I personally think nurse-administered anesthesia is perfectly appropriate in many cases. In fact, a 2014 study by the Chochrane Collaboration research group concluded that it was "not possible to say whether there were any differences in care between medically qualified anaesthetists and nurse anaesthetists." But if the patient is anxious about the procedure, or if the treatment scope is extensive, the extra cost of an anesthesiologist can be well worth the money. What I consider extensive liposuction can easily take up to 4 hours, so it would be reasonable to estimate that anesthesia administered by an anesthesiologist could cost about $2,000 in this scenario.

The “crescent lift” technique is mostly used for women who have a very small amount of sagging to correct, and involves one small incision that runs halfway around the top half of the edge of the areola.  It’s usually only done when a patient is undergoing a breast augmentation, and even then only rarely. It’s more of a preventative measure, unlike the other options, which are focused on breasts that have more advanced sagging.
Any licensed physician can perform liposuction, but it's usually performed by plastic surgeons and dermatologists in their offices with local anesthesia, though it may be performed in a hospital under general anesthesia. No special training is required, though some doctors' professional associations recommend it. When choosing a doctor, you may want to consider whether they have had specific training for liposuction and how many they have performed.
Next, your surgeon will insert a thin vacuum tube, called a cannula, through the incision and into the deep fat layer. Your surgeon will move the cannula back and forth to break up the fat cells, and, with the help of an attached syringe or vacuum pump, suction them out. Because a significant amount of blood and other bodily fluids are removed along with the fat, you will receive replacement fluids intravenously during and after the liposuction procedure. Of course, this part of the procedure can vary somewhat, depending on the type of liposuction you select.
Certain health conditions may prevent patients from being suitable liposuction candidates. People with chronic ailments such as diabetes and high blood pressure are more likely to achieve less-than-desirable aesthetic results. Individuals who have compromised immune systems and those who suffer from diabetes, poor blood circulation, heart disease, or lung disease should not undergo liposuction, as they could suffer serious health complications. If patients have recently had another surgery in the area they would like to treat, they should wait until the area has healed before considering liposuction.
Cost is incredibly variable. It depends on the city and the provider. If you go to a plastic surgeon in New York City, it costs a lot more than seeing a non-plastic surgeon in a rural area. There are plenty of non-plastic surgeons offering discount liposuction. But, this can be somewhat risky due to their limited training backgrounds. And bad liposuction is very difficult to fix - I perform a lot of revision liposuction trying to fix poorly performed liposuction.

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Next, your surgeon will insert a thin vacuum tube, called a cannula, through the incision and into the deep fat layer. Your surgeon will move the cannula back and forth to break up the fat cells, and, with the help of an attached syringe or vacuum pump, suction them out. Because a significant amount of blood and other bodily fluids are removed along with the fat, you will receive replacement fluids intravenously during and after the liposuction procedure. Of course, this part of the procedure can vary somewhat, depending on the type of liposuction you select.
Although the mastopexy procedure is one of the safest and most rewarding plastic surgeries, concern about breast lift scars is natural for women who are considering the procedure. As a woman and a breast surgeon, I have a deep understanding of the mix of emotions that can accompany a breast lift. You’re longing for a return to the high, perky breasts you had in younger years, before major weight loss or prior to pregnancy and breastfeeding. At the same time, you realize any surgery carries risk and excess scarring is one of them. Here we’ll provide expert tips to help you avoid visible breast lift scars.

There have been cases of children as young as 12 undergoing liposuction. While this is uncommon, there are rare instances in which a doctor may perform liposuction on a teen, especially after major weight loss that may have left one or two lingering bulges of fat. Generally, a doctor will assess a teenager's emotional maturity and self-esteem before agreeing to perform liposuction. The majority of these patients choose to have one problem area contoured to help with self-esteem issues. Some teens are affected by excess fat under the chin, in the calves, hips, or other areas, and it can be a source of embarrassment and ridicule among peers. In these cases, liposuction can eliminate this fat and produce a more sculpted, toned appearance.
Certain health conditions may prevent patients from being suitable liposuction candidates. People with chronic ailments such as diabetes and high blood pressure are more likely to achieve less-than-desirable aesthetic results. Individuals who have compromised immune systems and those who suffer from diabetes, poor blood circulation, heart disease, or lung disease should not undergo liposuction, as they could suffer serious health complications. If patients have recently had another surgery in the area they would like to treat, they should wait until the area has healed before considering liposuction.
Before patients are permitted to undergo liposuction, their candidacy must first be determined by a qualified plastic surgeon. The best candidate is someone who is in excellent health, is within 25 pounds of his or her ideal body weight, and has deposits of fat that have not responded to diet or exercise. Men and women over the age of 18 who meet the necessary health qualifications may be great candidates for liposuction.
Any procedure that lifts the breast will require the surgeon to make an incision and that incision will leave a scar on your breast. In most cases, the scar will eventually fade and the positive aesthetic outcome of the ‘lifted’ breast will far surpass the remnants of a scar. But the fact is, you will have a scar following a breast lift (whether or not an implant is involved in the procedure). In fact, breast lifting actually occurs in breast reductions, too.

Botox Breast Lift: There are more and more uses of Botox that researchers are finding as time goes on. A Botox Breast Lift is not an approved use of botox by the FDA. Here’s how it works: Botox is injected into your pectoralis muscle. This causes a relaxation of the muscles in the chest and your back muscles then begin to lift your breast. The lifting is not dramatic though and it only lasts about three to four months. The advantage, however, is that there are no scars because surgery was not done. There’s also no recovery time as there is with a breast lift surgery.
Cryoliposlysis is an alternative fat reduction treatment that does have FDA approval. This treatment uses cool temperatures to freeze stubborn fat cells without impacting the surrounding skin or muscle. As the cells crystalize, the body can expel them naturally over a period of several months. To perform this treatment, the doctor will apply cooling panels to the treatment area for about 40 minutes. Like most patients, you will likely find the session relaxing, and you can read or even nap as your fat cells are frozen away. You may enjoy optimal results after just one appointment, or you may benefit from multiple sessions. You should be aware, however, that this treatment is more suited to some areas of the body than others. Doctors typically use cryolipolysis to treat the abdomen, thighs, and hips.
Radiofrequency fat removal uses radiofrequency waves to heat unwanted fat cells. The high-power waves can demolish these cells, yet the surrounding cells will be unharmed. Typically, you will have several short treatment sessions. Many experts hail radiofrequency treatments, such as Vanquish and Accent® Ultra, for their ability to remove fat and improve the appearance of cellulite with minimal discomfort and no need for anesthesia. However, this technology has not yet received FDA approval for use in fat removal, and therefore, many doctors are hesitant to offer this form of treatment.
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.
Trying to eliminate pockets of excess fat that accumulate on the abdomen, flanks, thighs, and other areas of the body can be a frustrating process. Often, diet and exercise on their own are just not sufficient to the task. In such cases, many people who want to achieve more aesthetically pleasing body contours turn to liposuction, which has been one of the most popular plastic surgery techniques for more than three decades now. This safe, proven procedure has allowed millions of patients to improve their figures through the precise targeting and removal of isolated deposits of fat. Often combined with other plastic surgery procedures such as abdominoplasty ("tummy tuck" surgery) and breast augmentation, liposuction is a potentially ideal solution for anyone looking to refine and rejuvenate their contours.
"I was drawn to Dennis Hurwitz, MD, for three reasons," my patient Tara explains. "First, his years of helping both men and women achieve results that made them feel better about themselves. Second, my consultation with him was informative. He was engaged the entire time, answering each and every question knowledgeably and honestly. Third, considering his reputation, the pricing was more than reasonable."
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.”
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. 
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.

I recently performed liposuction for Tara, 49, an active woman who wanted to rejuvenate her figure.  "Diet and exercise were not enough at this juncture in my life," Tara said. "I wanted to look - and, more importantly - feel better about my appearance both in and out of my clothes. It was definitely worth the cost. Self-confidence is always worth the cost."


Radiofrequency fat removal uses radiofrequency waves to heat unwanted fat cells. The high-power waves can demolish these cells, yet the surrounding cells will be unharmed. Typically, you will have several short treatment sessions. Many experts hail radiofrequency treatments, such as Vanquish and Accent® Ultra, for their ability to remove fat and improve the appearance of cellulite with minimal discomfort and no need for anesthesia. However, this technology has not yet received FDA approval for use in fat removal, and therefore, many doctors are hesitant to offer this form of treatment.
The horizontal mastopexy goes by many names, including the “Horndesky Method” and “Ultimate Lift.” This technique enables surgeons to create a new position for the nipple without leaving a vertical scar from the areola to the breast crease. Instead, a horizontal incision is made across the entire breast above the areola, and the surgeon excises the skin below it while preserving the nipple. 

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.
I perform a liposuction breast lift/reduction known as Breast LipoLift®. This specialized technique spares more nerves and blood supply as well as removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast, I then remove the excess skin to tighten the breast and create a more proportional silhouette with better cleavage. This procedure is also more accurate than traditional breast lifts or reductions since I use 3D measurements to uncover size asymmetries. During the procedure I remove exactly whatever is more from the larger side to get as close to symmetry as possible. Since I perform this less invasively the recovery time is faster and drains are not necessary. Over 90% of my patients are out to dinner the next evening taking only Advil and Tylenol if even needed. The size would depend on the proportion with your body versus going for a cup size.  It has been proven to have less complications than traditional breast reduction (please see my Breast LipoLift® page web page) and should not affect nipple sensation, mammograms, cancer risk or breast-feeding. 
Body lifts: Body lifts are more comprehensive treatments designed to target the abdomen, thighs, and buttocks at the same time. During this procedure, a doctor will create circumferential incisions, running along the groin, thighs, hips, and waist. In addition to tightening damaged muscles, he or she may use liposuction to remove fat from one or more of these regions.
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