Thank you for your question, which is one frequently heard in consultations about breast lift surgery. The vertical scar is necessary as the lower part of the breast needs to be tightened from side to side. This can only be done by tightening not only the breast tissue of the lower part of the breast, but also tightening the skin of the lower part of the breast. This tightening involves removing extra skin - and hence the vertical scar.


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.
PAL uses an up and down, vibrating-like motion of the cannula to acquire greater fat removal. When compared to simple suction-assisted liposuction, PAL requires less energy for the surgeon to operate while also resulting in greater fat removal. It is commonly used for difficult, secondary, scarred areas, and when harvesting large volumes of fat for transfers to other areas.[9]
The concept of liposuction surgery may seem simple, but, as with any type of surgery, the process is actually quite complex. A skilled physician will be well trained in all aspects of the liposuction procedure, and will be able to explain the process to you in as much detail as you wish. Of course, each procedure can vary significantly, depending on the treatment area and the type of liposuction you select. However, most procedures follow the same basic outline:
A Bra Lift with Laser (Laser Bra Lift): Some doctors will want to use a laser bra lift as an insurance policy that your breasts won’t sag. It’s actually not really an alternative to breast lift surgery as it is an extra procedure. In the laser bra surgery, the laser is used to create a bra-like effect that protects the surgical results of the breast lift. Laser energy will always stimulate the production of new collagen fibers, which give you more support of any tissues. Always look at the before and after pictures to see whether or not you think there is enough improvement.
Cellulite is caused by fat cells pushing through the collagen, the connective tissue directly beneath the skin's surface, causing a dimpled appearance. The appearance of cellulite is not related to the amount of body fat an individual has and is prevalent even in healthy and underweight people. Cellulite is more common in women because men have a tighter collagen mesh pattern beneath their skin. Liposuction can help aid cellulite removal in both men and women, but it is important to remember that there is no permanent "cure" for cellulite. The success of cellulite removal is dependent on many factors, including genetics. Because of this, patients should not expect liposuction to eliminate cellulite from their bodies.

In addition, surgical scars typically heal much more cleanly than accidental trauma and often form a thin, almost imperceptible line. For many of my patients, when the scar is fully mature after one year, it is difficult to see that vertical scar, but scar healing does vary by individual. An important aspect of my surgical patient care is a comprehensive scar care regimen to help optimize your ultimate scar.


Less common is the Vertical Scar Technique, which has less scarring than the Wise pattern, but has a vertical scar visible in the middle underside of the breast. The vertical scar has the advantage that it can give the breast a better shape and the scar does eventually fade with time.  I use this technique primarily for breast lifts and breast reductions of any size.  
Most importantly, in cases of breast lifts with implants, there are hardly any wound complications with this technique. There’s a good reason for this. When you add an implant to a breast lift, you are filling up the skin envelope and, as a result, you do not need to take out much skin at all. You really only need to take out enough skin to move the areola to the new position higher up. The procedure is safer, and has less scars. That’s why the Benelli is my favorite.
Choosing a liposuction surgeon based on the lowest price might ultimately be the most expensive choice, If the initial cosmetic results are so bad that another surgeon must be paid to repair the work of the first liposuction surgeon. Among the most common undesirable outcomes of liposuction are 1) incomplete liposuction with very little evidence that liposuction was actually done, 2) excessive liposuction producing an unnatural or disfigured appearance, 3) irregular and uneven results with unsightly depressions in the skin, and 4) large scars that reveal that the patient has had liposuction. Caveat emptor (Buyer beware).

In 1977, Fisher and Fischer reviewed 245 cases with the planotome instrument for treating cellulite in the lateral trochanteric (hip-thigh) areas. There was a 4.9 per cent incidence of seromas, despite incision-wound suction catheters and compression dressings; 2.0 per cent of the cases presented pseudo-cyst formation that required removal of the capsule (cyst) through a wider incision (+ 5.0 mm) and the use of the panotome.[14][15]
Recovery also involves unique expenses. Compression garments are very important in liposuction recovery, aiding the healing process and helping the skin conform to your refined contours. I usually provide one free garment. Subsequent garments can cost between $50 and $100. During your recovery, you will be prescribed pain medication to ensure your comfort. Depending upon whether insurance covered any portion of your treatment, and the specific pain medication prescribed, this can cost can range from under a hundred dollars to several hundred dollars.
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.
Tummy tucks: One of the most popular forms of body contouring, with a tummy tuck, a doctor can tighten the abdominal region via an incision running between the hipbones. In a full tummy tuck, he or she may also relocate the belly button up higher on the abdomen. By using liposuction to remove excess fat, the doctor can give patients a flatter, trimmer stomach.
Like you, I do have patients who come to me concerned about scarring before their surgery. Afterward, however, few patients ever mention it to me, because the overall surgical result is so transformative. There is a surgical technique called the periareolar breast lift, which only involves an incision around the nipple / areolar complex, and the incision hides well along the border of the more darkly pigmented areola. However, you would be better suited for the vertical breast lift, and it is important not to choose the wrong technique in pursuit of fewer scars. The technique used determines how much lift can be achieved. In general, there is a significant difference in the aesthetic outcome of a mediocre versus a high quality breast lift, and by choosing a suboptimal surgical technique, you may compromise your ultimate aesthetic result in terms of breast shape or perkiness.
Liposuction patients should continue to monitor their incision sites in case of infection, and they should schedule check-up appointments with their surgeons to monitor healing. Excessive swelling can sometimes be a sign of other risks or side-effects, so it's important for individuals to communicate with their doctors to ensure everything is going smoothly.
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.
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.

Power Assisted Liposuction : By employing a cannula that has a vibrating tip, surgeons are able to break up fat cells for easier removal. Power assisted liposuction also allows for more fat removal, smaller incisions, and a reduced recovery time. This procedure is quite safe since the cannula can be moved with smaller, more exact movements. In some cases, however, patients may have looser skin than they desired.
PAL uses an up and down, vibrating-like motion of the cannula to acquire greater fat removal. When compared to simple suction-assisted liposuction, PAL requires less energy for the surgeon to operate while also resulting in greater fat removal. It is commonly used for difficult, secondary, scarred areas, and when harvesting large volumes of fat for transfers to other areas.[9]
In 1977, Fisher and Fischer reviewed 245 cases with the planotome instrument for treating cellulite in the lateral trochanteric (hip-thigh) areas. There was a 4.9 per cent incidence of seromas, despite incision-wound suction catheters and compression dressings; 2.0 per cent of the cases presented pseudo-cyst formation that required removal of the capsule (cyst) through a wider incision (+ 5.0 mm) and the use of the panotome.[14][15]
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!
While there is no upper age limit for patients who want to have liposuction, there are risks associated with any type of surgery. Therefore, patients should be in basically good health in order to safely undergo the procedure. Patients who suffer from serious medical conditions or who take certain medications may not be good candidates for liposuction. Consult with your primary care physician and plastic surgeon to find out whether you are an appropriate candidate for this procedure. Because liposuction removes fat but does not tighten skin, patients with good skin elasticity tend to experience the most aesthetically pleasing results. Older patients typically have less supple skin than younger patients.
Nonsurgical fat reduction treatments can also treat small pockets of fat, but be aware that RealSelf members give these procedures a lower Worth It Rating than they do liposuction. They usually require multiple treatments, over many months, to see a significant improvement—and the results are typically not as dramatic as those you’d get with lipo. After a nonsurgical fat reduction procedure, the body flushes out the damaged fat cells over time. Dr. Marosan also cations that “Patients who undergo nonsurgical fat reduction and then opt for liposuction surgery are more difficult to treat, due to the extensive internal scarring. In my practice, over 50% of my body sculpting patients had previous nonsurgical or surgical fat reduction, with suboptimal or poor results.”
A technique called "tumescent liposuction" is the most common method for removing fat around the stomach, buttocks, thighs and ankles. It's also considered the safest. "Tumescent" means that large amounts of buffered salt water are injected into fatty tissue beneath the skin. The doctor makes a cut in the fatty area to be treated, then inserts beneath the flesh a strawlike tube called a cannula that is attached to a vacuum. At the end of the cannula is a stiff wand. The doctor moves it back and forth in rapid motions to loosen fat. The procedure takes 45 minutes to two hours, with a recovery time of up to two weeks. The full effect of liposuction is seen six to 12 weeks after the procedure is performed. After the procedure, the area is bandaged and the patient must wear a compression garment for one to two weeks. Pain and bruising may last up to two weeks, and swelling may last for two weeks to two months.
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