In 2010, 13.1 million cosmetic procedures were performed in the country, with about 88 percent accounting to non-invasive treatments.  Meanwhile, almost half of the patients were in their 40s and 50s, a clear manifestation of Americans’ obsession to youthful beauty.

One advantage of non-invasive cosmetic procedures over surgical ones is that they involve no recovery or require little downtime.  However, one consideration is that they often need maintenance so the patients can preserve their youthful appearance; for instance, Botox and collagen injection must be repeated at least every six months.

The International Association for Physicians in Aesthetic Medicine (IAPAM) is expecting that non-invasive cosmetic procedures especially those treating the signs of aging will increase in numbers.  Botox and Dysport, which both uses neurotoxin in small dosage, will continue their popularity.

Dermal fillers such as Restylane and Juvederm will also continue their popularity.  These treatments are used to “fill in” hollowed facial areas such as the cheeks although certain types can also used in lip augmentation.

In addition, non-surgical body contouring procedures such as VelaSmooth and Zerona will continue their popularity.

Over the past couple of years, liposuction has been one of the most popular cosmetic surgeries in the US.  But nowadays, new technologies have made it possible to perform the procedure without using incisions; in fact, some doctors simply inject a concoction of drugs to the fatty areas to melt these away, allowing the body to naturally flush these out.

These are the advantages of minimally invasive procedures over cosmetic plastic surgery:

• The treatments are performed quickly.
• Most procedures are relatively painless or at least the discomfort can be minimized by local anesthesia.
• Bed rest is not required because there is little or no downtime.
• Side effects are minor.  But in case the patients develop some swelling, redness, and bruising, these symptoms will likely subside a day or two.
• The procedures are ideal for patients who do not want the idea of going under the knife.
• Most non-invasive treatments provide instantaneous results because there is little or no symptom such as swelling and bruising.
• The non-invasive cosmetic procedures are much cheaper than plastic surgery.

Traditionally, December is the month when most plastic surgeons are fully booked.  This is not surprising as most people would like to take advantage of the long vacation, allowing them to enjoy enough rest during their recovery instead of taking a leave off work.

Also, cooler weather (December to March) requires people to wear “bulkier” clothes—this is an advantage to patients who want to conceal swelling and bruising, which are symptoms often associated with facelift, brow lift, neck lift, and liposuction.  Another bonus is that sun exposure can be minimized.

It is important to note that exposing the incision site from the sun can result to hyper-pigmentation and more visible scars.  For this reason, the treated area should be covered by clothing; trousers, scarves, jackets, and even wide-rimmed hats can be helpful in protecting the skin.

On the other hand, people who want to undergo plastic surgery to prepare their body for summer (hello tiny bikinis!) are often recommended to have the procedure in spring (April to June); in this way, they will have enough time to recover and wait for the swelling and bruising to subside.

Liposuction, body lift, breast augmentation, buttock enhancement, and tummy tuck are just some of the most popular pre-summer preparations among plastic surgery patients.

And just like in winter, spring (only applicable in Northern states) allows patients to wear bulkier clothing that can conceal their post-surgical swelling, bruising, and other symptoms; they will also enjoy long holidays and spring break.

By contrast, summer is not a great time to have cosmetic plastic surgery unless for those who want to use their vacation time to recuperate.  But if a patient chooses this season to have her procedure, a reasonable option is to stay indoors, making sure that she stays in an air-conditioned room to enjoy a comfortable recovery.

Patients should remember to stay away from the sun and never hang out in the backyard or poolside (even under the shade) as the heat may still exacerbate the swelling and bruising, which in turn leads to longer recovery.  Also, they run the risk of developing hyper-pigmentation which can darken the incision sites.

Laser resurfacing is particularly not ideal during summer because the treated area should not be exposed under the sun for at least six weeks.

Just previously, Burge said that she gave her daughter a £6,000-voucher for breast augmentation as a present for her birthday.

First and foremost, plastic surgery should never be imposed by parents to their children unless these are purely done for reconstructive purposes—and apparently, liposuction and breast augmentation are not.

Dr. Tarick Smaili, one of the leading Los Angeles plastic surgeons, said that cosmetic surgery should only be conducted on patients who are physically and emotionally mature, adding that “such procedures should never be brought up by parents to their children, especially those who are not bothered by their appearance.”

“The desire to have cosmetic surgery should only come from the patients themselves, not from anyone else.  Even your parent, husband, wife, or friend should not dictate what you have to do with your appearance,” Smaili said.

However, Burge claimed that she just want to “invest in her daughter’s future” and even compared the plastic surgery vouchers to something like “an investment for education.”

Burge, who has been reported to spend nearly $1 million for cosmetic plastic surgery, disproves accusation that she is a bad mother and defends her stance by saying that “good looks is important and there should be no stigma for anyone wanting to be beautiful.”

But despite her claims, Smaili believes Burge’s presents to her daughter can send a bad message to her young mind.

“Any ethical, self-respecting cosmetic surgeon would not recommend such thing.  First and foremost, board-certified plastic surgeons like me would not perform procedures if there is really no flaw or if the patients are too young to understand the ramifications of such procedures,” he said.

Last year, Burge gave her daughter a breast augmentation voucher and claimed that it has always been a request of her child.  (In the UK, the legal age for this procedure is 16, while in the US the Food and Drug Administration requires a patient to be at least 18 if she will choose saline implants, or 22 if she wants to have silicone implants.)

Meanwhile, perhaps Burge has to realize that the best gift she can give her daughter is letting her develop physically and emotionally at an appropriate rate for her age.

As people age, they lose a significant amount of fats in their face that leads to a tired, old appearance.  During the previous years, the loss of facial volume was only treated with soft-tissue fillers which are relatively safe, although some patients may develop allergic reaction.

Meanwhile, this is not a concern in using fat transfer since no synthetic material is introduced in the body.  For this reason, many patients are choosing this treatment over alternative fat injections such as Radiesse, Juvederm, Restylane, and Sculptra.

However, fat transfer is not just about collecting fatty tissues and then transferring these to another body part.  To increase the survival rate of the fats, plastic surgeons perform purification method in which they separate and remove the blood, tissues, and other impurities.

By employing the proper purification treatment, doctors can increase the survival rate of the fats to 65 to 85 percent which means the result can be long lasting (or even permanent) and also noticeable.

After removing the impurities, the fats are injected to a new area at a varying level in order to encourage better absorption and achieve a more symmetrical and natural appearance.

The good thing about this procedure is that patients enjoy two benefits: they can remove the excess fats from their abdomen and areas where these accumulate, and they can augment the parts which need to be more prominent such as the buttocks, cheeks, and breasts.

For treating larger areas such as buttocks and breasts, patients should have enough fats especially in their abdomen to achieve a drastic change in size.  With this consideration, thin or petite individuals may not have the same noticeable result compared to those with a good amount of fatty tissues in their body.

In case that fat transfer is not ideal or even impossible to perform, patients may choose biocompatible implants to augment and/or improve their breasts, buttocks, chest, cheeks, calves, and other deflated-looking areas which are supposed to be prominent.

Perhaps the most notable development is the tumescent liposuction which has allowed plastic surgeons to perform fat removal completely under local anesthesia.  This is not the case during the previous years when the procedure was conducted under general anesthesia or heavy intravenous sedation which may expose patients to higher risk of complications.

The tumescent liposuction uses a mixture of drug which is injected to the fatty areas to make these more dense, thus easier to be dislodged and suctioned out from the body with very little trauma on the surrounding tissue.  For this reason, patients nowadays can expect faster recovery, minimal or almost no bleeding, and less post-operative pain and discomfort.

Aside from minimizing the surgical trauma, the tumescent fluid has also made it possible to use a smaller cannula or stainless steel tube for suctioning the fats out.  With an outside diameter of less than 2mm, this instrument can easily fit into tiny, round incisions which can completely heal for as short as two weeks without forming any visible scar.

To further improve the fat suctioning process, plastic surgeons complement the tumescent liposuction with power-assisted technique in which they use a motorized cannula that can effectively dislodge the fats by producing, tiny accurate vibrations.  With this new design, doctors can eliminate 25 to 30 percent more fatty deposits than manually pushing the tube back and forth which may injure the surrounding tissue.

In addition, power-assisted liposuction can make the procedure safer since it shortens the surgical time, reduces bleeding and trauma, gives doctors more precision, and paves way for a faster recovery.

Because this liposuction technique allows more precision, this is highly ideal in treating fibrous fats that are notoriously difficult to remove.  These are usually found in the male breasts, back area particularly the bra line, inner thighs, and around the navel.

As with any fat removal technique, power-assisted liposuction involves risks such as irregularities in the skin due to disproportionate collection of fats, unsightly pigmentation in the incisions (although this usually fades over time), and seroma or the accumulation of excess fluids under the skin.

However, patients can significantly reduce such risks by only consulting with board-certified plastic surgeons who have been practicing liposuction surgery for at least five years.

Among female patients, the leg is one of the most commonly treated areas due to its tendency to store excess fats which may not respond even to the most rigorous exercise and diet.

In the Western culture, long and slender legs are an epitome of sexual attractiveness and youthful beauty.  On the other hand, legs with pockets of excess fats are often considered as cosmetically displeasing.

Compared to other areas in the body, the excess fats in the legs are easier to be removed since there is no deep compartment of fatty tissues.  However, plastic surgeons do not perform liposuction on the area behind the knee as it contains important blood vessels and nerves which may be injured by the suctioning device.

Nowadays, most doctors use the tumescent liposuction technique when treating the excess fats in the legs.  They start this procedure by injecting the fatty area with fluids containing lidocaine, which is believed to be the safest type of local anesthesia for fat removal; and epinephrine which is a blood vessel-constricting drug that minimizes the risk of excessive bleeding and toxicity by spreading the effect of lidocaine for up to 36 hours.

And with the use of the tumescent solution, patients can skip pain medications for more than a day because the numbing effect of the local anesthesia is prolonged by the epinephrine.

Plastic surgeons avoid excessive liposuction since this may lead to injury in the blood vessels and cosmetically displeasing leg contour which is further aggravated if the patients will gain weight.  This is because the areas with residual fat will increase in size during weight gain and the regions without fatty tissues will not change, thus resulting to emphasized lumpiness and irregularities.

Compared to earlier fat removal techniques, tumescent liposuction has a shorter recovery since it uses smaller incisions which also minimize the risk of visible scarring.  Meanwhile, these tiny holes in the skin (or adits) are left open to enable the excess fluids and anesthetic solution to drain out from the body.

In addition, the use of adits can dramatically reduce symptoms such as swelling and bruising, thus making the recovery more comfortable for patients.

To promote good hygiene, adits are covered by absorbent pads which are held in place by elastic compression garments.

During the previous years, fat removal plastic surgery was only performed using a large cannula (instrument for removing the fats) which can result to higher risk of bleeding, surgical trauma, and visible scarring.  Fortunately, these problems have almost been eliminated after the introduction of tumescent solution which is injected to the treated area to make suctioning less traumatic on tissues.

Meanwhile, the water-jet liposuction takes the tumescent technique one step further.  In this approach, plastic surgeons use a probe that releases a thin, wedge-shaped jet of water combined with local anesthesia that will dislodge the fat cells—just like a hose that clears away the debris from the ground.

This liposuction technique was developed and marketed by German company Human Med AB.  The device for this procedure is sold under the brand name BodyJet, which is the only available version in the market.

In terms of safety, plastic surgery specialists believe the water-jet liposuction is better compared to other liposuction techniques as it provides more precision and does not involve any risk of burning unlike in laser-assisted method.  Clinical research data also showed that BodyJet is as effective as any of the legal liposuction devices that are currently used in the US, thus prompting the Food and Drug Administration in 2008 to declare this as safe and effective when performed as directed and if given to the right patients.

Just like most fat removal techniques conducted today, water-jet liposuction is performed under local anesthesia which is mixed to the water that is used to dislodge the fatty deposits.  This means that general anesthesia, which has a higher risk of complications, is no longer needed.

Because of the BodyJet’s precision, plastic surgeons believe that the tissues are exposed to a minimal level of trauma which means that patients can expect less pain during the healing period, faster recovery, and less swelling and bruising.

Since the water jet liposuction is a relatively new procedure, plastic surgeons have yet to conclude if this will become the most sought-after fat removal technology, or just turn out to be a less invasive substitute for tumescent lipo which is currently the most preferred choice.

The excess skin in the abdominal area may be caused by weight loss and natural effects of aging.  However, this aesthetic problem commonly occurs after several pregnancies which may weaken and stretch the muscle, tissue, and skin.  And for women who have C-section, the loose skin may be further aggravated by the pockets of fats which usually accumulate in the upper area of the incision.

While the excess fats in the abdomen may respond to a rigorous exercise, this may not be enough to improve the weakened muscle and stretched skin.  In this case, plastic surgeons believe that tummy tuck may be the only option to improve this aesthetic problem, and which may be combined with liposuction to remove the fatty deposits.

If plastic surgeons have to combine tummy tuck and liposuction, they usually perform the fat removal procedure first by making several small incisions where they can insert the cannula, a slender suctioning probe attached to a vacuum pump.  The fatty tissues are then dislodged by moving the device back and forth, although some doctors prefer using the motorized cannula which produces accurate, tiny vibrations.

Once the fatty deposits in the abdomen are suctioned out, plastic surgery specialists will create a U-shaped incision with its bottom touching the pubic line while its two sides are curving upward to the hips.  This surgical approach is highly recommended for patients with a significant amount of panniculus.

But for women who have less sagging skin in their abdomen, the best plastic surgery approach is the mini tummy tuck which uses a shorter incision.

Through the abdominal incision, doctors can manipulate and suture the weakened muscles and remove the excess tissue, skin, and fats.  For patients who need the most correction, they may need a second incision around the navel which will allow surgeons to place this to a higher position and remove the excess skin around it.

After the weakened muscle is repaired and the excess skin and fats are removed, plastic surgery specialists will close the incisions using staples or sutures.  In many cases, they will leave temporary drains to prevent seroma, a condition in which the blood and other body fluids accumulate under the skin.

One of the most commonly treated areas in liposuction for men is the chest.  Since overdeveloped breasts are generally associated with feminine figure, such condition may lead to self-consciousness and low self-esteem which makes plastic surgery important for some patients.

To treat the excess fats in the male breasts, plastic surgeons use tumescent fat removal technique in which they inject the area with a solution which can lessen the surgical trauma by making the fatty deposits firmer and swollen.  With this procedure, patients can expect minimal or even no bleeding unlike in the previous method called dry liposuction (because no fluid is used) in which blood transfusion is even performed due to the significant bleeding.

Nowadays, most doctors have abandoned the dry liposuction surgery as it is also associated with prolonged recovery, higher surgical trauma, more pain and discomfort after the procedure, excessive swelling and bruising, and visible scarring.

With the introduction of tumescent technique, it has become possible to use micro-cannulas or fat-suctioning probes which have a 1 to 2mm-diameter body that can fit into shorter incisions.  For this reason, plastic surgeons have almost eliminated the risk of visible scarring and lowered the surgical trauma.

These are the other advantages of using micro-cannulas: smoother result, more precision for targeting smaller pockets of fats, shorter recovery, and less risk of complications.

But since the fats found in the male breasts are very fibrous, some doctors prefer using motorized cannulas that are designed to produce tiny, accurate vibrations.  With this instrument, plastic surgery specialists have found that they can remove 30 percent more fats compared to manually moving the probe back and forth.

And because of the accurate vibrations of the motorized cannula, male patients will also enjoy less surgical trauma and bleeding which can further shorten their recovery.

While there are new liposuction techniques and equipment that have paved way for a safer and faster removal of the excess fats, the cost of the procedure is still higher for men than women because doctors have to use more complex methods so their patients can achieve the best possible result.

Perhaps the most notable advancement in liposuction surgery is the tumescent technique in which doctors inject the fatty area with anesthesia-containing solution to make this firmer and swollen, thus leading to a gentler and faster removal of fats.  And since the fluid is also mixed with epinephrine, which constricts the blood vessels, there is almost no bleeding and the risk of toxicity is significantly reduced since the effect of local anesthesia is spread to longer hours.

In fact, the numbing effect of the local anesthesia can last for up to 36 hours which means that patients can avoid additional pain medications during this period.

Aside from making liposuction surgery significantly safer, the tumescent technique provides a smoother result compared to “dry method,” the earliest fat removal treatment in which plastic surgeons do not use any solution to destroy the fats.

Many plastic surgery specialists have abandoned the “dry method” since it involves significant bleeding and higher risk of scarring because it uses larger cannulas or suctioning probe in order to dislodge and remove the fats.

Using larger cannulas also lead to higher risk of uneven appearance since the instruments lack precision unlike fat-suctioning probes which come in smaller sizes.

But with the introduction of tumescent liposuction surgery, it has now become possible to use smaller cannulas with a 1 to 2mm-diameter body which can fit into tiny incisions, thus leading to almost no risk of visible scarring, more precision in removing and dislodging the fats, faster recovery, and less surgical trauma on the surrounding tissue.

In addition, the tumescent solution has also allowed plastic surgeons to collect more amounts of fats without predisposing their patients to a high level of trauma, a main concern in the “dry method.”  But still, many are limiting themselves from collecting more than 3 or 4 liters of fats in a single session just to ensure the safety of their patients.

In case that there is a need to collect more amounts of fats, it has become a standard in plastic surgery to perform more than two liposuction treatments several months apart.

Meanwhile, the introduction of smaller cannulas has also made it possible to use adits, which are small openings in the skin that measure 1 to 2mm.  After performing liposuction, surgeons do not suture the incisions so the anesthesia, blood, and other fluids can be drained out of the body, thus leading to shorter recovery.