The 39-year-old actress was spotted on the Hawaiian beach during the holiday with a more toned and shapelier body.  Some experts have said that she may have increased her bust size by a cup.

While Diaz’s body appears to be shapelier than the previous years, some people are really not convinced if she had the procedure as the increase in her bust size was not as significant as compared to other celebrities who have gone under the surgical knife.  In fact, some bloggers even said that a slight weight gain may be the primary reason for the actress’ improved figure.

During previous interviews, Diaz was quoted saying that she would love to have a curvier figure, something she said she was not “naturally gifted.”

Meanwhile, the actress was not a first-timer in plastic surgery.  In 2006, she had rhinoplasty or nose surgery after sustaining injuries; however, the Hollywood star said she would rule out cosmetic surgery.

Whether Diaz has gone under the knife or just gained some weight that resulted to a shapelier figure, it is really hard to tell since the increase in her bust size was not dramatic.  And because the actress has brushed off rumors of her alleged breast augmentation surgery, the only thing people can do is speculate.

But assuming that Diaz had breast implant surgery, her decision to choose smaller implants is commendable as it resulted to a very natural appearance rather than looking “heavy” on top.

Meanwhile, Dr. Tarick Smaili said that he is seeing more and more women opting for the natural look.

“I see that the growing trend is having smaller implants so the results will be natural that it would be hard or even impossible to tell if a woman has undergone plastic surgery or not.  In fact, we’ve seen Hollywood celebrities such as Denise Richards and Pamela Anderson downsizing their bust size with another augmentation surgery,” the leading cosmetic surgeon said.

During the previous years, the actress has been accused of yoyo dieting that left her with a very thin frame and flat chest.  But after she gained some weight, she now looks healthier and shapelier than the previous years.

Panniculectomy is probably the most popular plastic surgery procedure for massive weight loss patients as it targets the midsection of the body, the area which has the most tendency to develop hanging skin and tissues that may lead to back problem, breakdown of skin, ulcers, irritation, foul odor, and poor hygiene.

Abdominoplasty (tummy tuck) is different from panniculectomy, although these two plastic surgery procedures treat the abdomen.  In abdominoplasty, plastic surgeons reshape and tighten the underlying muscles and eliminate the excess skin and fats, but in panniculectomy, they only remove the hanging skin and fats.

In some cases, panniculectomy is performed with another abdominal surgery such as hysterectomy (surgical removal of a woman’s reproductive organ) or repair of the abdominal wall.

According to plastic surgery specialists, candidates for this procedure should have excess skin and fats extending as low as their hips, genitals, and buttocks to the extent that walking, sitting, and standing have become relatively difficult.

To make sure that the result of panniculectomy will most likely last a lifetime, plastic surgeons require their patients to have a stable weight for at least one year or even longer if they have had lap band or gastric bypass surgery to make sure that they are no longer nutritionally deficient due to the sudden decrease of food intake.

Plastic surgeons start the procedure by administering general anesthesia that will put their patients in a state similar to sleep.  And once the drug takes effect, they will create a vertical incision that starts from the lower area of the breast bone (sternum) to the pubic bone, and another horizontal cut that covers the pubic area.

Through these incisions, plastic surgery specialists can remove the excess skin and fats and then pulled together the remaining skin to close the surgical wound.  In some cases, small tubes are inserted to drain the excess fluids which can promote faster recovery.

As with any surgery, panniculectomy involves risk of complications and recovery.  With this, it is important for patients to rigidly follow their surgeon’s post-operative instruction that will reduce the risks and promote faster healing.

During the recovery period, patients are restricted to lift more than 10 lbs. and perform rigorous exercises that may put pressure on their abdominal area.

While this plastic surgery procedure is commonly known as a way to aesthetically improve the body, this is also used to treat the physical symptoms associated with panniculus (excess, hanging skin in the abdominal area).  These include back problem, foul odor, breakdown of skin, ulcers, irritation, poor hygiene, and difficulty in walking and sitting.

However, not all patients who have panniculus can have tummy tuck as this procedure, as with any plastic surgery, involves recovery and certain risks especially for individuals who have serious health issues and healing problem.  For this reason, doctors perform a screening test that will differentiate a good candidate from a high-risk patient.

A good candidate should have a normally functioning immune system to ensure that she will not be exposed to skin necrosis (death of skin tissue), unnecessary scarring, infection, and other complications.  But aside from being physically healthy, it is also important that she is emotionally and psychologically stable so that she can have a full understanding on the limitations and risks of this surgery.

It is also important for a patient to have realistic goals and expectations which can determine if she will be satisfied with the result, according to plastic surgeons.

Most patients who ask for tummy tuck surgery are women who are left with sagging skin and weakened muscles due to several pregnancies.  However, plastic surgeons recommend postponing this procedure for individuals who are still considering having babies as childbearing can reverse its result.

Massive weight loss patients are also a good candidate for this procedure, especially if they have had weight loss surgery such as gastric bypass and lap band.  According to plastic surgeons, shedding more than 100 lbs. of weight will usually result to the development of panniculus and hanging skin in other areas of the body.

But since these patients have a significant amount of excess skin and tissue and pockets of fats, they will receive a more extensive technique in tummy tuck which involves longer incisions, more scarring, and higher risk of complications.  But despite such downsides, this approach may be the only way to provide the best result for these individuals.

Patients should remember that there are many details which must be considered even before their plastic surgery begins.  In this way, they can avoid possible complications and reduce risks associated with any cosmetic procedure.

To differentiate a good candidate from a high-risk patient, plastic surgeons conduct screening test and consultation which will allow them to know a person’s medical history (including his family’s), prior surgeries, and previous and current medications.

During the initial consultation, patients should bring a list of pharmaceutical medications, vitamins and herbal supplements, and over-the-counter drugs they are currently taking.  In this way, their plastic surgeons can identify which medications should be temporarily stopped.

It is important to note that certain medications can affect a person’s healing ability which may predispose him to delayed healing, infection, skin necrosis (death of skin tissue that may lead to unnecessary scarring), and other serious complications.  For example, aspirin and other non-steroidal anti-inflammatory drugs can impede with the natural process of blood clotting; with this consideration, plastic surgery specialists usually require their patients to stop these medications two weeks before and after their operation.

Aside from avoiding certain medications, patients are also advised to quit smoking (and avoid the second-hand smoke) at least two weeks before their surgery.  This is because the nicotine has been found to delay the body’s healing ability by inhibiting the oxygen from reaching the surgical wound.

As a result, smokers usually experience delayed healing that increases their chance of developing skin necrosis, a condition which may lead to infection and unnecessary scarring.

Days before their surgery, patients are advised to buy all the medical garments, accessories, and other things they will need during their recovery period.  Ideally, they should also appoint someone who can be their companion within the first several days of their recuperation.

Meanwhile, plastic surgeons will also provide their patients with a list of post-operative instructions which usually include the proper diet, medications to reduce swelling and other symptoms, compression garments and other medical accessories, activities to avoid (strenuous exercises and heavy lifting), and proper care to the incision site.

By following strictly the pre- and post-operative instructions, patients can significantly reduce the risks associated with cosmetic surgery.

To treat breast ptosis (sagging breasts), plastic surgeons use mastopexy or what is more commonly referred as breast lift surgery.  This is a highly individualized procedure that is used to achieve a more natural appearance and address the specific problems of each patient.

As with any plastic surgery, breast lift requires recovery because of the incisions in the actual breasts that will allow doctors to remove the excess skin, manipulate the underlying tissue, and even raise the position of the areola and nipple on the breast mound.  If needed, some plastic surgeons also use permanent sutures that are placed inside the breasts to help support the tissue.

For women who need the most correction, full mastopexy is the most ideal breast lift technique in which plastic surgeons create three incisions in the breasts that resemble a nautical anchor (which is why the procedure is also called as anchor incision).

The first incision is made around the areola or the pigmented part of the skin, the second one is placed vertically from the areola to the breast fold, and the last cut is made across the breast crease.  Through these incisions, plastic surgery specialists can drastically change the contour of the bust.

Since full mastopexy requires extensive incisions, this involves prolonged recovery, higher risk of complications, and more bleeding and scarring.  In addition, this approach may not provide a good result particularly on women with smaller breasts and patients with minimal to moderate breast ptosis.

To date, there are many modified breast lift techniques which mostly involve fewer incisions, less risk of complications, and shorter scars.  In general, these minimally invasive procedures are ideal for treating smaller bust with minimal to moderate sagginess.

The lollipop incision is probably the most common modified breast lift technique and is best suited for women with medium-sized breasts with moderate to severe ptosis.  In general, this approach is not enough to re-sculpt large breasts that severely droop and is usually too extensive to treat smaller bust with less noticeable sagginess.

This procedure uses the same incision sites in anchor-incision, minus the horizontal cut across the breast crease, the area which takes the longest time to heal.  With this, surgeons said that women can expect shorter recovery and fewer scars.

If needed, some women may have additional procedure in the form of breast implant plastic surgery if they want to make their bust, particularly the upper poles, appear fuller and rounder.

Because every patient has a specific aesthetic problem, plastic surgeons have developed different surgical techniques in performing ethnic rhinoplasty.  This usually includes augmentation to increase the size, suturing to reduce the base of the nostrils, and cartilage grafting to refine or lengthen the nasal tip.

For Asian-Americans, the most common technique for them is the nose lift or augmentation since their bridge and tip usually lack any prominence.  In some cases, their nasal bridge even “disappears” from the eyelashes when viewed sideways.

To correct this aesthetic problem, many plastic surgeons will just reshape the cartilage to increase the size of the nose.  But in case that there is not enough supply of this tissue, they may graft this behind the ear without affecting its function or appearance, or in some cases, in the rib or pelvis.  By using a patient’s own cartilage, there is no risk of adverse reaction and rejection.

But in case the patients do not want to have an additional surgery from cartilage grafting, their plastic surgeons may recommend the use of Gore-tex which is said to be the safest implant for rhinoplasty due to its high tissue compatibility.  According to a study, this material has a porous structure that allows tissue to grow inside and become part of the nose, thus resulting to a more natural look.

For Hispanic patients who usually have a thick skin and fats on the nasal tip (which makes it appear round and bulbous), dermal fat removal and suturing technique can alter this aesthetic problem.  In certain instances, manipulating or reshaping the cartilage can also improve this part of the nose.

Some Hispanics also have a flat bridge or hump in the ridge of the nose.  To improve their appearance, reshaping the cartilage is also an effective plastic surgery technique for these patients.

For African-American, cartilage grafting is also a good approach as it can remove the humps and decrease the size of the bridge or tip.  If needed, an excision is placed at the base of their nose to correct the nostrils that are too large, although some plastic surgery specialists allow a slight nostril flare which looks natural and even flattering to certain patients.

The anchor-shaped incision is the most commonly used approach in breast lift.  In this procedure, plastic surgeons make an incision around the circumference of the areola, a vertical cut starting from the areola to the breast fold, and another one across the breast crease.  (The image below is an example of breast ptosis or sagging.)

While the anchor-shaped incision is the most effective approach to treat severe sagginess, this is usually too invasive for women who have a mild to moderate case of drooping breasts.  With this consideration, plastic surgeons have developed a less invasive technique called donut mastopexy which involves less incisions that results to minimal scars, shorter downtime, and reduced risk of complications.

The donut mastopexy, which is also called as concentric or Benelli breast lift technique, generally provides a satisfying result for the right patients.  However, this approach is not ideal for women who have severely sagging breasts and those with extremely large bust size; in such conditions, the traditional breast lift, which is the anchor-shaped technique, is still the most recommended plastic surgery.

Because the donut mastopexy is not as extensive as the anchor-shaped technique, it is usually performed under local anesthesia together with a sedative.  However, some plastic surgeons still administer general anesthesia that puts patients in a state similar to sleep.

Once the anesthesia has taken its effect, surgeons will then create incisions around the circumference of the areola, allowing them to remove a donut-shaped piece of skin around this area.  After this, the remaining tissue is reattached; if needed, doctors also alter the size of an enlarged areola to further improve the appearance of the bust.

After making the necessary alterations, doctors will carefully close the incisions around the areola using sutures.

As a stand alone procedure, donut mastopexy can provide a satisfying result to smaller breasts with minor sagginess.  However, some patients may ask for complementary procedure (through breast implant surgery) to further lift their breasts and make these appear firmer and fuller.

Most plastic surgery specialists prefer to place the implants under the chest muscle rather than over it so that more skin and tissue can serve as a natural padding that will prevent sagginess in later years.

One of the most important pre-operative instructions for patients is to avoid herbal supplements which are found to have negative effects during and after plastic surgery.  According to the American Society of Plastic Surgeons (ASPS), most of these natural supplements can aggravate bleeding and prevent normal healing.

These are some of the most popularly herbal supplements which are found to have dangerous side effects during and after a surgery:

• Ephedra

This supplement is used to promote weight loss, treat respiratory problems such as bronchitis and asthma, and increase the energy level of a person.  However, the US Food and Drug Administration (FDA) has banned this agent which is found to raise blood pressure, and increase heart and metabolic rate that may lead to a heart attack or stroke.

• Echinacea

This is commonly used to treat or prevent bacterial, viral, and fungal infection from chronic wound, arthritis, and ulcer.  However, some studies suggested that this supplement may cause immunosuppression and lead to delayed healing and infection.

• Chondroitin

This agent is often used to treat osteoarthritis.  However, people who are taking this supplement has a higher risk of complications related to uncontrollable bleeding during surgery.  Meanwhile, the effect of this agent can be further aggravated if a person is taking blood-thinning medications such as aspirin.

• Glucosamine

This supplement is usually mixed with chondroition and contains chemical substances which can simulate the effect of insulin that may lead to hypoglycemia during the operation.

Aside from these herbal supplements, ginseng, garlic, kava, gingko biloba, milk thistle, and goldenseal may also cause dangerous side effects to patients undergoing plastic surgery such as breast augmentation, tummy tuck, liposuction, etc.

What Patients Should Do

It is very important for patients to tell all their previous and current medications, including the herbal supplements they are using, to their plastic surgeons.  (Some people would just ignore this information thinking that supplements are harmless because these are natural.)

For patients taking supplements, particularly those examples stated above, are required to stop using these for a certain period of time which can range from one day to several months before and after the surgery.

Hint: be careful! Giving cosmetic or plastic surgery as a gift at any time of year can be like entering a minefield.

Just make sure the wish list is in the complete interests of your beloved. Too many guys are overawed what cosmetic plastic surgery can do for the fair gender, including:

• Lip augmentation for fuller kissers
• Breast augmentation
• Tummy Tucks

And what are women thinking for guys?  Maybe a little more hair on the head, fewer frown lines on the face, not so many deep wrinkles and folds across a worried brow with a forehead lift and so on.

Here’s the rub and the sticking points: your sweetie may be perfectly happy with the lips she has or the face he presents to the world.

So if you slip a coupon for a cosmetic plastic surgery procedure into an envelope, thinking you are going to delight your sweetheart, you may have another, not-so-pleasant think coming. In fact, you may have your head handed to you!

It’s happened many times before. Essentially, you are saying “I don’t like your breasts and want them fixed” or “Your frown lines make you look like a grumpy old thing.”

Then, the giftee may be insulted. Besides, plastic surgeons are very keen on quickly finding out if a patient wants plastic surgery to please somebody else. Studies have shown that the happiest plastic surgery patients are those who want it for themselves.

Even if your gal or guy has bemoaned the appearance of a body or facial part in the past, be sure and ask about it before giving surgery as a gift.

If you’re really serious about it, start by suggesting a properly trained, fully qualified plastic surgeon. (Read more about finding an excellent, board-certified plastic surgeon.)

Good starting place for a woman:  a spa or MediSpa coupon. Lives there a woman anywhere who does NOT like pampering? Guys tend to have thicker skins about appearance but if your fellow is a Metrosexual who is into ultra-good grooming and skin care, he may also be in the market for spa treatments.

Best advice of all? Stick with thoughtful, clever cards, flowers and candy!

What’s going on?  Well, here’s a primer on how plastic surgeons reason:

Any surgeon realizes that all surgery carries some small risks. Things can go astray during and after surgery so the surgeon balances possible risks against the likely benefits.

In cosmetic plastic surgery, benefits are a:

• Better looking nose
• Face
• Bust line
• Stomach

But if the risks start to outweigh the benefits, the surgeon is likely to turn down requests for rejuvenation surgery.

What exactly are the risks?

Consider health: patients with high blood pressure, type I or II diabetes, heart trouble or other serious health woes may not receive permission to go under general anesthesia.

Smoking complicates anesthesia and retards healing tremendously so some surgeons nix smokers. Ditto obesity, family history of lung or brain woes, a couch potato lifestyle and less than optimal blood chemistry.

After surgery, some bruising and swelling are expected but infection is always a possibility as well as dehiscence, when a closed incision opens again.

The surgeon must also consider: “Will the body part on which I operate still function? “ Any nose job patient must breathe while any eye lift patient must be able to close and blink the eyelids.

Sometimes, the risks pile up against doing the surgery well – or even safely — so the surgeon says, sorry, no. The classic example is Michael Jackson’s nose. A responsible surgeon would have turned down more surgery after his second rhinoplasty. (He’s rumored to have had six to ten nose jobs.)

Other  celebrities are examples of plastic surgery gone bad because the star used charm, star power and personality to beg, wheedle and cajole younger surgeons into doing risky or unwise procedures.

Thus, we see actress with:

• Balloon-like breast augmentations with no cleavage
• ”Trout pout” lip augmentations

Yet another reason for carefully balancing risks and benefits: happy patients with great breast enhancement, rhinoplasties or face lifts are walking advertisement for the surgeon – and will bring in anywhere from two to five more patients. So it’s in the surgeon’s best interests to make sure you look good.

However, one bad outcome and unhappy patient can turn away ten more.