Watch first two segments of their story on 20 / 20 ABC News.

According to the ISAPS data, plastic surgeons in the U.S. performed more plastic surgery procedures in 2009 than surgeons from any other country, for a grand total of more than 3 million procedures.

Of these 3 million procedures, approximately 1.3 million were surgical procedures, while the other 1.7 million were non-surgical procedures.  Brazil was the only other country wherein plastic surgeons performed more non-surgical cosmetic procedures than surgical cosmetic procedures last year.

Injectable wrinkle-relaxing treatments, including Botox and Dysport, were among the most popular non-surgical cosmetic procedures in both the U.S. and the world in 2009 with more than 2.7 million procedures performed.  More than 1 million hyaluronic acid filler injections and laser hair removal treatments were also performed last year.

Non-surgical procedures were so popular in the U.S. last year that unlike plastic surgeons in nearly every other country included in the ISAPS statistical, U.S. plastic surgeons actually performed more non-surgical procedures than surgical procedures in 2009.

Although ISAPS statistics suggest that plastic surgeons most frequently perform non-surgical cosmetic treatments, their primary areas of expertise are generally breast surgery, body contouring, facial plastic surgery and revision surgery.

In fact, liposuction and breast augmentation were the most popular plastic surgery procedures performed worldwide in 2009, with more than 1 million of each performed by plastic surgeons.  Tummy tuck, or abdominoplasty, and breast reduction were also performed on more than half a million times.

Blepharoplasty, or eyelid surgery, was the third most popular surgical procedure internationally, also breaking the one million mark according to survey results, while rhinoplasty, or nose surgery, was the second most popular facial plastic surgery procedure and accounted for more than half a million of total plastic surgeries performed worldwide last year.

Because body issues like overly large or small breasts, stubborn fat deposits, excess or sagging skin and nasal deformities are common problems associated with the natural aging process that affects men and women worldwide, it comes as no surprise that procedures designed to correct these issues were among the world’s most popular cosmetic procedures in 2009.

If you’re considering plastic surgery in 2010, remember to seek an experienced, board-certified Seattle plastic surgeon for your body contouring or breast enhancement procedure.

These crimes resemble the old dine-and-dash routine, where diners eat a meal at a restaurant, then purposely leave the establishment without paying the bill, however when this kind of criminal hits a doctor’s office, the revenue loss suffered is far greater than that of your average Olive Garden.

Popular media has dubbed these criminals “Botox Bandits,” as Botox and other injectables like Restylane, Juvederm and Radiesse tend to be their treatments of choice.  Whatever you call them, these thieves are becoming a widespread problem that is changing the face of cosmetic medicine.

Physicians in Arizona, Texas, California, Florida and Nevada, and even internationally in the UK and Australia, have reported getting hit by “Botox Bandits” who had thousands in wrinkle relaxing and injectable filler treatments then fled without paying their bill.

Cosmetics crooks typically give the doctor’s office staff some sort of excuse to leave after their treatment is complete, such as needing to withdraw cash from an ATM or go out to their car to get their purse or check on a waiting child.  Other patients wishing to get out of settling their tab write bad checks, knowing they don’t have the funds to cover them.

Florida law enforcement reported catching local perpetrators of these crimes, including the highly publicized cases of Jaime Merk and Maria Chrysson, two “Botox Bandits” who got busted after stiffing area doctors for thousands in beauty treatments, spreading awareness about this issue and forcing physicians to guard against this increasingly common criminal practice.

More and more doctors are being forced to require prepayment for injectable treatments, facial rejuvenation and other services.  Many doctors also require cash, credit or debit card payment and will not accept checks for elective procedure services that are not billed through insurance.

Upfront payment may be a bit off-putting to some, but given the recent crime wave, understanding and cooperation will not only help doctors protect their businesses from fraud and revenue loss, it will also foster a more trusting relationship between patients and their partners in beauty.

Medical device manufacturer Cytori Therapeutics recently received European approval (CE mark) of its Celution and PureGraft systems, two new breakthrough devices designed to increase the applications of autologous fat grafting using stem cell-enriched fat, as well as improve the efficiency of autologous fat graft preparation for standard fat injection procedures.

The Celution System

Cytori’s Celution System works by extracting and separating stem and regenerative cells from a patient’s own fat tissue, which has created new medical applications for autologous fat grafting, such as breast reconstruction and certain types of wound healing.

Of the first 30 patients who were involved in European trials for breast reconstruction via fat grafts prepared by the Celution System, 73 percent reported they were satisfied with their breast reconstruction results one year after the procedure was performed.  The physicians who evaluated these patients also reported an 80 percent satisfaction rate with breast reconstruction results after one year.

In addition to its application for fat graft preparation in wound healing and breast reconstruction, the Celution System is now approved for digestion of fat tissue to extract, wash and concentrate a patient’s stem cells and other associated cells for use in other autologous fat grafting procedures including:

• Brazilian butt lift or buttocks augmentation
• Fat injection for wrinkle treatment
• Fat transfer to facial areas experiencing lipoatrophy or volume loss

The PureGraft System

The PureGraft System, which was FDA-approved for use in the U.S. in 2010, is a membrane-based tissue filtration device designed for use as a standalone graft preparation product, as well as a complement to the Celution System.

Used independently, PureGraft efficiently and reliably produces optimal graft tissue for use in autologous fat grafting procedures, while used in combination with the Celution system, the PureGraft system lowers tissue processing times and increases processing volumes.

The PureGraft System works faster than other fat graft preparation products, taking only 15 minutes to purify a fat graft ranging from 50 to 250 mL by removing excess and unwanted fluid, lipid, blood cells and debris in a controlled manner.  The consumable-based system is used within a sterile field and does not rely on centrifugation during the purification process as most other tissue filtration devices do.

The Celution and PureGraft systems are exciting innovations in reconstructive and plastic surgery because they promise to offer breast cancer patients the opportunity to have their breasts reconstructed using their own fat, as well as improve fat injection or fat transfer results for cosmetic surgery patients seeking fuller, more shapely buttocks and youthful facial volume.

Keep in mind that the success of fat grafting is greatly dependent on the skill of your surgeon, so you should seek a highly experienced Seattle plastic surgeon if you decide to pursue any fat transfer procedure.

Sheyla Hershey with 38KKK breast implants

Although many would argue that indulging in tales of botched plastic surgery is a waste of time, there are lessons to be learned from the often outlandish and bizarre stories, especially as it pertains to breast implant disasters.

An article in the Orange County Register pointed out that some of pop culture’s most recent breast implant catastrophes offer women considering breast augmentation three valuable lessons, if not outright warnings, regarding what NOT to do to achieve successful surgical outcomes.

Lesson One: For plastic surgery, you need a REAL plastic surgeon

When mother of four Kenyatta Brown sought breast augmentation in February 2010, she nearly bled to death during this relatively routine procedure because she chose to have the surgery done by an Atlanta eye doctor.  Enticed by the low price, Brown’s attempt to save cash by having breast augmentation done by an ophthalmologist nearly cost her life.

You wouldn’t go to a plastic surgeon for an eye exam, so don’t go to an eye doctor or any other physician practicing outside his or her specialty for breast surgery.

Breast augmentation is a plastic surgery procedure and should be performed by a surgeon certified in plastic surgery by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada.

Dr. Richard Rand is a board certified Seattle plastic surgeon with over 20 years of experience performing breast augmentation with FDA-approved saline and silicone breast implants.

Lesson Two: Be prepared for revision surgery costs and travel for follow up

British Extreme Makeover winner Nicola Stratton flew to Los Angeles for over 30 hours of plastic surgery on the hit TV show, but when she experienced common breast implant complications after surgery, she was unprepared for the required travel and expense of her breast revision surgery.

It is important that you have access to your original breast augmentation surgeon for follow up should complications or the need for revision surgery arise.  Otherwise, you may place yourself at risk for health problems if conditions like infection or hematoma go unchecked, as well as compromised aesthetic results caused by deflated or encapsulated implants.

Lesson Three: Bigger is not always better with breast implants

Sheyla Hershey, owner of the world’s biggest breast implants, has recently been making headlines again after traveling to Brazil to have her bust size increased to 38KKK using an implant size that is illegal in the U.S.

After surgery, Hershey developed a potentially fatal staph infection, and in order to combat it, the gigantic implants had to be removed.  Hershey may also lose all or part of her natural breasts as a result of the infection and will likely have to undergo additional breast revision surgery in the future.

The moral of the story here is to keep your breast augmentation goals reasonable and seek a breast implant size that fits your frame and lifestyle.

Additionally, Hershey’s story illustrates that seeking plastic surgery abroad can be risky in large part due to the fact that many countries outside the U.S. and Canada do not have laws regulating plastic surgery safety protocols, such as limits on the size of breast implants that can be used.

These new injectables not only offer patients more choices for wrinkle reduction, volume restoration and facial rejuvenation, but also more competitive pricing and better results afforded by innovation and better technology.

New Hyaluronic Acid Fillers

Many of the new injectable fillers headed for the U.S. are composed of hyaluronic acid gel, including Belotero by Merz, a hyaluronic acid (HA) filler similar to Juvederm offered in three concentrations—soft, basic and intense.

Belotero has already been filed with the FDA and is purported to provide an improved level of tissue integration that causes fewer incidences of lumps and bumps than other hyaluronic acid fillers.

New additions to the Juvederm and Restylane families of injectable HA fillers may be headed to the U.S. as well.

Juvederm Hydrate and Restylane Vital are thinner hyaluronic acid filler formulations are used for treating areas that have been historically difficult to correct with fillers, such as the back of the hands, décolleté and neck, and both purportedly offer wrinkle prevention by boosting skin hydration and elasticity.

Unlike Juvederm Hydrate, Restylane Vital offers a specialized automatic injection pen that regulates product injection volume and speed for more precise results.

Thicker hyaluronic acid filler formulations Juvederm Voluma and Restylane SubQ are designed to add volume to large areas of the face, such as the chin and cheeks.  SubQ is also reportedly used for buttock and breast augmentation.

Innovative injectables: Beyond HA fillers

In addition to the new hyaluronic acid fillers poised to enter the U.S. marketplace, injectable fillers composed of other materials may also soon be available.

Novabel, the first injectable filler composed of spherical, flexible structures called Geleons formed from marine algae extract, reportedly makes cosmetic injections virtually painless and also improves skin elasticity.  The composition of Novabel is also said to make injection easier and reduce swelling, making it ideal for adding volume to thin-skinned facial areas, such as the eyelids and tear troughs.

Derma Veil, a pure collagen stimulator made of polylactic and polyglycolic acids (PLGA), is another new non-HA filler that may make its way to the U.S.  If approved, Derma Veil would be use primarily for facial volume restoration and compete directly with Sculptra Aesthetic.

New botulinum type A injectables

Two new botulinum type A neurotoxins, Xeomin and PurTox, may join Botox and Dysport to become part of the arsenal of wrinkle relaxing injectables available in the U.S.  In fact, PurTox has already completed clinical trials and may be closing in on FDA approval.

PurTox and Xeomin are purported to offer theoretical benefits over Botox and Dysport, such as faster, longer-lasting results and decreased possibility of allergic reaction and development of blocking antibodies.  These benefits have not yet been proven, however and likely will not be explored until further testing is completed.

According to the study authors Drs. Michael Fried, Richard Shaw, Matthew Trovato and John Owsley, nearly 98 percent of patients reported their face lift results as “very good or beyond expectations” in the one-year period following their face lift surgery. Nearly 13 years later, more than 68 percent of face lift patients said their results continued to be “very good or beyond expectations” and felt that they looked 10 years younger.

Only 31 percent of patients who participated in the study indicated that they were disappointed by some aspect of their long-term face lift outcome, which suggests a majority of facelift patients experience a high degree of satisfaction with facelift results in the long term.

The study is reportedly the first to measure long-term facelift patient satisfaction rates and included 89 participants. Each patient surveyed had a superficial musculoaponeurotic system–platysma facelift, or SMAS facelift, performed by study senior author Dr. John Owsley between January 1, 1994 and January 1, 1999.

Variations of the SMAS facelift technique exist, but all SMAS facelift techniques involve repositioning and tightening the SMAS, which is a sheet of muscle and connective tissue on the cheek that contributes to facial expression. The results of a SMAS facelift are typically longer lasting than those of a subcutaneous, or skin-only, facelift, and improvement of sagging skin and jowls is an expected outcome.  An extended SMAS facelift offers the same benefits as a SMAS facelift, plus correction of nasolabial folds.

When considering face lift surgery, it’s important not to get caught up in the brand names, marketing terminology and surgical techniques. For best results, it is essential to seek a highly experienced Seattle face lift surgeon who can customize your face lift procedure to meet your unique goals.

The warning was issued after an inquiry by the French Society of Plastic, Reconstructive and Aesthetic Plastic Surgeons revealed the breast implants lack an essential protective barrier, making them more susceptible to rupture, and are filled with unapproved silicone gel that has not undergone safety tests.

When ruptures or leaks are found in breast implants, a breast augmentation revision may be recommended to replace breast implants; however, it may not always be necessary.

Some women choose not to have revision surgery if their ruptured implants do not cause problems with breast appearance or health, while others choose to have breast explant surgery, or breast implant removal, but do not have their ruptured implants replaced.  When breast implants are removed and a breast augmentation revision is not performed, a breast lift may be performed to remove skin stretched by the breast implants.

Unlike the faulty French PIP breast implants, silicone breast implants used for breast augmentation surgery in the U.S. are filled with safe, FDA-approved silicone gel, but they may rupture due to age, implant malfunction or trauma.  Ruptures are easy to detect in saline breast implants, as the implants deflate and noticeably lose volume, while an MRI is necessary in order to detect a rupture in silicone breast implants.

If you discover one or both of your breast implants have ruptured, don’t panic, as there is no immediate health risk.  Consult an experienced, board-certified plastic surgeon who can show you before and after photos of satisfied patients and help you decide whether breast augmentation revision or breast explant surgery, with or without a breast lift, is right for you.

Only the first 10,000 people who donate will receive the Latisse free trial certificate. You may remember last year’s campaign led by Brooke Shields. This year, the campaign is led by lifestyle designer Kathy Ireland, professional ballroom dancer Chelsie Hightower and style guide Bobbie Thomas. Watch the video to learn more about the campaign and see important product information about Latisse.

“With approximately 1.5 million bottles sold since launching the product a little more than a year ago, LATISSE is giving back by helping the Make-A-Wish Foundation grant the wishes of children. Through the campaign, we will double each individual’s donation, with a maximum donation of $250,000, through October 31,” said Robert Grant, President of Allergan Medical, a division of Allergan, Inc.