1.I have always been told by my doctor that I have to lose weight first in order for any major surgery to be safe.

2. It affects the cost. The more fat, the more you have to pay.  You should lose as much weight as you can by yourself.  Then you will not have to pay as much for the procedure.

3. I have heard that many use this procedure just as a finishing touch ....after a large amount of weight has been lost.

Oh yeah, I remember being a bit bewildered at the idea of cleaning up for the cleaning lady, but it does make sense.  The less the cleaning lady has to do, the less you have to pay.  The less excess fat the surgeon has to take off, the less you have to pay.