Legs are often overlooked in Cosmetic Surgery. However, think about how much of your "person" is legs??? We all want to work on our faces, abdomens, and breasts but often forget about one of the larger parts of our body. What can be done??
Here are the common problems:
1. Lost tone and shape of the butt.
2. Saddle bags or outer thigh enlargement.
3. Inner thighs becoming large and "rubbing" together.
4. Weight gain in the anterior or front of the thigh and knees.
5. Spider veins.
6. Varicose veins.
These are the most common complaints I hear from day to day. These complaints are due to hormonal changes and the process of getting older. Also, genetics can play a role in how we all gain weight.
First, the butt. What can you do when the shape of the area is lost? The most common problem is not that the shape is lost, it has become hidden. Most of us gain weight in the hip or love handle area (the muffin top) and in the outer thigh or saddle bag area. When these areas enlarge, the but area becomes smaller in comparison. So how can this be fixed?? What I usually recommend is liposuction. Liposuction of the outer thigh and hip area makes them smaller and the secondary result is a more shapely butt. We can also take the fat from these areas (which is usually high quality) and transplant it into the butt. This will increase the volume of the buttocks and after liposuction of the surrounding areas, you can have the shape you are looking for. 
In this photo, you can see the improved shape of the buttocks after liposuction. It looks bigger because the surrounding areas are smaller.
Second, the Saddle Bag. These are the areas that not only "shrink" the butt, but also create a problem when trying to get into jeans and dresses. I hear it all the time, "I cannot buy jeans that fit my waist and thighs at the same time"!! Liposuction is what I use to attack these areas. It can be an amazing transition when you can drop 2-3 pant sizes with one in office procedure. Other procedures that are advertised may or may not work for you...this one is guaranteed.
You can see from this photo that indeed, you can drop a significant number of pant sizes and regain your shape.
Third is the inner thigh area. I hear it all the time...."I hate that my thighs rub together". We can actually lump three and four together, the inner thigh, anterior thigh, and knee areas. Again, what we use is liposuction. These areas are fairly easily done and the recovery time is short. All of the areas can be done together to re-shape the entire upper leg. Small incisions about the size of the end of a pen are used in the groin area and in the fold at the base of the buttocks. Within a few weeks the difference will become visible and you will need to find some new pants...but don't, because, it will continue to get smaller for 4-6 weeks.
The next complaints are of veins. Spider veins and varicose veins are ugly. They are also, sadly, very common. Caused by heredity, trauma, child birth, and life style, they come and stay. They trap many people in long pants making it embarassing to wear anything else. Spider veins are considered a cosmetic problem. They are the small, blue veins that are very close to the surface of the skin. Treating them requires professional evaluation to make sure no other bigger problems with the veins exist. Once other venous problems are ruled out, they are treated by injecting small amounts of a substance to obliterate the vein. It does cause some inflammation and this procedure, called sclerotherapy, is best done in the fall and winter....NOW! It may take several treatments to get rid of them all, and may require maintenance. We charge $300 per session, very competitive. Varicose veins are a different story. They require more extensive evaluation and treatment. Much less than in the past however. Getting rid of these veins, when symptomatic, is done as an office procedure and is usually covered by insurance.
Come see us NOW to get ready for next summer....remember your legs....they need attention too!
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Here is a common picture that shows and labels the areas we are discussing. As we age, the face loses volume..ie fat. We get it where we don't want it and lose it where we'd like to keep it....go figure!
This picture demonstrates a before and after of a nasolabial fold filled with Radiesse....Nice result I think. The area is softened quite nicely. This is done in the office with very little discomfort and an immediate result. We could also use Juvederm in this area. Both fillers last a year or more and there are few problems with them.
Here we see in the before picture how the nasolabial folds are prominent and the marrionette lines are too. These lines are present at the corners of the mouth and cause the lip corners to turn down. When filled, the result is pretty amazing. You get a much more youthful appearance with no surgery and no recovery time.
A third area complained about is the glabellar area. Botox works to soften this area but when the lines persist, it is a great place to fill.
The stretch marks in this photo would indicate to me that a tummy tuck would be a better choice for her...why? Her skin will have less of a chance of contracting after the fat is removed because of the poor starting skin quality. It will be more likely than not that her skin will not contract. This does not rule out liposuction for her but she must understand that, in clothes, she will look better and more sculpted, but in a swimming suit, the skin will still look bad and possibly more saggy. If her skin were smooth, she would be a much better candidate.
Gynecomastia during adolescence is made of fatty tissue with a bud of breast tissue under the nipple. By the early 20's it should be gone, if not, it may become a real problem. The problems it causes are not generally physical but psychological. Wearing normal clothing becomes an uncomfortable situation for a guy that has breast tissue and makes one very self conscious. Working out to develop pectoral muscles can often times only make things worse...so what's a guy to do??
First of all, be patient. It is hard to do but fortunately, in a majority of cases the problem resolves after hormone changes settle down. In cases that don't resolve, we can take care of the problem. Usually, in the normal case, I will liposuction the chest and remove the "bud" of breast tissue. I do this through a small incision in the arm pit to liposuction the chest of excess fatty tissue. I then make an incision through the nipple to remove the small bud of breast tissue. We do this in the office procedure room using some IV sedation and tumescent local. It takes less than an hour and can be life changing. We have you wear a compression shirt for about 3 weeks and from that point on, normal clothes can be worn without the worry of those two little reminders poking through. The incisions heal very well and go unnoticed after a healing time of a few months.
We can lift the breast in this instance but it will not make the upper part of the chest full. Once the nipple has been repositioned into a more appropriate spot, we have all the skin left below it. This skin must be removed and the skin envelope tightened. We now have a breast that is much perkier with a nipple position that is elevated. 
As you can see, there is a great improvement in shape and nipple position. However, from this 45 degree view, the upper aspect of the breast is very sloped. Many women don't mind this and that is fine but if upper breast fullness is desired an augmentation is required with an implant. That's where the problem comes in. The second problem is this; now that we have a tighter breast skin envelope we are now going to place an implant that will stretch what we have now tightened. This can easily be done and since we have lifted the nipple we put the implant below the muscle. What this does is fill in the upper pole of the breast and helps you regain that youthful breast that was lost.
As you can see from the picture, on the lateral view and 45 degree view the upper pole is now full with good cleavage...nice result.
(melasma or brown spots from the sun)