The common misconception:

Many people have the idea that liposuction is a weight loss procedure. Actually, liposuction goes best when you are at, or near, your normal weight. The point of liposuction is not to reduce your weight but to remove bulges that may show through  clothing.

Liposuction is often done in connection with gynecomastia surgery. In most guys, there is some fatty tissue over the main chest muscle, the Pectoralis  major. That can be liposuctioned with good results but the dense, fibrous tissue lying under the nipple must be surgically excised.

Liposuction is also used in another procedure that men like, the Torsoplasty. Once many guys have a flat chest, they eyeball the rest of their torso more critically and decide the flabby stomach and love handles should also go.

(Check out some Torsoplasty and gynecomastia before and after pictures for yourself.)

Liposuction is done on those locations, big time. But only where the fat is what we doctors know as superficial, that is, lying just under the skin.

If you have a rotund pot or beer belly, that fat is too deep down around your internal organs for liposuction and you must remove that on your own – with serious workouts and a reasonable, low calorie diet.

Women most often request liposuction of:

• Thigh bulges
• Love handles
• Flabby upper arms

Now for the news I mentioned: For the first time, the International Society of Aesthetic Plastic Surgery (ISAPS) has compiled the numbers and types of cosmetic plastic surgeries done worldwide in 2009.

The most popular procedure in the world? You got it, liposuction! It accounts for18.8 percent of all plastic surgery done globally but is second in America. (Breast augmentation is in first place here.)

The world’s most popular procedures two through five are:

• Breast augmentation – 17%
• Upper or lower eyelift – 13.5%
• Nose jobs – 9.4%
• Tummy tuck – 7.3%

Here’s another statistic you might find interesting.

The top 5 nations for performing large numbers of plastic surgery procedures are:

1. United States
2. China
3. Brazil
4. India
5. Mexico.

Here is my interview on WCBS-TV’s “The Early Show”. Go to: http://www.cbsnews.com/stories/2010/08/09/earlyshow/health/main6756741.shtml

Yearly, the professional plastic surgery societies like  the American Society for Aesthetic Plastic Surgery (ASAPS) crunch the numbers on the previous year so we know the ages of patients having all the popular cosmetic plastic surgeries – like face lift and breast augmentation – plus the numbers of each procedure completed, the cost of plastic surgery and so on.

For the most recent set of statistics – 2009 — all plastic surgery procedures and techniques declined by two percent over 2008’s statistics, due to the recession. Surgeries declined 17 percent while nonsurgical procedures went up almost a full percent.

Along with the decline in procedures went prices.

For gynecomastia surgery, the average cost of cosmetic plastic surgery during 2009 was $3,294, $116 less than the previous year.

Of course, the $3,294 is the average surgeon fee. Usually, you must add on charges for the operating facility and for the nurse anesthetist or a board-certified anesthesiologist, along with some other items incidental to the procedure like medications, pathology fees, compressions garments and so on.

Currently, interest in all types of cosmetic plastic surgery is increasing which brings us to another question over which economists are always scratching their wizened heads.

When are prices going back up?

We would imagine that as more patients inquire about, and go ahead with, man boob surgery or other procedures, the prices will rise.

So, could now be a good time for a bargain if you’ve already been thinking about gynecomastia plastic surgery? Will prices go up in 2010?

Could be! Hey, we don’t have a crystal ball, either!

But if you combine a lowered price for surgery with other common discounts, you may realize quite a savings.

An all cash, paid-in-full arrangement is usually worth a three percent discount while agreeing to have your surgery during the doctor’s least busy time may be worth one to two percent. In many places, if you agree to fill in for patient whose surgery is canceled at the last moment, you could receive another one to five percent discount.

Best case scenario: 10 percent is nothing to sneeze at! That equals a possible savings of 329 smackers on the average ’09 gynecomastia surgery.

While some pediatricians and even plastic surgeons are against it – thinking the lad may outgrow the condition – the teen patient’s life can be hellish if the condition does not go away. Others say the breasts may grow back after surgery. (They don’t!)

According to the American Society of Plastic Surgeons (ASPS), 14,203 patients between 13 and 19 went under the knife in 2008 for male breast reduction.

(2009 statistics will be available soon.)

While I’m not a psychologist, anybody who hears these lads’ stories would conclude some damage is being done at a critical time in a young man’s life when he should be building self-confidence, not having his image torn down daily.

For the teen with large breasts (or “man boobs” as they are cruelly known) teasing and finger pointing can also destroy his fledgling ability to relate to both boys and girls.

Recently a teen gynecomastia patient complained of school bullies flicking his breasts as if he were a girl. And here’s what he said about his social life, which is usually very active for any teenager: “I don’t like going out because it seems like everybody is staring at me.”

It turned out that Tim’s father also suffered as a teen with large breasts and did not want to see his son go through the same thing.

One boy, pictured below, was only 12 when he and his family came to see me about male breast reduction surgery.  (Read The Post-Standard article from  Syracuse, N.Y. about teens with gynecomastia .) The after picture was taken in February, 2010.

After surgery, the youngster was so motivated, he lost 35 pounds through diet and exercise!

In another case, a mother wrote about her son whose breasts started growing when he was only 10.

Some female classmates said it would not be cool to have a boyfriend with bigger breasts than they had! Naturally, the lad was crushed.

(Read the touching letter of the mother whose son had gynecomastia.)

I’ve performed male breast reduction surgery on over 175 teens and recommend it, if certain diagnostic criteria exists like:

• Stability for at least two years.

Breast size have not changed

• Being emotionally mature.

He must understand treatment is an operation, with all that entails.

(Read more about when teens should have gynecomastia surgery.)