape the buttocks by removing excess fat.”

How long does it take? A buttock lift typically takes around 3- 4 hours under a general anaesthetic; longer if its performed in tandem with other lower body contouring such as implants or thigh lifting.

Is it painful and what is the downtime? Pain following any surgery depends on the individual’s personal tolerance for pain. Mild discomfort is managed post operatively with oral medication. Recovery and care following surgery depends on the procedures performed, however you can expect to spend several nights in hospital and be limited in your physical activity for a short period of time following surgery as your body recovers.

Patients usually return to work within 2-4 weeks. Heavy lifting and vigorous activity needs to be avoided for up to 6 weeks.

What about scarring? It depends on the extent of lifting. With a body lift, a scar line runs low around the lower abdomen area and around the hips to the midline of the back.  With a lateral thigh and buttock lift, the scar line is shorter from the sides to the back. The lines are designed to fit in an aesthetic way to the shape of the body.  Scars fade surprisingly well over time and long term are not an issue.

Ballpark Cost: Again, costs depend on the extent of surgery and so cannot be estimated prior to consultation.  Costs are made up of surgeon’s and anaesthetist’s fees and hospital costs. Some Medicare rebates apply and if you are in a private health fund, part or all of the hospital costs may be covered.

BODY TITE – SURGICAL

Procedures to zap fat can sometimes create as much of a problem as the one it treated – without the extra “padding”, there’s the risk of being left with a whole lot of loose skin.

Body Tite promises to address both fat and skin using a technology called RFAL, or Radio Frequency Assisted Liposuction.

In addition to fat reduction, which is said to be gentler due a pre-heating process, Body Tite uses the oscillation of radio frequency to essentially “shrink” skin into a tighter state.

Traditional liposuction doesn’t address slack skin, which may be an issue for people who’ve experienced the stretching that comes with weight fluctuation or pregnancy, or the loss of elasticity with age.

Before and after Body Tite, by Dr Jospeh Ajaka

“Body Tite uses radiofrequency to melt fat, tighten skin and stop bleeding, thus causes less bruising and allows a quick recovery time,” says cosmetic surgeon Dr Joseph Ajaka, of Sydney’s Cosmos Cosmetic Clinic.

The system can be used on most of the areas that traditional liposuction is performed, such as the hips, buttocks, thighs, arms and neck and “is very useful for tightening of the skin post-pregnancy and for treating `tuck shop’ arms,” adds Dr Ajaka.

A patient is given light sedation, followed by a small incision and the injection of a numbing solution into the area to be treated.

A cannula is then passed under the skin which has an external probe to measure the temperature of the skin to ensure uniform energy delivery throughout the treatment area.

The doctor delivers radiofrequency into the area until he/she feels it has melted enough fat and tightened the skin. The procedure takes between one and two hours. Some swelling and a feeling of tightness in the skin is to be expected and the patient is asked to wear a compression garment for a week afterwards.

Dr Ajaka says the system is quicker than laser-assisted lipolysis “and may be more effective for skin tightening.

“Patients see optimum results for their body shape in 6 weeks and 3 months for the skin tightening.”

Ballpark cost: Between $3-$12,000 depending on the size of the area(s) to be treated.

ALMA ACCENT XL – NON SURGICAL

Accent body contouring is a non-invasive procedure using a radio frequency (RF) device to give the abdomen a flatter and smoother profile, slim the hips, thighs and buttocks and firm the upper arms without incisions, pain or downtime.

A handheld device is used to apply deep thermal heating to the fat bundles to bring about new collagen formation and shrink fat cells. It also stimulates circulation, which helps drain trapped fatty deposits and toxins.

Before and after Alma Accent XL treatments

“The Alma Accent XL has been our preferred skin tightenting and skin resurfacing technology for the past 12 months,” says Dr Philippa McCaffery of Clearskincare clinics.

“It is easy to use, the results are consistent and our staff and clients love it. The treatments are comfortable with a combination of local anaesthetic and skin cooling.

“Downtime is generally 1-2 days, a much more do-able option for most clients than 71-10 days downtime with fractional CO2 laser.”

Depending on the area, treatment may take 15-45 minutes. Patients will see an immediate visible improvement, but results are cumulative over ensuing months.

Generally, no more than 5-7 treatments at 2-week intervals are required.

Ballpark Cost: Prices range from $250-$350 per treatment.

BUTT BLASTERS – EXERCISE

If you can’t get to a gym or class, Blake Worrall-Thompson, owner and director of Ministry of Wellbeing (1300 80 40 92), has devised some butt blasters to do on your own:

• Glute Bridges: Lying on your back with your knees bent and feet flat on the floor push your bum up and squeeze it at the bottom of the movement, when you come down stop just before your bum hits the ground and repeat the exercise. Set of 20
• Walking lunges: stepping out with one leg, drop the back knee towards the ground and push up with your front leg so you become upright. Then step out with the other leg  and complete the same exercise. 20 each leg.

• Hamstring tucks: Lying down with your feet placed on top of a swiss ball, pick your hips up off the ground and then tuck the ball in towards your body using your hamstring.
• Step ups: Step up on to a box or bench and step down. 20 each side.
• Side raises: Lying on your side, keeping your body in alignment lift your top leg as high as you can keeping your head, hips and feet in a straight line. 20 each side.

This routine should be completed 3 times a week and as you get stronger look to add weights to the exercises. This in conjunction with some form of cardio will give you the butt you’re looking for in 4 weeks!

It’s important that you also look at your eating. Cut out sugar (taking part in alcohol-free Dry July to raise money for cancer research will help a lot; check out www.dryjuly.com) – and the body fat will slide off you!

BOOTY WORKOUT – PILATES

Pilates is said to be the secret to Pippa Middleton’s perfect posterior. It is an exercise system focused on building strength without bulk, improving flexibility and agility, developed in the 1920s by physical trainer Joseph H. Pilates.

Pilates can involve machinery or be done on a mat, often utilising various pieces of equipment. The primary focus is on awareness of the spine, proper breathing, core strength and flexibility.

The outcome is strong and supple body, toned tummy and bottom, balanced legs and a strong back. Pilates expert Renee Scott, owner of Balance Moves studio in Bondi Beach, Sydney (02 9300 9444), has devised these bottom-firming exercises to do at home.

All exercises are recommendations only and at your own risk. See a doctor for clearance if necessary.

Pelvic lift. Lie on your back with bent knees, legs hip width apart and parallel. Start lifting your bottom toward the ceiling, slowly rolling and articulating your spine, vertebra by vertebra. Hold it at the point where the hips and shoulders are in one diagonal line. Then peel back down in the same fashion to the starting position. Focus on contracting your hamstrings and glutes. Do this 5-10 times.

Pelvic lift pulses. As above, but when you reach the upward position hold it there and add pulses, pushing your bottom a few centimetres further to the ceiling 10-20 times, then roll back down.

Pelvic lift rotations. Lift as above and then rotate through the waist to tilt one side of the body, lowering a buttock cheek to the floor. Move back up to full height and tilt and lower the other side. Repeat 5-10 times.

Side kick leg series:

1. Lie on your side so that your body is in one line, from tail bone to head. Have your knees bent in front of your body, heels in line with the bottom. Focus on keeping your torso stable and straight while moving your leg, as if you were wearing a very firm corset.  Keep your feet glued together and open the top knee to the ceiling, opening through the hip and engaging the glute (buttock) muscle, then lower. Repeat this 10 times and do on the other side.
2. Lie on your side as above, this time with the legs straight. Lift the top leg to hip height and, keeping the torso stable) move the top leg forward and back. Use controlled movements rather than “swinging” your leg, as the aim is not to move the hips but to work the glute. Do 5 forward-back moves on each side.
3. In the same position as above, lift the leg to hip height with a slight rotation of the foot and knee from the hip joint. Do 10 small circles of the leg in each direction and then turn to the other side and repeat.

Plank on the elbows. Roll onto your stomach and come into a plank (see picture above). You can stay on your knees or move to the full position on your toes. Focus on drawing in your stomach to the lower spine, like you were doing up a tight belt. Keep your shoulders away from your ears, which will make your back muscles work harder, and squeeze your glutes. Hold for 30-60 seconds. Repeat several times if you wish.

It just goes to show that even if you have a figure to die for, dimpled thighs can still be a killer. (Note to Kate: The fag dangling from your fingertips isn’t a good look, nor is smoking recommended for anyone battling cottage cheese lumps and bumps, or interested in preserving their health overall.)

But cellulite is not a disease, a condition or a syndrome. It’s fat by any other name, just stored differently.

“While many look at cellulite as a disease – a harmful build-up of toxins that must be healed – it’s no such thing,” says Sydney cosmetic physician Dr Deborah Davis. “It’s a perfectly normal and natural way of carrying fat.”

Of course knowing it’s “just” fat is no great consolation to those who have cellulite.

For many, the way it manifests on the body – on hips, thighs, buttocks, knees, abdomen and even arms – in cottage cheese-like lumps can seem a scourge as debilitating as an illness.

Affecting up to 85 per cent of women at some time, in some way during their lives, doctors know that cellulite can be genetic and most believe there’s a strong hormonal component to its development.

Fatty tissue gets caught between layers of connective tissue. The tissue hardens, which causes the lumps or dimples that are characteristic of cellulite. While healthy diet and regular exercise can certainly help improve its appearance and keep cellulite under control, it’s not a fix.

Nor are surgical fat reduction methods like liposuction.  “You might think that if cellulite is just fat, liposuction is just what you need,” says Dr Davis, of Sydney’s Heber Davis clinic. “But that’s not the case. In fact, liposuction can actually make cellulite look worse.

“The problem is that liposuction can really only get at fat that’s deep down beneath the skin. Cellulite is generally too close to the surface for liposuction to help.  As well, since it’s the fibrous bands that really give cellulite its appearance, getting rid of fat alone doesn’t really achieve much.”

Indeed, there is no “cure” for cellulite – though the quest rages worldwide among medical and scientific boffins – but certainly there are better than ever means of significantly reducing it, with an array of sophisticated clinical and salon procedures, and potent home products.

THERMAGE

The new Thermage CPT claims to smooth out the puckering caused by cellulite by zapping the skin with capacitive radiofrequency (CRF) energy.

The heat from the energy penetrates deep into the skin, breaking down and shrinking the undulating fat cells responsible for cellulite’s formation.

“Additional improvements with the new Comfort Pulse Technology including pressure and heat sensors at last make it a truly safe procedure,” says Dr Garry Cussell, of Sydney’s Facial Rejuvenation Clinic.

“Done correctly, there is absolutely no downtime. There is no redness, swelling, peeling, pigmentation concerns or skin burning or pitting – as have been reported with some of the older machines and other types of radiofrequency skin tightening.

“The addition of the new vibration technology with the CPT machine is what enables increasing energy to be delivered deeper into the skin, thus providing increased tightening and effectiveness. The comfort pulse technology enables us to go 25-30 per cent deeper in a treatment than previously. This of course translates to better results for our clients.

“As you age the quality, elasticity and strength of your collagen changes, causing your skin to sag, and lose its firmness and tightness.

“The Thermage CPT is excellent at lifting and tightening all loose skin as well as significantly improving areas of fat and cellulite – in particular we are getting excellent results on the face, around the upper neck and jowls, and slimming and lifting the facial contours. On the body it improves areas important to most people – especially the buttocks, upper thighs and upper arms.”

The Thermage body procedure takes anywhere from an hour to 90 minutes, and you can return to routine activities right after treatment.

Most people require only a single treatment, although full results may not become noticeable for several months. Treatments cost around $3000-$5000 depending on areas treated.

IONITHERMIE

This technology works by using two kinds of electrical stimuli (galvanic and faradic) with a conductive, thermal masque – of  algae and clay containing active ingredients derived from plant extracts – to penetrate deep into the cellular level where cellulite resides.

Developed over seven years of clinical research and safety testing by French biochemist Oliver Fouche, Ionithermie launched in France in 1979.

As well as targeting cellulite, the system improves skin and muscle tone, with the added benefits of slimming and detoxification.

It is highly recommended for spot reduction (thighs, abdomen, love handles, hip, upper arms) and as a kick start to a weight loss program.

The manufacturers of Ionithermie say more than a million treatments are performed annually worldwide and is used in spas, salons in over 80 countries.

To make an appointment at a salon near you, contact Claudia on 0433 722 639 or email info@bodyelite.com.au.

ULTRASHAPE

This one of the few technologies that has scientific evidence to prove it works as advertised, according to Sydney plastic surgeon Dr Mark Kohout, using “focused ultrasound to break down the fat cells under the skin surface. Many other technologies sound good in theory but have not been proven in human subjects.

“The best results are in women with relatively normal body weight but a couple of bulges that are difficult to reduce with diet and exercise. We recommend four treatments spaced 2 to 4 weeks apart

“You feel a sting as the ultrasound is delivered, and there is a warm glow after treatment for about an hour.”

Depending on the size of the area, each treatment can cost between $250 and $900.

ENDERMOLOGIE

A “deep-massage” approach to body-contouring, Endermologie uses a device that suctions the skin with a vacuum and kneads it with a set of rollers.

It was developed in the 1980s in France to treat the scars of burn victims, who began to notice improvements in their cellulite as well.

Endermologie was the first treatment approved by the US Food and Drug Administration (FDA) to allow the claim of “temporary reduction of cellulite”; it also reduced body measurements, increased circulation, relieved muscular pain and spasms.

In addition to the targeted areas, Endermologie treatments can help increase lymphatic flow and help promote better circulation throughout the body.

Usually up to 14 initial treatments are necessary, once or twice a week, to achieve optimal results, with monthly visits for maintenance. Treatments are around 30 minutes. Reputable salons offer packages costing around $1200-$1500 for these initial treatments.

The majority of patients compare Endermologie to receiving a very deep massage and find the treatment relaxing. The intensity of the rolling action can be adjusted to personal comfort level.

Minor, temporary bruising might occur, similar to that from a deep tissue massage.

VELASHAPE

This technology uses “infrared light, radiofrequency energy, vacuum-pulsed negative pressure and specially designed rollers that smooth out the skins surface at various points”, according to the manufacturers.

The process claims to break down hardened connective tissue in order to allow the body to naturally remove fat cells, shaping and slimming the body by reducing cellulite and circumference. It requires no incisions or anaesthetic and patients can immediately return to normal activities without side effects.

An initial series of four treatments are performed once a month, with follow-up treatments recommend to maintain results.

Although non-invasive, the rollers may cause bruising in people with sensitive or fragile skin. Those with pacemakers or implanted metal in the treatment area are not suitable for treatment.

HYPOXI

In a nutshell this requires being strapped into an airtight chamber that looks like a bit like a giant nutshell with bike peddles. You peddle away on these for around 30 minutes, in order to keep your blood flowing in the lower half of your body.

It targets buttocks, knees, thighs and stomach to help smooth and reduce those areas.

“Obviously in our line of work we’re inundated with products and treatments that claim to reduce cellulite, eliminate water retention and generally make us look 10kg lighter after only one session or a week’s worth of application,” says Yasemin Turker, Editor in Chief of our sister site, Primped.com.au, who tried the regime.

“Hypoxi, however, is not one for making extreme claims and failing to deliver. And, with every 30-40 minute session, you have to peddle your way to looking slimmer and smoother. None of this sitting around doing nothing. business. You have to work for it.”

Dr Norbert Egger, who created Hypoxi, realised that if you could stimulate blood flow to a specific area of the body, your fatty acids would metabolise faster in that area, making you lose weight and reduce cellulite more effectively. And that exercise was key to speeding up the process.

“Hypoxi recommends you take 12 sessions. This could be twice a week for 6 weeks or 3 a week for 4 weeks,” says Yasemin. “The hardest part for me was to have no alcohol or carbs for at least 4-6 hours after Hypoxi training. “After peddling away for 4 weeks for 30 minutes at a time, I’d lost 5.5 cm off my stomach, 3.5cm off my hips, 3.5cm off my contracted leg and a total of 22.5cm off my entire lower half.

“As well as the numerical measurements, I noticed a huge change in my skin tone: it was definitely smoother, less bumpy.”

Hypoxi starts from around $69 per session, or $690 for a course of 12. Prices may vary slightly from location to location. For more information call 1300HYPOXI.

MESOTHERAPY

Developed by French doctor Michel Pistor in 1952, mesotherapy involving a series of injections of homeopathic medications, vitamins and natural extracts into the mesoderm (the middle area of the skin), directly affecting the fat pockets. It claims to break down fat and flush it away during the body’s natural metabolic processes.

Mesotherapy is widely practiced in France and proponents of claim that it is the only truly effective method for treating cellulite, although there is no scientific evidence to support this.

A series of around 10 treatments costing about $2000 is required and results are said to be permanent, as long as the patient does not experience a significant weight gain.

The technique should be performed by a medical doctor and patients should know exactly what substances are being injected.

LIPO DISSOLVE

This is a safe and effective method for the reduction of unwanted fat, says Dr Deborah Davis. If you are a relatively fit individual having trouble reducing fat in specific areas, then Lipo Dissolve may be just what you are looking for. The treatment injects a combination of substances such as enzymes, vitamins and phosphatidolcholine (a natural soy substance) into the unwanted fat pockets in order to melt them away. This injection increases fat metabolism which allows for the efficient break down fatty deposits in order to naturally absorb and remove them from the body.

It is not a weight loss alternative but simply helps “receptive” individuals remove excess pockets of fat that will no longer be reduced by diet or exercise.  The injections will help with the natural metabolic process of breaking down and removing fat cells from the body.  About four treatments will be needed for successful results and patients will receive these treatments every four to six weeks. Each series of injections costs around $350 and as many as six sessions may be required, 4 to 6 weeks apart.

Try this at home …

BEAUTY MOUSE

A gadget that looks like a computer mouse, embedded with 480 ultra-fine micro needles and a rolling width of 50mm, meaning you can cover larger body areas quite quickly. The device is designed to be rolled over cellulite-prone areas, helping to stimulate microcirculation and to deliver active substances into deeper layers of the skin.

It’s targeted at anyone who suffers from cellulite and lack of body firmness and claims firmer skin in four weeks.

Manufacturers recommend that after showering, on clean skin, you apply the accompanying Dermaquest Dermafirm anti-cellulite cream to problem areas and roll the Beauty Mouse over the top. As the needles are 0.2mm in depth, the process of penetrating the top layer of the skin, creating micro-channels to allow substances to gain deeper access in the skin, is painless.

“Due to the large amount of needles involved, we advise that people use the device only once a day,” says Sean Abel, of Beauty Mouse distributors Clinic Care. Use of the Mouse is said to achieve firmer skin in four weeks.

Beauty Mouse is $285.  As continued used will lead to the needles getting blunt, aim to replace every six months if using year-round. Dermaquest DermaFirm anti-cellulite cream, $150, is available at selected beauty and cosmetic clinics or call Clinic Care on 1300 799 709.

The foods you eat, as well as the way you eat and digest them can cause the stomach to swell, making you look and feel fatter even though your weight is not actually the issue.

Bloating is defined as the abnormal swelling of the abdominal region due to gases. Not only can bloating be uncomfortable, even painful, but a cause of much embarrassment in the form of flatulence.

By adjusting your eating habits and being more alert to the “triggers” that cause your belly to bloat, you could find it “deflating” by a dress/pants size or more, even overnight.

If your issue is indeed belly fat, your approach needs to be longer term, whether through diet and exercise, clinical treatments that literally melt felt or, in more extreme cases, undergoing surgery.

It’s not just a matter of appearances. The particular type that accumulates in the abdominal area is called visceral fat (better known to us as belly fat). This fat is metabolised by the liver, turning it into cholesterol and circulating that through the blood, resulting in a dangerous plaque build up and consequent narrowing of the arteries. The more visceral/abdominal fat you have, the more likely you are to suffer heart disease, diabetes, stroke and hypertension.

Depending on the size of your problem, you may see results in as little as a week and certainly a month. Here are 20 ways to be belly flat (in no particular order of importance):

1. What Goes In Must Come Out. Too little fibre and fluid in your daily diet, a sedentary lifestyle and some prescription medications and painkillers can cause constipation. Which can cause bloat and a whole host of other nasties. “People who do not go to the toilet properly are therefore holding kilos of poo,” says colonic therapist Leanne McGraw, of Release Colonics, Newtown, Sydney. “We eat three times a day and should go to the toilet just as many times, but virtually no one does this, so we can end up to holding 3-10kg of extra weight in excrement,” she adds. “Many people eat well and exercise, but they still hold onto these waste products. To get rid of this build-up I recommend regular colonics – once a week or fortnightly – to ensure the gas and bloating is eradicated and the kilos are dropped.”

2. Don’t Be Intolerant. Food allergies are usually easy to identify – at best, the afflicted person may break out in a rash or swell up; at the extreme end of the spectrum they may have difficulty breathing, even go into shock and need urgent medical treatment.

Food intolerances are more insidious, causing digestive upsets (bloating among them) and a general malaise.

Self-diagnosis of food intolerances – especially to wheat, gluten and lactose – has become very “trendy” and many people unnecessarily eliminate healthy dairy and whole grains from their diets.

If you have persistent bloating or digestive disturbances that you suspect are due to an allergy or intolerance, it is important to see a doctor or qualified health professional for a proper diagnosis.

If the problem is recent, you might benefit from reducing the amount of the “suspect” food and/or eating it with other foods. In the case of dairy, it can help to choose aged cheeses and yogurts, which are lower in lactose.

3. The fibre of your being. To get your body into a better digestion/elimination rhythm – thus weight loss mode – a good start is to eat a diet high in soluble fibre (25gm daily for women and 38 for men). Get this from whole grains, fruits, vegetables, legumes (also known as pulses, including dried peas, beans and lentils), nuts and seeds. When increasing your intake of wholegrains, like brown rice, be sure to drink plenty of water and not to neglect your good fats. Add a little olive oil to your brown rice or to the accompanying meal. But make sure that you are not overeating fibrous foods like cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, kale, cabbage, and bok choy) and legumes (which contain an indigestible carbohydrate called raffinose) as they can themselves lead to bloating over time.

4. Gas traps. Not only can certain foods (as above) contribute to bloating and flatulence, the way we eat and drink can lead to the same result. Some suggestions for avoiding gas build-up:

* Eat slowly, chewing every mouthful thoroughly before swallowing and do not slurp your drinks. In this way you can prevent pockets of air entering your digestive tract.

*Avoid talking while chewing; save the chat for between mouthfuls. Apart from the fact it’s way more polite, you can also avoid swallowing air.

* Avoid eating hard lollies, chewing gums and drinking fluids with a straw.

* Reduce your intake of carbonated drinks (ideally cut them out of your diet). They tend to add to the amount of gas in your body.

* Identify triggers. Keep a diary of what seems to cause bloating and try to avoid it. Fizzy drinks, acidic foods, spicy foods and caffeine are common culprits.

5. You’re Sweet Enough. Jorge Cruise used to be 18kg overweight. Today he is internationally recognised as a health expert for busy people and is the author of three consecutive New York Times bestselling series with more than five million books in print, including his latest, The Belly Fat Cure (Hay House, RRP $29.95, available at leading  retailers. Visit www.hayhouse.com.au for more information).

“For years, experts have told you that you’re overweight because you eat too much and don’t exercise enough,” he says. “They were wrong. The truth is that you are eating too much sugar.

“Here’s a fact: we consume more than 47 teaspoons of sugar each day – that’s about 189 grams a day. Research has shown that before the Industrial Revolution, around 200 years ago, daily consumption of sugar was some 15 grams.”

This sugar is not just the crystals in a bowl we stir into coffee or sprinkle over cereal, or the overload in chocolates, lollies and soft drinks. It’s contained in a wide range of naturally-occurring and processed foods from fruit and fruit juice to honey and syrups, white bread (including any bread with white flour), all but wholegrain pasta, white rice, white flour and products made with it – eg. cake, cookies, doughnuts, bagels and muffins – potatoes, products with added sugar (eg. canned fruits in syrup), jams, jellies, salad dressings and sauces with added sugar and sugar-cured meats (ham, for instance, is often cured with salt and sugar).

“Sugar consumption can lead to a condition known as `insulin resistance’, which by itself drives up insulin levels and keeps them up,” says Jorge. “Insulin is produced by your pancreas to manage your blood sugar and control the accumulation of fat, especially around your waistline. Increased levels of insulin will make you fat and make sure you stay fat.

“Various breakthrough studies done at Harvard University over the past decade have clearly shown that the main reason you have `belly fat’ is that you’ve been eating too much sugar and processed carbohydrates, which keep your insulin levels chronically high – not because you’ve been eating too much fat or protein. It’s that simple.”

6. Don’t fake it. “Many of my patients suffer from bloating because they consume too much sugar alcohol in artificially sweetened foods and drinks,” says dietician Dawn Jackson Blatner, a spokesperson for the American Dietetic Association and author of The Flexitarian Diet. Experts recommend consuming no more than 2-3 servings per day of artificially sweetened foods and drinks.

7. Protein power. The importance of protein for healthy weight loss is huge. Not only does protein help to build muscle and boost metabolism, it also fills you up and curbs your appetite. Choose good protein that is low in fat, such as egg whites, broccoli and tuna canned in water or brine, cottage cheese and lean organic chicken or meat. Remember, protein should be supplemented by some carbs, (good) fats, lots of vegetables and some fruit.

As proteins – and fats – satiate your hunger fast, it’s almost impossible to overeat them. “My top pick for proteins are almost always lean meats,” says Jorge Cruise. “My top picks for fats are those that come from egg yolks, raw butter, extra-virgin olive oil, flax oil, or fish oil – and never dangerous hydrogenated oils.”

8. Too much of a good thing. It might be that you think that “little bit extra” every day won’t make a difference, or you’re simply not aware of the unnecessary kilojoules you’re consuming. It all adds up – to a lot of unnecessary kilos. Take cappuccinos and lattes. In 1940 Australians consumed just 500g of coffee a year, but by 2002, we were knocking back 2kg of it – and all the milk, and perhaps sugar, that goes with it. Weigh up how many you actually need each day and and opt for the light milk version. Just by switching, you can save you about 315kJ each cup, which equates to a saving of about 3.2kg of weight each year.

Beware “little” extras. “What seems like nothing for one day can be a lot over the week,” comments Susan Alexander. “Remember a large latte or muffin can have more kilojoules than a small meal!” If you think fruit juice is fine, Susan recommends squeezing orange juice until your glass is full. “A glass of juice has all the kilojoules from all the oranges used, but you would never eat that many whole fruit at once.”

9. Diet delusions. Things that seem to be taking care of your waistline could actually be sabotaging it, says Susan Alexander, accredited practicing dietician of Alexander Dietetics. “Be very careful with foods marked ‘lite’ or ‘low fat’ as these often contain more sugar and total kilojoules than full fat items,” she says. Susan adds many high GI foods are popular, such as watermelon and rice crackers, and these are often over-eaten. “Over-consumption of these foods is turned to fat anyway, if not used immediately for energy. Another problem can be ‘diet’ biscuits and snacks, which offer little nutrition.” Other things to look out for are frozen yoghurt as a substitute for ice-cream, fast food salads which may have fatty dressing or have bread, cheese and bacon bits added. Nuts, dried apricots and banana chips can be deadly if eaten in large amounts – also protein bars which can have a high fat and kilojoule count. Instead, take a leaf out of the book French Women Don’t Get Fat. Be like the French and eat a little of what you desire, rather depriving yourself of tasty morsels and then having a big blow-out, says author Mireille Guiliano. Eat for pleasure, not for punishment.

10. Don’t tipple over. We love our drinks, especially during summer and the festive season. Make sure you’re not drinking too much and be careful to choose low-kilojoule alternatives. A standard sized white or red wine (100ml) is worth around 300kj – so make sure the glass sizes aren’t any bigger. A nip of spirits (45ml) is about 440kJ, so just be certain to add low-kilojoule mixers such as mineral or soda water to your liquor. Juices and full-strength soft drinks add many more kilojoules. A glass of Champagne (120ml) is about 355kJ, so keep to one toast! And beware creamy, kilojoule-laden cocktails.

11. Hormone havoc. “Sometimes reproductive hormones get out of balance, sometimes due to polycystic ovary syndrome,” says natural therapist and herbalist Jennifer Chalmers, co-director of Phoenix Holistic Centre in Sydney’s Bondi Junction. The balance between oestrogen and progesterone may be disrupted for a whole range of reasons. “When oestrogen is allowed to dominate and be out of balance, weight gain is a common consequence.”

Also check your thyroid. Says Dr Michael Elstein, of Sydney’s Eternal Health Medicine Centre, and author of You Have the Power (Merit Publishing, $24.95), your thyroid makes you burn fat and regulates metabolism. An underactive thyroid, known as hypothyroidism, reduces the capacity of the thyroid to burn fat, which may slow you down and be responsible for weight gain. He adds, “If you are putting on weight, have cold hands and feet, feel sluggish and slow and are losing hair, it may be worth seeing a doctor and having a proper evaluation to see if your thyroid is working properly.”

Have you diabetes? Make sure you’re not predisposed to diabetes type 2, as this may mean you gain more weight overeating over the short term, than non-genetically prone counterparts. According to at 28-day study undertaken at Sydney’s Garvan Institute of Medical Research, in which scientists mimicked the overfeeding that typically takes place during periods like Christmas, people with a family history of diabetes gained over a kilogram more than the rest who had no family history of diabetes, (3.4kg as opposed to 2.2kg).

12. Pass On The Salt. It helps the body in water retention but retaining too much fluid can make you look fatter. Cut down on the intake of salty foods, especially salty processed snacks and fast foods. And when combined with alcohol, the problem is escalated. “ We often hear people complaining they have put on a kilo, even 2kg in one evening after a lapse in their diet,” says Dr Pierre Dukan, the Paris-based nutritionist and author of international best-seller The Dukan Diet (Hodder & Stoughton, rrp $35). “When we analyse what was eaten we can never track down the amount of food to provide thos extra kilos. It was simply the combination of an over-salty meal and drinks; salt and alcohol combine to slow down the throughput of water drunk.

“Never forget that one litre of water weighs 1kg and two teaspoons of salt are enough to retain this water in your body’s tissues for a day or two”.

13. Get Moving. As much as some exercise equipment companies would like you to believe, you cannot reduce the belly bulge by spot reducing. This also means exercises targeting the belly area such as sit-ups, or pilates core work will not decrease visceral fat. What they will do is firm and tone the muscles that won’t actually be visible until the visceral fat is reduced.

A good cardio workout of 30-60 minutes a day, at least five days a week, is sufficient to improve your digestion and get your metabolism pumping. Walking to and from work 20-30 minutes in each direction or cycling is an excellent way to get trim and healthy fast. Jogs are another great option and a good way to de-stress.

Hint: If you cycle, walk or jog moderately BEFORE breakfast, you are calling upon stored fat for energy.

Increasing muscle will increase your metabolism and fat burning will be far more efficient. Remember, strength training for woman does not mean you will build muscle like a man – it will not only boost metabolism but create a shapely figure and contribute to bone density.

And don’t overlook the power of “incidental exercise” … instead of taking the lift or escalator, try to walk up stairs. Don’t grab buses or taxis if you can walk – plan ahead and go a little earlier so you can get there on time. Use a bicycle when possible. Remember cars are choking up the environment! Do your own housework and gardening, and don’t just watch your kids play – participate.

While exercise isn’t necessarily everyone’s favourite pastime, it shouldn’t be gruelling or unpleasant.

14. Water works. Drink plenty of water, six to eight glasses a day being a good benchmark. The increased water intake will assure the body of habitable situation, and the body will release excess of water from its cells. It also helps digestion and elimination. Try a glass of warm water with a squeeze of fresh lemon or lime juice when you wake up, to kick start the day and your bodily functions. Don’t count in your recommended daily fluid intake things like soft drinks, fruit juice or alcoholic or caffeine beverages (the latter two actually dehydrate you – you’ll need more water to balance them out!).

15. Saturation point. Fluid retention can make you look heavier and reflect as extra kilos on the scales. It can be either due to too much salt in the diet (causing the body to retain water along with it) or, ironically, dehydration. When you don’t drink enough water your body goes into “starvation” mode and stores water in its cells for future use (much as it reacts to a crash diet).

“Day-to-day fluctuations in weight are usually caused by changes in the fluid balance in the body,” says Jennifer Chalmers. “Severe fluid retention can indicate serious conditions with the liver and kidneys, but most fluid retention is due, surprisingly, to dehydration.” The answer is to drink more water and watch the sodium (salt) in your diet.

“Take vitamin B6 daily. It acts as a natural diuretic (substances that increase urine flow). It will help the body to flush out excess of water. Make sure that your intake is not more than 100mg in a day as the over intake of diuretics may make the body deficient in water content.”

Another tip is to fill a bath with lukewarm water and soak for fifteen minutes. This helps the body to lose its excess water content, and hence reducing bloating.

16. Put The Freeze On Fat. Doctors trialling a new technology that harnesses the chill factor to beat stubborn fat bulges say it is showing the most promising results yet. Non-invasive body contouring systems have flourished in Australia over the past few years. While it’s early days, CoolSculpting by Zeltiq is different, according to Dr Jeremy Cumpston, of Ageless Clinics in NSW.

“CoolSculpting has been developed by the same Harvard University team that developed laser hair removal and fractionated laser skin rejuvenation ( Fraxel ) laser technology,” he says.  “The results out of Harvard clinical trials have been groundbreaking in that the vacuum-based procedure managed to reduce fat cells by a minimum 22-25 per cent per treatment per area.  This is without needles, without surgery, without anaesthesia.

“Unlike most other [fat reduction] therapies, the device does not shift fluid from between the fat cells which simply re-accumulates. Nor does it involve painful and invasive needles. It causes real cellular change to the targeted tissue that results In fat cells undergoing apoptosis – accelerated cell death.

 “The response in my practice across six clinics in NSW has been enormous. We are booked out with both treatments and consults in all our regional clinics and we are near capacity with our Sydney clinic.”

It is not for everyone, however, notably those who are significantly overweight.  “It is perfect for people who have bulges that, despite healthy eating and exercise, they are unable to shift,” adds Dr Cumpston. “It is important that the potential clients are assessed by a physician before undertaking CoolSculpting for this reason.”

 17. Don’t Stress. Scientific research has shown that stress can contribute significantly to bulkier bellies. “It’s due to Cortisol, a hormone released from adrenal glands called,” says Stephen Eddey, Principal of Health Schools Australia. “When the levels are too high, it encourages fat gain around the waist.

“Cortisol is released when the body is undergoing stress. When it is increased, the so-called “sex hormones”,  or “slimming hormones” -  Progesterone,  Testosterone and  Oestrogen – are reduced”. 

A better diet and particularly more exercise will help decrease your stress levels.  Take time out for yourself and tap into the benefits of healing pursuits like walking, yoga, swimming, meditation, massage, aromatherapy and acupuncture.

18. Menopause. Women at menopause often experience weight gain, especially around the stomach. This is often due to declining oestrogen levels and loss of muscle tissue. As the muscles decrease in size, the metabolism slows down. To pep up a flagging metabolism and build up muscles, the Victorian Government recommends a low fat, high-fibre diet, regular and sustained aerobic exercise, weight training or weight bearing exercise.  See a doctor for a full assessment of your condition before embarking on a treatment program.

19. Trust the good guys. The use of probiotics (“good” or “friendly” bacteria) can help neutralise gas caused by over-population of “bad” bacteria. Probiotics can be found in capsule, liquid, powder or tablet form and in cultured dairy products like yoghurt. Acidophilus drinks (such as Yakult) can be found in supermarkets and health food stores. Once ingested, probiotics colonise the intestines to suppress the growth of potentially harmful bacteria, improve immune function and enhance the protective barrier of the digestive tract.

“Prebiotics” are also thought to improve the balance of probiotics in the intestines. They are non-digestible carbohydrates that stimulate the growth of beneficial bacteria in the intestines. Sources of prebiotics include fructo-oligosaccharides (FOS) and inulin, found in onions, asparagus, chicory and banana. FOS is also available as a supplement and is sometimes combined with probiotic dietary supplements.

Some studies suggest that peppermint tea, ginger, pineapple and parsley may also help reduce bloating.

20. Leave it to the experts. Bloated bellies could be part of a bigger problem, such as irritable bowel syndrome (IBS), or an even more serious condition like Crohn’s Disease or forms of cancer. If bloating is a persistent problem it is wise to see your GP for a thorough check-up. He or she may prescribe medications such as antispasmodics if IBS is diagnosed, or recommend further tests to expose any other underlying causes.

You can fake a good appearance with make up but radiance is the ultimate sign of truly natural beauty and, of course, good health. But, as we head into the holiday season, a year of hard work and stress can put the dimmer switch on the sort of glow that seems to beam out of every pore.

So here’s 15 ways to make people wonder of you’ve just come back from a long, restful vacation even before you go.

1. Lustrous Lather

Many women exfoliate their faces regularly but don’t realise that dead skin cells can also leave the rest of their body looking dull and tired. Scrub up with a good body polisher. Try: Premium Spa Frangipani & Coconut Sugar Body Scrub, $14.95* (* all prices quoted in this article are recommended retail only).

2. Brush On Health

Using a bronzer that just leaves your skin looking brown can be worse than staying pale. You need a pink edge to a powder to achieve a healthy glow. Clinique Fresh Bloom Allover Colour, $59, combines three powder shades to create a soft, luminous glow. Use all over the face or on the cheekbones.

3. Slick and Sexy

Body lotion is great for moisturising and making your skin soft to touch. But if you want people to see a sexy glow – use a body oil. Not one that leaves marks on your clothes, though. Kiehl’s Superbly Restorative Argan Dry Oil,  $70 (call02 9931 8888), can be used on the face, body and hair to protect, smooth and boost shine and radiance. The hero ingredient is fair-trade organic Moroccan Argan oil, combined with Vitamin E, organic sesame oil, patchouli, eucalyptus and cedarwood.

4. Cell Turnover

Real glow comes from light reflecting off the skin and that won’t happen if your face is covered with dead skin cell build-up. For almost professional mini-peel results at home, Olay Regenerist Thermal Skin Polisher, $19.99 (from supermarkets, mass retailers and pharmacies) is a self-heating, exfoliating product that combines the power of micro-crystals with moisturising ingredients to cleanse and polish the skin without irritating it.

5. A Good Foundation

A change of seasons, hormonal ups and downs and lack of sleep can all affect the appearance of the skin. During summer glaring sunlight can make a foundation that looked fine in winter appear mask-like, so you really need two foundations – sheer for day and a creamy one for night. One of the best bases for anyone with an active lifestyle is Clinique Superfit Makeup Oil-Free Formula, $49, which contains a new technology – Aerogel – which looks super-natural and allows the skin to breathe even when you are exercising. At night smooth on Maybelline New York Dream Liquid Mousse Foundation, $21.95, containing elastomers mixed with moisturisers to smooth the skin’s surface.

6. Brighten Up

Many moisturisers target uneven skintone but increased radiance also stems from increased blood flow to the skin’s surface. Clarins HydraQuench Cream for Normal to Dry Skin, $78, strengthens the blood micro-circulation for added glow, in addition to providing multi-layered hydration.

7. Shine On

If your face is glowing and your hair doesn’t match up, you’ve wasted your time. The Schwarzkopf Extra Care Liquid Silk range helps to moisturise and amplify the natural shine of your hair by smoothing the surface of each strand. Kick-start the process with Liquid Silk Shampoo and Conditioner (both $6.99) and add extra lustre with Liquid Silk Gloss Instant Repair Treatment, $7.99. If your hair is dry and brittle, reach for Liquid Silk SOS Repair Treatment, $7.99.

8. Take Your Vitamins

Vitamin C isn’t good only for colds. This powerful antioxidant also protects the skin against damaging free radicals and clarifies your skintone. Revlon’s Absolute C Radiance skincare range offers maximum results with six products – Creamy Cleansing Foam ($22), Eye Gel Essence ($27), Moisture Cleansing Milk ($22), Moisture Creme ($32) Moisture Lotion ($32) and Moisture Toner ($22).

9. More Moisture

Only a well-hydrated face looks radiant. That doesn’t mean simply using the right face cream. If you use too harsh a cleanser, you risk undoing all the good work of your moisturiser. Avon Anew Ultimate Age Repair Cream Cleanser, $34.99, is a luxuriously creamy, anti-ageing cleanser that leaves over-40s skin radiantly clean.

10. Eyes Bright

If lines and wrinkles are making you look permanently tired, switch to an eye cream that deflects attention. Burt’s Bees Radiance Eye Creme, $34.95, is enriched with royal jelly and rosehip oil to increase radiance and firmness in the delicate eye area and boost cell regeneration.

11. Night Shift

After days or weeks of sun exposure, pollution and stress, your skin needs to rest and refresh itself, too. While you sleep give the process a helping hand with Olay Regenerist 14 Day Skin Intervention, $39.99. A kit containing 14 vials, this two week specialist night treatment accelerates skin exfoliation, hydrates and reduces the appearance of wrinkles with micro-powders.

12. Shimmer Your Strands

For a special night out liven up your stresses with a spray serum with subtle hints of shine. L’Oreal Paris Elvive Nutri-Gloss Conditioning Shine Spray, $6.95, can also be used two to three times a week if you want the shimmer look to be permanent.

13. Sensitive Issues

Summer winds, sun exposure and environmental changes can roughen and redden sensitive skin which robs it of its glow. Innoxa’s Super Sensitive range will help to keep your skin calm and balanced. Choose from Creme Cleansing Milk ($17.95), Toner ($14.95) and Gentle Day & Night Cream ($27.95).

14. Body Firming

No amount of shine or glitter will hide a lack of skin elasticity. Nivea Body Contouring Cream Q10, $9.92, is formulated to firm your stomach, thighs and derriere. Iso-proteins also boost collagen in the skin’s surface to make it look more toned.

15. Close Shave

Most Australian women prefer to shave their legs rather than use depilatories or wax. But when you have to get the razor out every couple of days to keep your legs hair-free, you can easily roughen and irritate the skin if you ease a cheap razor or – ouch – shave dry. Gillette Venus Embrace Shaving System, $14.99, is the first five blade shaver for women. Don’t be frightened by the number, this is the girl’s equivalent of the Gillette Fusion for men which gives the closest and smoothest of shaves because of the close positioning of the blades. The curve-hugging blades are also surrounded by a Protective Ribbon of Moisture to remove every hair and leave the skin feeling super-smooth.

From the Australian company that developed the top-selling Photon Photo Rejuvenation home light sytem, Skin Physics Liposculpt ultrasonic body sculpting system incorporates a combination of low frequency ultrasound waves, infrared heat and microcurrent massage to target fatty deposits in problem areas.

The handheld device, designed to be used in conjunction with a specially formulated body-sculpting gel, claims with regular use to “target stubborn fat deposits, reduce the appearance of cellulite, improve overall skin tone, assist in firming and skin and toning the body”, with no pain, down time or side effects.

“Liposculpt™ uses a specific frequency of sound waves that penetrates deep into the skin in order to create sonic vibrations within fat cells,” according to Dr Curtis Crasto, Scientific Director of the Igea Group (developers of Skin Physics products).

“The chosen frequency also allows the powerful ‘fat burning’ actives in the Liposculpt gel to be efficiently delivered into the skin. They enable the breakdown of fats that are then transported away as ‘free fatty acids’ by the circulatory system or used by the body for cellular energy.

“The impact is a reduction in localised fat deposits and an overall improvement in the appearance of cellulite and skin condition.”

Ultrasound technology has been used for several years for clinical body-contouring, in systems such as UltraShape.

A non-surgical alternative to liposuction (and Smartlipo), it is designed for people who are not clinically overweight, have tried the diet/exercise route and just cannot shift stubborn fat deposits. How many treatments needed is dependent on an individual’s size and the severity of the problem areas, but the average is three and can cost close to $1000 per treatment, depending on the practitioner.

Results are usually seen after the second or third treatments, after a few weeks (when the liver has had time to break down and expel the `melted’ fat).

While there will inevitably be detractors who say a home system cannot achieve similar results (or could, indeed, be unsafe), the expense – and outlay of time – involved in clinical procedures is nonetheless beyond the reach of many people.

Dr Crasto insists with regular use according to instructions, Liposculpt (with a recommended retail price tag of $349), will achieve results comparable to those of clinical treatments – and is completely safe for home use.

“Significant clinical research has been done on ultrasound technology and its optimum safety and usage parameters,” he says. “Some of the devices used in cosmetic clinics utilise high intensity focused ultrasound (HIFU) technology and this does require a trained doctor. However, advances in ultrasound technology have made it possible to use other modalities of ultrasound that are safer.

“Due to our combination treatment method using mild unfocussed ultrasound, our at-home treatment does not have the safety issues associated with HIFU treatment. Over the long term our system can lead to impressive results without the cost and the expertise needed in the handling of HIFU devices.”
Liposculpt works in three ways:

Ultrasound Therapy: The handheld device passes therapeutic frequency ultrasound waves through the various layers of the skin. These vibrations can bring about changes in the volume of fat cells and have the mechanical effect of a cellular massage which temporarily disrupts fat cell membranes. Unfocussed ultrasound that is able to exert a mild mechanical force (microstreaming effect) on the cells/tissue effect also helps increase blood circulation and lymphatic drainage to reduce fluid trapped between the fat cells and decrease the localised inflammation of the tissues.  The Body Sculpting Gel been specially formulated to conduct the sound waves to deliver powerful fat burning actives deep into fatty tissues, promoting the reduction of trigylcerides within the fat cells. The advanced technology liposomes and collagen-building agents also work to stimulate cellular building and skin repair.

Infrared Heat Therapy: the silver collage around the handheld massage probe has been engineered with carbon fibre elements to emit infrared rays with a spectrum of 8-12um. These can get deeper into the skin and subcutaneous tissues than other wavelengths of light. They generate a gentle heating action just below the skin’s surface which increases the temperature of these tissues, improving circulation and reducing fluid retention. Cellular metabolic activity accelerates, leading to faster fat-burning and tissue regeneration.

Microcurrent Therapy: Low-voltage current delivered by electrode contact pads and cables (which can be operated in five program modes and five intensity levels)  excites muscles, causing them to contract involuntarily (passive movement). Muscle movement consumes energy and burns fat, sugar and carbohydrates and promotes circulation.

“The ultrasound-cosmeceutical combination in the system is based upon technology which has been clinically demonstrated to be effective and allows the at-home user to treat cellulite in a mild, safe and pain-free way,” adds Dr Crasto.

“Due to our combination treatment method using mild unfocussed ultrasound, our at-home treatment does not have the safety issues associated with HIFU treatment. Over the long term our system can lead to impressive results without the cost and the expertise needed in the handling of HIFU devices.”

If you have an hour…

These treatments have no downtime (you can go straight to the party) and deliver glowing, youthful skin.

Medi-facials
Designed to deliver powerful antioxidant, vitamin, and nutrient therapy into the skin while exfoliating and treating concerns with minimal inflammation. Medi-facials use cosmeceuticals – top-quality skincare products that contain high levels of active ingredients, offer outstanding skincare benefits and leave the skin soft and glowing.
Cost: $250

Ultherapy
The first non-surgical procedure to deliver a tightening effect to the facial contours and skin using ultrasound technology. The 30-minute face and neck procedure triggers the body’s natural healing response, resulting in new and improved collagen, which gradually tightens and lifts the skin tissue over the next 30 to 90 days. Skin seems plumped immediately after the treatment and there are no signs of trauma to the surface of the skin.
Cost: from $1,200

Before & After

Botox
According to registered nurse Marilyn Cassetta, “My female patients may start, when deemed appropriate, as early as their late 20’s and I also see more than a few seniors in their late 70’s to early 80’s. Males are also increasingly concerned about their “worry and frown lines” and have helped to make Botox the number one non-surgical option around the world.

“This process involves the injection of a toxin into the selected muscle(s) with an ultra-fine needle that will, over a 3-7 day period, cause a temporary relaxation of up to several months.” (Results might be achieved even sooner than 3 or 4 days if the patient flexes the injected muscles more frequently on the day of injection.)

When an experienced practitioner offers the treatment, there is often minimal or no bruising, or other telltale signs. Cassetta says: “A more refreshed and relaxed appearance is achieved, with less visible wrinkles. Minimal doses can be used which result in a more natural look, not a frozen face.”
Cost: from $ 220

If you have a day…

These procedures have minimal downtime, you’ll look great by the weekend) and are perfect for then you want to look refreshed and relaxed.

Dermal Fillers
If you’re experiencing a loss of facial fullness or sagging cheeks, or the deepening of the lines between the nose and mouth are your concern, or you’re after a more defined lip line or fuller lips, consider using one of a number of different types and strengths of dermal fillers, which will quickly rejuvenate your appearance. Downtime is minimal and any residual signs of swelling or bruising are usually gone in one to three days.
Cost: from $440

If you have a week or two…

These procedures have some downtime, but you’ll look years younger in time for the Christmas party. They deliver smooth, clear and blemish free skin.

Laser
Paramedical aesthetician, Maureen Cole recommends, “ProFractional, which is a quick and comfortable laser procedure with little down time. It’s used for improving the overall appearance of your skin.”

ProFractional uses laser energy to create thousands of microscopic channels in the skin that are surrounded by areas of healthy, untreated skin. The zones of untreated skin invigorate the body’s natural healing process, and the treated areas stimulate production of new collagen, plumping up the skin and smoothing out wrinkles, lines, scars and other irregularities. “If you’re looking for younger looking skin, or to improve scars, wrinkles, or sun damage in a comfortable treatment with a fast recovery, then you maybe an ideal candidate for ProFractional,” says Cole.
Cost: from $1,600

Phototherapy
This procedure safely and comfortably fades the appearance for skin imperfections caused by the sun, and uneven skin tones caused by brown and red spots (such as rosacea, spider veins and age spots).
Cost: from $450

Blepharoplasty
This is otherwise known as eye-lid surgery. According to Cosmetic and Plastic Surgeon Dr. Warwick Nettle: “Eye-lid surgery is performed on the upper and / or lower eyelids to reduce sagging and bags under the eyes by incising at the crease of the upper eyelid and / or along the line of the lower lid, removing fat or excess tissue from these areas.”

The surgery itself takes anywhere from 1-1.5 hours for upper and lower lids and can be done under general anaesthetic, or under local anaesthesia with sedation. Most patients go home the same day. Stitches are removed from lower lids in around three days and upper lids in around five days. Swelling gradually dissipates around 10 days after surgery. Most patients can resume normal work and activities in about 10 days.
Cost: from $4400.00

If you have two weeks to a month…

These procedures do have downtime, but the upside is that you’ll look better than you did 10 years ago.

Mini face-lift
Dr. Nettle utilises the Lateral SMAS-ectomy or L-lift that, “produces a natural, harmonious appearance. Fat transfer techniques can also be incorporated with surgery to increase facial volume, particularly in the hollows under the eyes and can provide subtle yet effective results. Many ‘mini-lifts’ can be performed as day surgery and people are generally up and about in a day or two, but should take it easy for the first week after surgery. Most people are back at work about 2 weeks after surgery.”
Cost: from $15,500

Breast Augmentation
Most breast augmentation surgery is performed under general anaesthesia. The procedure usually takes one to two hours with a further one to two hours for post-operation recovery. Patients are generally up and about in a day or two, but should plan on taking it easy for the first week after surgery. Most people can return to work one week after surgery, and sutures are dissolvable. The wound remains taped for two weeks then the scar is managed daily for four weeks thereafter.

Plastic, reconstructive and cosmetic surgeon, Dr. Benjamin Norris, who is also a breast and body expert says: “Each patient is different, so I work closely with each individual to determine the right size and shape implant for their body shape. It’s important that the implant selected should be appropriate to the patient’s breast tissues and frame. Women don’t want obvious implants, they want to enhance the look of their breasts without overwhelming their natural physique.”
Cost: from $10,000 – $13,000

Liposculpture
Dr. Norris says: “For the most part, liposculpture is done as ‘day surgery’ and the patient walks out of the hospital to head home.

”Downtime will vary depending on the patient, “Some patients are swimming at the beach within seven to 10 days, with others it may take two to three weeks. The extent of the procedure and speed of recovery depends on the number of treated areas and the amount of fat removed. Bruising can last from one to three weeks and swelling can persist for one to two months.” A compression garment is usually worn for two to six weeks after body contouring surgery.
Cost: from $6,000