There were many thousands of plastic surgeons and suppliers in Seattle last week. I go to the annual meeting at least every other year. i always expect nothing new, since I've been doing it for so long it's hard to believe anything could be better, but guess what?  every year I am surprised by the ingenuity of my fellow surgeons.
This year a British surgeon figured out how to cross link hyaluronic acid (Juvederm/Restylane) to make it thick enough to be injected under breasts and take the place of breast implants surgery. The cost is about the same, it still requires a "surgical setting" for sterility and the size is limited to a one cup size enlargement, but I predict it will be perfected to include much larger sizes and many other body parts (like hips & buttocks).
The variations in "powered liposuction" devices is emmense; There are laser, ultra-sound, radio=frequency, water jet and reciprocating devices all competing for the gullible surgeon's dollar.  Some cost over $100,000 per machine and do nothing but make it physically easier for the surgeon. That's a good thing for the thousand female plastic surgeons, but the rest of us prefer the hands-on feeling the standard liposuction method provides. The cost of the machines gets passed on to thew patients of course........someone has to pay for it.  The skin "resurfacing machines are similar.....20 differfent variations that do less, less & more less. All the senior surgeons, like myself, have gotten rid of their lasers and gone back to acid peels (in about 20 differfent strengths for different skin problems) because it is more effective, more reliable and way less expensive. The micro-surgeons have gained expertise and developed itty bitty tweeny weenie coupling collars to snap together tiny blood vessels the size of a big human hair. So there are more post mastectomy breasts being made3 out of back tissue, redundant tummy tissue and even buttocks if a ut lift is desirable with the bilateral breast reconstruction. Sometime they make the new nipple on the buttock before it is transfered to the braest site. Weird looking to say the least, ut quite effective and 90% reliable.  The other new develpoment is the Hollywood fanfare production techniques used to "sell" gullile doctors on products sold by huge corporations. Or maybe I'm just too old to like the loud noisy glitzy presentations. The younger surgeons understand rap better than me. I decide on proven effectiveness, reliability and safety which products I buy. And I bought several thousand dollars more than my book-keeper would like! Now I have to work hard enough to pay for it. We keep a larger inventory of surgical undergarments than most department stores, so that we'll have the right garmet for each patient when the time comes. I never dremed I would become an undergarmet salesperson! But then, I never dreamed I would be a plastic surgeon when I was in medical school  either. It was a process of elimination, eliminating the specialities I didn't care for. That left reconstructive surgery as my choice. The cosmetic part wasn't the goal, it just snuck in there without my noticing. So now I stock undergarments for sale! Thousands of dollars worth of them! I'm not complaining. I know it could be worse..I could be a proctologist and be stocking Pampers!
Dr. Foster