I had a consultation today for a breast lift with implant. I really do not want that long verticle scar that accompanies most breast lifts. The surgeon measured me and said I was a 29? He said that I would need the lift with the anchor incision, or I could just have the implant without lift, but the implant would go on top of the muscle. I'm really dissapointed because I do not want that large vertical scar. What are my other options for a lift? I have another consultation scheduled with a different surgeon, but I want to know if they are just going to tell me the same thing.
Right now, surgeons follow guidelines that set a maximum extraction limit of 5,000 milliliters of fat (11 pounds) for all patients, regardless of variations in weight or body fat status. But the new study suggests surgeons could use a patient's body mass index (BMI) to determine how much fat extraction is safe. BMI is a rough estimate of a person's body fat based on height and weight measurements.
Aging brings on a general redistribution of body fat, especially around the middle. For women, childbirth can leave behind a roll of stubborn and unsightly belly fat. And, of course, genetics count for a lot, too. But when it comes to liposuction, not all fat is created equal. Fat that's resistant to diet and exercise is usually subcutaneous fat, which lies beneath the skin and on top of the abdominal muscle wall. The good news is that's what liposuction is intended to remove. Liposuction can remove pockets of flab, recontour your middle and improve your shape.
A circumareolar breast lift can enhance breasts with mild ptosis and results in almost no visible scarring; however, the lift of the nipple is limited to no more than 2 cm and the procedure often does not create a very perky breast as the breast tissue is effectively lifted. The scar can also be wide, it’s hard to keep the areola perfectly round, and this technique tends to flatten the breasts. An inverted-T lift can repackage breast tissue for a perkier appearance but the scar is an anchor configuration on the breast. The problem arises when you want an improved breast shape, better nipple position, and minimal scarring. Traditional techniques make you choose form over aesthetics, and for some women, this option is less than desirable.
Liposuction is a surgical procedure that removes fat via suction. It’s typically done with a thin tube, called a cannula, attached to a vacuum. No matter how healthy your diet or how often you work out, you can still have pockets of unwanted fat that resist your best efforts. With liposuction, an experienced surgeon can remove fat, contouring your hips, thighs, stomach, abs, waist, chin, or other areas. 
To maximize the success of liposuction surgery and minimize your risks, always follow your cosmetic surgeon's instructions for surgical preparation and postoperative care. If you smoke, your cosmetic surgeon will advise you to stop two weeks prior to and following liposuction surgery. You may also choose another avenue for fat removal. There are non-surgical liposuction alternatives available to patients who are not good candidates for liposuction or simply prefer other methods.
Liposuction is very effective for shaping the abdominal area in men and women. The lower abdomen in particular tends to be resistant to diet and exercise, making even the most fit and active individuals insecure about their appearance. Pregnancy and cesarean births can have a disfiguring effect on the lower abdomen, which diet and exercise cannot correct. Most abdominal fat is located directly beneath the skin and can easily be removed through liposuction procedures. However, fat that is located deep in the abdomen (between the intestines) cannot be removed with liposuction because of the increased risk of severe complications. Abdominal liposuction may be performed in conjunction with a tummy tuck.
It’s a popular method because the incision enables doctors to reshape breast tissue and insert implants either above or below the muscle, leaving only a small scar along the top of the areola. However, it also has its downsides: only a minimal amount of lift can be achieved, not all sizes and types of implants will fit, and the majority of women desire a bigger boost than this method can deliver.
Also known as a vertical lift, this technique requires surgeons to make a keyhole shaped incision on the breast, preserving the nipple but removing any excess skin below it. The areola is then shifted up into its new position, while suturing the skin edges together results in a lollipop shaped scar around the nipple and a vertical line down to the breast crease.
Your comfort with the scars are a very personal aspect of the surgery, but to the extent you are able, I urge you to keep in perspective the lesser importance of the incision pattern. I advise patients never to compromise contour for a lesser scar. I’d argue that it is more important to choose a highly experienced board-certified plastic surgeon who is a specialist in cosmetic surgery of the breast and body. Good luck with your surgical journey!
Patients should be aware that, when liposuction is combined with other procedures, their risks for post-surgical complications will be a bit higher. Some doctors will space the procedures out to avoid these potential effects. Others may suggest removing less fat when liposuction is combined with other treatments. Although a few surgeons do not advise combining multiple procedures, most will do so, simply using extra precautions to protect their patients' safety. Although recovery time will be longer when procedures are combined, patients will only have one recovery rather than two separate procedures and two separate periods of downtime.

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Most board certified plastic surgeons will give discounts if more than one area is addressed at the same time. Be careful when comparing pricing between surgeons. Some surgeons will only give you their fee with the surgery center and anesthesiologist billing you separately. Other surgeons will give you a package price which will include their fee, the surgery center and anesthesiologists fee.
The moon-shape (crescent) lift involves a scar hidden along the upper half of the areola border.  The donut (circumareolar) lift involves a scar hidden around the entire circumference of the areola border.  These scars camouflage very well where the darkly pigmented skin of the areola meets the lighter skin of the rest of the breast.  These lifts work well when the nipple is only slightly downward pointing but positioned relatively well on the chest wall.  One of the disadvantages of these lifts is that they can only raise the areola up to a maximum of about 2 cm.  They also tend to flatten the breast shape and are not ideal when there is saggy breast tissue in the lower pole.  Therefore, based on the low position of your nipple areola complex and the amount of breast tissue laxity you have, you would not be a good candidate for either of these lifts.
Dr. George Marosan, a board-certified plastic surgeon in Bellevue, Washington, prefers VASER liposuction in most situations. “Fat comes out more easily with VASER—especially in men, where it’s more fibrous,” Dr. Marosan says. He also points out another great advantage of VASER lipo: While fat that’s liquified by laser lipo isn’t usable, fat broken up by VASER is still viable for transfer to the breasts, butt, or anywhere you want more fullness. “The VASER allows me to sculpt the body, revealing the underlying muscle and bony anatomy. This is an advanced technique that goes way beyond liposuction for fat removal only,” says Dr. Marosan.
In my experience, VASERlipoTM gives my patients better results, with less loose skin and quicker recovery. It's a three-step process of injecting a solution of saline and norepinephrine, applying ultrasound waves below the skin using a special probe, and evacuating the emulsified fat through a cannula. By using this advanced technology with knowledge and experience, you can remove the fat in a reasonable amount of time, in the most superficial layers so that the skin will reshape to a smaller size. Ultrasound allows for more selective damage to the fat, and minimizes trauma to neighboring connective tissue. By minimizing collateral trauma, more fat is removed, and the native elasticity of the connective tissue can shrink down to the smaller size.
Most doctors on RealSelf say that a good compression garment is essential to minimize swelling and bruising, help the skin smoothly adhere to the underlying tissue, and speed up healing; but some don’t think it’s necessary. Doctors who recommend compression garments often have patients wear them 24/7 (with a break for showering) for at least two weeks and then gradually reduce the number of hours they need to be worn over a period of three or more weeks. As a bonus, doctors say, compression helps ease discomfort. Follow your doctor’s instructions. 
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