Body Work

Cosmetic surgery is not as prevalent as brushing teeth, but it has become a bit of a national pastime. The American Society of Plastic and Reconstructive Surgeons (ASPRS) reports that procedures performed by its members rose 63 percent during the 1980s. The most popular is now liposuction, followed by breast work. Another new trend: 90 percent of cosmetic work is performed outside a hospital.

Worried about upper arms with bulges, not muscles? Liposuction - a.k.a. suction lipectomy, lipoplasty, or the fat-sucking operation - takes care of chubby armpits. If the problem is stretched-out, wrinkled under-arm skin resulting from sun damage or aging, an arm lift - or brachioplasty, to trim the excess skin liposuction doesn't treat - may be in order, too.

Over the last 10 years, the number one method of choice for smoothing lumpy abdomens, hips, and thighs has been liposuction. (The majority of liposuction procedures - 34 percent - address the hip and thigh areas, according to the ASPRS.) With a new miniaturized cannula (a hollow needle used as the fat vacuuming tool) in wide use, surgeons are now perfecting the operation in a variety of ways.

Perhaps the best news is that liposuctioned fat is now recyclable - it can be reinjected to plump up different parts of the body and face. Unfortunately, however, fat injections are not recommended for breasts, according to The American Society for Aesthetic Plastic Surgery (ASAPS), since these injections may cause calcification and obscure cancer detection.

In New York, John E. Sherman, M.D., a member of the ASPRS, has introduced what he calls "epi-surgery" - liposuction performed under epidural anesthesia ("sadd-leblock" anesthesia commonly used during childbirth). The advantage, according to Sherman, who has been removing fat with an epidural for three years, is that the procedure is less invasive to the body and the well-being of the patient. While bruising and after-care remain the same as with more traditional liposuction, epi-surgery does allow the patient to leave almost immediately after surgery is performed, without the nausea or "hung-over" sensation common after local or general anesthesia is administered.