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.
Unfortunately, there aren't any scarless breast lifts. You need to understand that there will always be a trade off - you will have scars but you will have the breast shape you desire. You cannot get one without the other. Anchor scars tend to be more unsightly, but may yield the best results for some patients. Other patients may get great results with a vertical lift, leaving a thin vertical scar that tends to heal very well.
For tumescent liposuction, the most common technique, your doctor will make one or more small (one-quarter inch or less) incisions in the area to be treated and inject a large quantity of a mixture of saline (salt water), local anesthesia, and epinephrine into your tissue. The fluid causes the fat to become swollen, firm, and easier to remove. (It also constricts your blood vessels, which reduces bruising, blood loss, and recovery time.) The surgeon then inserts the cannula through the same incision and passes it back and forth under the skin to break up the fat before suctioning it out. For a very small area, the procedure takes around 30 minutes, while a 360 liposuction—which includes the abdomen, flanks, back, and all around the torso—lasts three to four hours.
Liposuction is not a weight loss procedure, and it cannot eliminate stretch marks and cellulite from the skin. The treatment can only remove small, localized concentrations of fat. In most cases, ten pounds of fat or less will be removed from the treated area. The ideal liposuction candidate is already close to or at a healthy weight but is interested in subtle body contouring.
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.
Doctors on RealSelf stress that post-lipo weight gain can be an issue, if you don’t keep eating a healthy diet and exercising. As Beverly Hills, California, plastic surgeon Dr. Brent Moelleken notes in a RealSelf Q&A, “By nature, surgery causes soreness, and patients are usually restricted from full workouts for a period of time after surgery. This explains the weight gains often noticed immediately afterward.” But it’s important to get back into the exercise habit as soon as you’re able. “Some patients gain a false sense of confidence after liposuction,” he says. “If anything, patients should plan on being more active and healthier about their eating habits after surgery than they were before.”