Liposuction is one of the most commonly performed cosmetic surgeries worldwide, and the development of new techniques has provided plastic surgeons with a safe and efficient way to shape the human body through fat removal. Now, a new study illustrates what works — and what doesn’t — in liposuction procedures.

Over the years, the technologies and instruments used in liposuction have evolved significantly since its introduction. To determine whether all improvements have been for the better, a group of four plastic surgeons in Cali, Columbia, analyzed outcomes from more than 25 years of liposuction procedures performed on more than 26,000 patients. The study authors found that tumescent liposuction and laser-assisted liposuction (LAL) have improved the safety of liposuction procedures, reducing the risk of anemia, a common complication affecting 18 percent of all patients, while still delivering the best aesthetic results.

However, there are still some risks with every type of cosmetic surgery procedure. Tumescent liposuction has been shown to increase the risk of post-surgical seromas — a mass or swelling caused by the localized accumulation of serum (a yellowish fluid) within a tissue or organ that can develop after surgery. Also, the incidence of skin necrosis was significantly higher in patients who underwent UAL than for other techniques, which led the study authors to abandon this practice.

Although 90 percent of patients reported experiencing postoperative pain, regardless of the technique that was used, an average of 82 percent of patients were satisfied with the outcome of their procedure, and satisfaction levels were similar for all of the liposuction techniques covered in the review.

Study results appear in the current issue of the Aesthetic Surgery Journal. Before deciding on what sort of liposuction would be best, prospective patients are advised to talk to an experienced surgeon who is board certified in plastic surgery to discuss the treatment options available. Using a qualified surgeon will increase the odds of success, reduce the risk of complications, and help ensure that the doctor uses the most appropriate procedure — not simply the newest gadget.

Some plastic surgeons are taking the rhinoplasty process one step further by using injectable fillers after the initial surgery.

The American Society for Aesthetic Plastic Surgery reported that rhinoplasty continues to be a high-demand procedure, with 152,434 performed in 2008. But an article in the November/December 2009 issue of Aesthetic Surgery Journal explained the need, in many cases, for surgeons to inject soft tissue fillers into a patient’s nose to smooth out what the nose job couldn’t quite fix. Filler uses include correcting deformities, or adding volume to make the final result more closely resemble the intended design.

“Injectable fillers allow surgeons to correct post-surgical imperfections without the expense, anesthetic risk, or recovery downtime involved with additional surgery,” a press release quoted Steven Dayan, MD, co-author of the Journal‘s article.

Doctors are using injectable fillers such as liquid silicone, hyaluronic acid and calcium hydroxylapatite gel – though silicone, because  of complications, is ill-advised. Doctors tend to use these fillers on the top and sides of the nose while avoiding the nose or tip. A “less is more” technique prevents blood vessel or soft tissue damage or “bumpy” appearance that an excessive injection of filler can cause.

Fillers are becoming a common sidekick surgery due to the pressure on surgeons to “get it right the first time” and not have additional procedures.

Fillers are no substitute for excellent surgical results,” he said. “Rhinoplasty surgeons must continue to strive for perfection in the operating room.”

A study in the recent issue of Aesthetic Surgery Journal offers the theory that women have a few physical differences that may cause them to show signs of aging more quickly.

The study authors cited the that women have fewer sweat and oil glands – at least in certain parts of the body, such as the region around the mouth. With less oil being produced, researchers note, a woman’s skin will age faster and produce wrinkles sooner than male skin. Also, women have fewer blood vessels in the facial region around the mouth, which means less blood flow, leading to aging skin.

The doctors also noted that women have facial muscles closer to their skin than men do, which can pull on the skin and cause wrinkles. Added to all this, the doctors said, women experience hormonal changes in middle age that lead to less oil production in the skin and therefore more visible lines.

Beyond plastic surgery, the best way women can preserve their skin is to avoid smoking and too much sunlight – and to use moisturizers and skin creams.

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Cosmetic surgeons are now using dermal fillers to revitalize the eyes. A recent article in the Aesthetic Surgery Journal notes that hyaluronic acid fillers are a reliable, long-lasting treatment for improving the eye area, without undergoing an eye lift.

Similar to fat injections, hyaluronic acid–or HA–fillers are injected around the upper and lower eye to add volume and minimize the appearance of sunken and tired eyes. This procedure is generally performed in the office using a local anesthetic, and takes less than an hour to complete.

In addition, while some of the fat used in traditional filler techniques may reabsorb into the body or cause unpredictable hard areas and irregularities, HA fillers have been shown to last more than two years, and are completely reversible. They also present only mild side effects such as light swelling or bruising.

Dr. Val Lambros, who authored the article, noted, “The addition of volume may provide a better-looking result than traditional surgical procedures, and in some cases, filling in the brow expands the lid skin sufficiently to smooth wrinkles.”

These stories and more are featured in this week’s newscast. Click the video player below watch the full episode.

Organizations mentioned in this episode:

• LoveYourLook.com
• National Health Service
• Aesthetic Surgery Journal
• Dr. Val Lambros
• Dr. Douglas Steinbrech
• Global Industry Analysts Inc.
• Cosmetic Surgery Times

The latest issue of the Aesthetic Surgery Journal cautions surgeons to check what herbal or natural supplements patients may be taking. The report cites that as many as 40% of patients who have plastic surgery are taking natural supplements, which may hinder the results of the surgery or can increase the risk of complications, such as bleeding.

The report also notes that 70 percent of patients don’t bother to report to their surgeons any natural supplements they are taking. Whether they believe that natural equals safe, or whether they simply don’t believe that supplements could adversely affect their healing, isn’t clear.

Alan Gold, MD, president of the American Society for Aesthetic Plastic Surgery, says – quote, “Stopping certain herbal supplements prior to surgery is just as critical as stopping aspirin, ibuprofen and many other common drugs.”