Written by Bruce J. Nadler, MD
10 October 2006

Evolution: Changing Shape


One thing plastic surgery and bodybuilding have is common is the desire to change shape. The term plastic surgery comes from the Greek root plastikos, meaning the ability to change shape. As I was doing a leg workout the other day, I started thinking about its influence on the shape of my body.  The weight of the barbell on my back while squatting was certainly compressing my legs. The pull of the barbell during stiff-leg deadlifts was lengthening my arms. The mass of muscle I was developing in my lower body was probably diverting blood from my brain. Before you know it, I'll be dragging my knuckles on the ground as I walk and drooling from the mouth while grunting. This whole thing was a reversal of evolution! 


             Size Over Symmetry?

There seems to be another type of evolution occurring. This is an evolution in what is attractive and sought-after. Bigger seems to have replaced balance and symmetry. If I compare the physiques of the classic Greek and Roman statues, the physiques of champion bodybuilders of old and the current champions, this quest for size over all other considerations becomes evident.  It may be that this is the most controllable variable. There is even a mathematical formula to these statues. The measurement of the neck, biceps and calf are all equal and 10 inches more than the wrist.

              More "supplements" don't make you more symmetrical, but they can and do make you bigger. Even fluffing- the use of Synthol- was originally intended to help asymmetrical body parts and give more fullness to the weak parts. Now, it's used to pump up everything at the expense of symmetry. I fail to see the attractiveness of inflated bags of oil. It's necessary to get away from the logic that if a little is good, a lot is better. Not only is the appearance of a Synthol-inflated muscle bizarre, there may be damage to the muscle, as well.  There is a fascial covering that surrounds the muscle and fuses to become the tendon the muscle attaches to. Too much stretching of this fascia can weaken it and encourage muscle tears.


            Symmetry and Surgery

            The same sense of symmetry applies to changes due to surgery. When I evaluate someone, I not only take into account the specific change the patient is seeking; I also want to see how this impacts on the surrounding parts and the body as a whole. The need to do this was evident when plastic surgeons gave the same little upturned nose to everyone, no matter what the rest of the face looked like. And it's not a matter of just doing liposuction to the bulge in the lower abdomen. The sides, back, chest and pubic area should also be evaluated to seek smooth transitions. The contrast between a markedly corrected area and an out-of-proportion neighboring area can actually look worse than the original appearance. Patients will come to me wanting the biggest pectoral or calf implant that can be shoehorned in place. I suggest size depending on deltoid development, so the chest can accent the shoulders; or depending on the thigh sweep, so the calves don't overpower the leg. 

            The best results are obtained when the focus of diet, exercise and surgery are combined. The ideal chest configuration can be obtained by using liposuction, the proper implant and suggesting a change in chest training to concentrate on inclined rather than flat movements. The timing of the surgery should be when the other factors have been optimized, so the operation provides the final touches. A knowledgeable graduated plan to resume training after surgery is important, too. Starting too soon or too late can prevent the ideal results. All these factors should be complementary and not at odds with one another.