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Cosmetic Surgery The Next Generation

Boob jobs for men and other new ways we're reshaping our bodies

By Alexa Stanard

In the evolving world of plastic surgery, the search is always on for the latest and the greatest innovation. Think only your face can be lifted? Think again. And while liposuction and breast enhancement aren't going away, they've taken on a whole new twist.

Here's a look at some of the latest, most popular ways to change your physique - and some things to bear in mind before you go under the knife.

Boob jobs - for men

For the male set, it's not about being a 38D. Some men who want a chiseled chest now can have it, thanks to a relatively new procedure known as pectoral etching. To achieve a sculpted look, physicians use targeted liposuction along the chest muscles' lower and outer edges, leaving a modest fat pad over the pecs in order to create a contrast.

But before you have visions of being the next Matthew McConaughey, be warned: The procedure won't work for everyone. Ideal candidates are those who already are trim and have some muscle development, says Michael Freedland, M.D., a cosmetic surgeon in Bloomfield Hills. Artificially sculpted pecs on an untoned or overweight body will just look "funky," he says.

Pectoral etching sometimes is accompanied by implants inserted under the pectoral muscle. Implants for men are tricky, according to Freedland, partially because men lack breast tissue that cushions the implant and makes it look natural. Implants can shift, and fluid can accumulate, requiring revisions. They're best for those who are young and athletic and who are looking for definition - not those looking to be transformed.

"I think of the chest contouring - implants and sculpting - as more like liposuction than breast augmentation," Freedland says.

Of the 1.1 million men who had plastic surgery in 2006, approximately 400 had pectoral implants, according to the ASPS. That number doubled from the 200 men who received implants in 2005.

Yet, not all male breast surgeries are done to get that Adonis-like look. Some males choose to have breast reductions and/or pectoral etching because of gynecomastia, a condition in which fibrous breast tissue covers the pectoral muscle, causing breast enlargement. The condition poses no health risks but can be embarrassing.

A male breast reduction involves removing the tissue via liposuction, but doing so can be complicated because of the tissue's thickness, Freedland says. Risks for breast reduction include scarring, bleeding and changes in breast sensation, according to the ASPS.

Finally, men who have lost large amounts of weight can opt to have excess loose skin removed to reduce the size of the breast. The procedure typically leaves scarring, and those considering it must decide whether that is preferable to loose skin.

According to the ASPS, the national average cost for pec etching is $2,750, while pec implants average $3,500. The average cost for male breast reduction is $3,000.

A lift here, a lift there

Move over, facelifts, there are a couple of new body parts in town. According to the ASPS, from 2000 to 2006, the

number of arm lifts, or brachioplasties, jumped 4,300%, from 300 procedures to more than 11,000. And moving a little south, the number of thigh lifts went from 1,000 in 1992 to more than 17,000 in 2006.

"The majority of patients whom I perform arm and thigh lifts for are massive weight-loss patients," says Mariam Awada, M.D., a plastic surgeon in Southfield. "Typically these patients have undergone gastric bypass surgery and have had more than a 100-pound weight loss. They're left with severe excess skin and skin laxity."

An arm lift reshapes the upper arm from the underarm region to the elbow by reducing excess skin and fat. A thigh lift involves similar reshaping above the knee.

New techniques have increased the popularity of brachioplasty. Using liposuction rather than incisions to reduce arm size has led to less scarring in patients with limited amounts of loose skin, Freedland says. Ideal candidates are thin patients with excess skin and little fat whose weight has been stable for a year, Awada says. It's also important for the patient to have realistic expectations and be willing to accept visible scarring.

Patients should be prepared for a recovery period of several weeks and dressing or bandages might need to be worn, along with a small drainage tube. According to the ASPS, the national average for an arm lift is $3,500, while a thigh lift averages $4,400.

Lipo meets lasers

Anyone who's seen liposuction performed on a reality makeover show might think twice before hopping onto the operating table. After all, marking up someone's body, then using a tube to dig in and suck out fat looks almost violent.

But liposuction's getting better. Smart Lipo, a procedure imported from Europe, uses lasers placed inside the patient to break up the fat before it's taken out, allowing for easier removal and improved appearance after the procedure.

"Patients have less downtime and soreness, and we can get more fat out," says Charles Mok, D.O., of Allure Medical Spa, who in January 2007 began performing CoolLipo, a version of the laser procedure.

CoolLipo is used primarily for body contouring rather than for weight loss. Because the lasers first melt the fat, giving it a smoother consistency, a tube smaller than that for traditional liposuction is used. Only local anesthetic and sedation are required, and only one treatment is needed.

The procedure is commonly done on the neck, Mok says, and can also be performed on the arms, thighs, abdomen and back. The procedure costs between $3,500 and $5,500 at Allure, and has the same risks as those of regular liposuction, with the most common being soreness, swelling and bruising.

While CoolLipo is easier on the body than traditional liposuction, patients need to know it's still an invasive procedure, Mok says. Recovery takes a couple of days if a small area has been treated, and about five days for a large area.

As is characteristic of the land of plastic surgery, there already is an updated version of laser-assisted liposuction on the horizon. A newer, noninvasive procedure that uses laser paddles to melt fat and eliminates the need for it to be drawn out of a tube is being performed in the United Kingdom. The procedure, known as Laser Lipo, requires no incisions or anesthetic and is done in an eight-session course of 40-minute treatments.

But Mok is skeptical: "Although the external laser has been touted as reducing fat noninvasively and has undergone clinical studies, there has yet to have been any published information that supports the claims."