Fat Grafting: St. Louis Doctors Explain an Advanced Cosmetic Surgery Technique

In St. Louis, the cosmetic surgery specialists at West County Plastic Surgeons of Washington University see a variety of patients with a variety of needs. In this Missouri city, women and men seeking a new look are the same as those throughout the country: They want that area to be smaller, while this area could use some more volume. An increasingly popular solution to both problems is fat grafting.

While dermal fillers and even implants have taken an ever-larger share of the spotlight—and certainly have their own benefits—fat grafting is a cosmetic surgery procedure with multiple established uses, as well as a body of researchers continuing to explore new and innovative applications.

But first: What is fat grafting? The procedure is used to take fat from a donor area somewhere it’s plentiful on a patient’s body, after which it is processed and injected elsewhere into the same patient.

The process is, of course, more involved than that. Specifically, the procedure starts with a consultation with a professional cosmetic surgery specialist to determine whether fat grafting is the best options for delivering a patient’s desired results. With fat grafting is identified as the right course, the patient can expect a procedure in two parts: removing the fat and re-introducing the fat.

For removal, the doctor will administer a solution into the donor area to make the tissue firmer (known as “tumescent”), a technique that reduces both pain and blood loss, leading to less bruising and faster recovery. Using a cannula, the doctor will then loosen and suction out the necessary fat cells, collecting them in a special container.

Note that though fat cells are being removed, liposuction is not intended as a strategy for weight loss.

The harvested fat cells will be spun in a centrifuge to separate them from other materials removed along with them during the liposuction procedure. Once isolated, the cells intended for fat grafting are moved into small syringes, ready for injection where desired.

Because these cells are a patient’s own fat, the body is more receptive to them than other foreign substances. The “familiarity” lowers risks of rejection and related complications and extends the life of aesthetic results, often by years.

Patients should know that the volume of fat to be injected at this point is significant, but not large. As a cosmetic surgery procedure, fat transferddd is best used for contouring and detail work. West County Plastic Surgeons of Washington University uses the technique to correct post-mastectomy contour deformities in breast cancer patients, other contour problems around the body due to trauma or surgery, and hollow or sunken areas on the face due to volume loss and shifting fat.

For instance, fat grafting can be used to fill in a divot left behind after the removal of a benign leg tumor. It can also restore a youthful roundness to the apple of the cheeks, which also tends to pull up the sagging tissue that causes jowls.

Fat grafting can also be used in augmentation for patients who want to change the size and contours of their buttocks.

Because the nature of a treatment depends on its scope, the amount of time a fat grafting cosmetic surgery procedure may take typically ranges anywhere from one to five hours. Similarly, recovery may be expected to take anywhere from two days to two weeks.

As for future applications, the West County Plastic Surgeons of Washington University team is working with the American Society of Plastic Surgeons to study and evaluate other cosmetic surgery-related uses for fat grafting, including breast augmentation, the reconstruction of an entire breast, and healing aids enriched by stem cells.

Note that liposuction can be performed as a standalone procedure, without the doctor harvesting the fat for later use. Any patient considering combining fat removal with fat grafting should be sure to discuss the idea during the consultation.

Contact the West County Plastic Surgeons of Washington University team to learn more about fat grafting and related cosmetic surgery options, including facelift. Call (314) 996-8800 or reach out online.

Considering a Tummy Tuck? Harrisburg, PA, Surgeon Dr. John Stratis Outlines Your Options

Whether you have recently experienced weight changes, given birth, or simply developed a beer belly or “spare tire” over time, the contour of the abdominal area can be corrected with a tummy tuck. Harrisburg, PA, body and breast focused plastic surgeon Dr. John P. Stratis – one of the cofounders of the comprehensive cosmetic surgical practice at Stratis Gayner Plastic Surgery – explains how a tummy tuck or abdominoplasty is performed and the procedural options that are available to you.

A tummy tuck is a surgical procedure in which excess fat and skin are removed and the underlying muscles tightened to improve the look of the abdomen. While the operation can achieve dramatic results, it requires skilled and experienced hands to be safe and effective.

According to the latest statistics collected by the American Society of Plastic Surgeons (ASPS), the number of tummy tuck operations performed by member surgeons each year in the United States has increased by 104 percent since 2000. Individuals of all genders can receive tummy tucks. New mothers often have the procedure performed as part of a mommy makeover, while men often develop noticeable bellies as they age due to weakening and permanently stretched out muscles and skin tissue.

There are several types of tummy tuck surgery available to patients. Your surgeon will help you decide which procedure is most appropriate for you depending on your unique abdominal profile and the type and extent of results you are looking to achieve.

A traditional or standard tummy tuck is performed under general anesthesia and is performed on an outpatient basis. One or two incisions are made during surgery. One is made in the lower abdomen below the line of most kinds of underwear and swimsuits just above the pubic bone. A second may be made around the navel or belly button to allow the surgeon address the upper abdomen. Excess skin and fat will be removed, and the lower and upper abdominal muscles will be tightened. A new hole will be made in the repositioned tissue to allow the belly button to show through.

For some patients who have experienced extensive weight loss—whether with the assistance of bariatric surgery or otherwise—a fleur-de-lis tummy tuck may be ideal. In order to be effective long-term the patient must be committed to the healthy eating and exercise habits that enabled the weight loss.

A fleur-de-lis tummy tuck involves two incisions. While the first is made in the lower abdomen, the second is created vertically down the midsection to more comprehensively address the lax abdominal tissue. The length of this second incision depends on the amount of abdominal correction required, but it typically will not extend above the breastbone. The belly button may also be positioned at a level that looks more proportionate and aesthetically pleasing. Once the tummy tuck is complete, the surgeon will close the incisions with dissolvable sutures to heal properly. The procedure is performed under general anesthesia on an outpatient basis.

Your surgeon may recommend a mini tummy tuck if the cosmetic correction desired is minor. While a mini tummy tuck is less extensive than a traditional one, many patients find that the procedure gives them the results they were looking for with less recovery time required. A mini tummy tuck addresses only the lower abdomen, removing excess skin below the navel and repairing the muscles there. Some surgeons also perform liposuction along with the mini tummy tuck to better contour the remaining tissue

After any sort of tummy tuck is performed patients usually notice an immediate difference. Bruising and swelling in the operated areas are common and resolve in the weeks after. A special garment may be worn after surgery to keep these side effects to a minimum and allow the incisions the freedom to heal. A drain may also be used to reduce any buildup of blood and other fluid.

Some surgeons employ a long-acting local anesthetic, Exparel, during the procedure for sustained post-operative pain relief. They may also prescribe patients pain relief medications for their comfort during the recovery period and allow patients to do whatever they feel comfortable doing after the procedure. This “self-limiting” leads to a faster recovery. It typically takes about six weeks after a tummy tuck for patients to be able to safely and comfortably return to all their normal activity, but most patients can drive and return to work after a week.

Dr. Stratis is board-certified by the American Board of Plastic Surgery and specializes in performing tummy tuck procedures. To learn more about the surgery and which method may be most suitable for you, request a consultation with him online or call the practice at (717) 728-1700.

Four Ways to Rejuvenate an Aging Neck, from Surgery to Kybella®

While a wrinkled and sagging face bears most of the blame for giving away a person’s age—or even making someone look older than their years—the reality is that the neck also significantly contributes to the problem. Considering the 2015 introduction of Kybella®, Boston-area board-certified plastic surgeon Christopher Davidson, MD, has appreciated the increasing availability and popularity of neck-focused procedures and treatments. Here are four to consider:

• Kybella®

A primary aesthetic complaint from both men and women is a double chin, caused by a pocket of fat that can stubbornly refuse to change no matter how consistently someone diets or exercises. This fat is a problem for anyone who wants facial definition, as it softens what would otherwise be angular lines and creates the impression of multiple chins—especially when looking down. Since fat-reducing lifestyle alterations are not always successful, the most effective treatment often involves the physical destruction of the unwanted fat cells. Kybella® accomplishes this by rupturing them with deoxycholic acid, a chemical the body uses to break down fat during digestion. The form used in Kybella® destroys fat cells it encounters in the submental area, and these cells are then eliminated from the body.

Kybella® is an injectable, and a single treatment session can involve up to 40 or 50 injections, all carefully placed in the targeted area. The FDA has cleared Kybella® for use in reducing double chins, and since its powerful active ingredient can damage any cells it encounters, application is limited to specially trained medical professionals who can minimize risk and maximize results, which appear over the course of weeks and months as fat is gradually removed.

• Liposuction

Another option for eliminating unwanted neck fat is liposuction, which involves removing fat cells by suctioning out the unwanted material with a thin tube known as a cannula. This takes the fat cells in question out of the equation and can give the chin-to-neck transition area more definition. With the fat gone, results are immediately noticeable—and will become increasingly apparent as post-procedure swelling subsides. Patients who choose this method are often those searching for a double chin treatment with fast-acting results.

• Neck lift/facelift

Not all aesthetic neck issues are due to excess fat. In fact, the loss of fat can, in some cases, leave loose skin behind. Young, healthy skin readily conforms to body contours, but after years of being stretched out by underlying fat, some skin—especially skin that has lost collagen, hyaluronic acid, and elastin due to aging and environmental factors—simply won’t shrink back down.

Sagging skin on the neck creates a turkey wattle effect, and drooping skin on the face, due to volume loss higher on the cheeks, can form jowls that appear at the jawline. A facelift is a surgical procedure that lifts away those jowls, while a neck lift focuses on tightening the skin below the chin. Together, these two options can significantly revitalize a patient’s profile, so they are frequently performed in combination.

These procedures may also involve some amount of fat removal via liposuction.

• Juvéderm Voluma®

As noted above, volume loss in the cheeks leads to problems farther down, as the natural structures holding tissues in a firm, youthful position give way to laxity. By reintroducing volume with the hyaluronic-acid-based injectable Juvéderm Voluma®, support can be temporarily rebuilt, rounding out what is known as the “apple” of the cheek and effectively pulling up the sagging tissue that forms jowls.

Any of these options can be performed as a standalone procedure, but they may also be combined to produce a desired youthful effect over time.

Learn more about any of the neck treatments and procedures mentioned here, including Kybella®, from Boston-area plastic surgeon Christopher Davidson, MD, who has more than a decade of experience in the field. Call his office at (781) 237-7700 or visit his contact page.

What You Should Know About Safe Liposuction in Los Angeles

Many patients who are thinking about undergoing liposuction in Los Angeles find themselves wondering, “How much fat can I remove safely?”

First, it should be noted that liposuction remains one of the safest plastic surgeries to help patients remove stubborn fat that won’t respond to diet or exercise. The most common side effects from liposuction are generally temporary swelling, bruising, and soreness; irritation or minor scarring around the incision; and loose skin that often tightens after a few months. Less common side effects of liposuction might include color changes to the skin or some uneven surfaces in the treated area.

Of course, one of the most significant differentiators between a safe, successful liposuction and a procedure that comes with more serious complications or side effects is the skill of the physician. In a recent study by Northwestern University’s Feinberg School of Medicine, the University of Illinois’ Division of Plastic Surgery, and the Lehigh Valley (Pa.) Health Network, the researchers found that only about 1.5 percent of patients experienced a post-operative complication following liposuction. What’s more, they found that the most significant contributing factor to a safe surgery was not the procedure itself, but the skill of the doctor administering the liposuction.

Interestingly, they also found that patients with a higher Body Mass Index (BMI), were able to safely tolerate having larger volumes of fat removed through liposuction.

“BMI plays a role in outcomes of liposuction volumes, and higher-BMI patients may be able to tolerate more liposuction than lower-BMI patients,” one of the researchers said.

In other words, they discovered that patients with a high BMI were able to safely tolerate higher volumes of removed fat, whereas patients with a lower BMI needed to have less fat removed to stay within safe limits. It should be noted that the cases surveyed for the study did not result in any serious complications.

Another study came to similar conclusions when examining complications in cases of high-volume liposuction. In the study compiled by authors from the Loma Linda University School of Medicine and California Medical Association, they determined that liposuction at the hands of trained physicians is significantly safer: “Experience has shown that when properly trained surgeons perform large volume liposuction under ideal conditions, it is a safe and effective procedure for removing excess fat with low complication and morbidity rates.”

That study concluded with five pillars of safety when it comes to liposuction:

  1. The surgeon must be properly trained and educated in liposuction
  2. The anesthesiologist must be well trained and have a complete understanding of the physiology associated with infusion and removal of large volumes of fluids.
  3. The facility should be certified and accredited and must be completely equipped to deal with any problem or complication that may occur during or after the procedure.
  4. The support staff should be thoroughly trained and familiar with the procedure.
  5. The patient must be a strong candidate for the procedure.

Liposuction was the second most popular cosmetic procedure in America in 2015, according to the American Society of Plastic Surgeons. There were 5 percent more liposuction procedures last year as compared to the year before, making for a total of 225,000 Americans who chose to take hold of their appearance and remove stubborn fat. And yet, even with so many people opting to have a liposuction procedure, it still remains a safe option when patients make sure to pick the right surgeon who will help them get to the look they want.

If you have more questions when it comes to liposuction, Los Angeles is fortunately an excellent area to find a trained, accredited, and experienced physician to handle your procedure. Dr. Steve Svehlak and Dr. Dan Yamini have been safely performing liposuction and other cosmetic procedures for patients in the area and are happy to answer your questions and help you determine the best way to achieve the look you want. You might also consider liposculpture, in which a surgeon with an artistic eye can help sculpt contours to the patient’s desires. Dr. Svehlak and Dr. Yamini have many years of experience in this technique, as well as with laser technologies like “SMART Liposuction” and ultrasound “Vaser Liposuction” to further ad to the refinements of the procedure. To schedule a consultation, contact Sunset Cosmetic Surgery online or call them directly at 310-858-9100.

Breast Augmentation for Breast Asymmetry

Breast asymmetry, or the unevenness in the size, shape, and/or position of a person’s breasts, is not an uncommon or unhealthy condition. David Kaufman, MD of St. Joseph’s Hospital of Long Island, states that many women experience some degree of breast asymmetry. This can range from a barely perceptible variance in appearance to breasts being different cup sizes. While breast asymmetry is normal and healthy, it can be a difficult for women with significantly uneven breasts to find bras, clothes, and bathing suits that fit well. Not only is significant breast asymmetry physically uncomfortable, it can affect the self-confidence of females affected by it. Plasticsurgery.com states women looking to make their breasts more even should consider undergoing breast augmentation.

How can breast augmentation in Santa Monica serve patients with breast asymmetry? According to Finesse Plastic Surgery, there are several options available including utilizing breast augmentation surgery to insert a saline, silicone or Gummy Bear Breast Implants into one or both breasts; or using a fat graft to correct unevenness in a patient’s breasts.

The most popular asymmetry corrective option in Beverly Hills is breast augmentation surgery. Patients may opt to have the small breast filled with a saline or Gummy Bear Breast implant to make it larger or shapelier, matching the general form of its counterpart. As it tends to look more natural, a Gummy Bear Implant is a favored option for a single breast implant. Adversely, Patients may decide, instead of just the one, to have both breasts augmented to equalize and enhance their appearance. This procedure is a superb two for one deal: not only will patients correct their asymmetry; they will get the size and shape breasts they want.

Whether patients choose a single or double breast augmentation, there are several options available for both procedures. Mark Youssef, MD of YOUnique Cosmetic Surgery in Santa Monica, CA, offers a handful of surgery options for breast augmentation, giving patients the ability to choose what best meets their needs. Dr. Youssef can insert saline, silicone, or Gummy Bear implants through a peri-areolar, inframammary fold, or transaxillary incision. A peri-areolar incision is made along the bottom curve of the areola, and allows the surgeon to be incredibly precise. An inframammary fold incision is made under the breasts’ crease, and work well with larger implants. A transaxillary incision keeps scarring at a minimal, as the surgeon cuts along the fold of the armpit and forms a path for the implant to be inserted in the breast. For patients interested in saline implants, Dr. Youssef can utilize a TUBA incision, in which a cut is made along the upper curve of the navel and a channel is created to insert implants in one or more breasts. These four options work wonderfully for single or double breast implants as they offer natural results and leave minimal scarring.

The most natural type of breast augmentation may be a fat transfer, which is a non-surgical procedure. As states on the American Society of Plastic Surgeons’ website, surgeon removes fat from an unwanted area of the patient’s body and injects it into their breasts, or in some cases, breast. This procedure is best for women who want to subtly change the appearance of their breasts, and works well to correct slight breast asymmetry. Surgeons can use fat transfers to add volume to specific areas of the breast, which can correct both size and shape asymmetry.

While completely normal and healthy, breast asymmetry can be unsightly, uncomfortable, and in some cases, painful. Women looking to bring symmetry to their breasts can utilize breast augmentation, both surgical and non-surgical, to achieve their perfect look. If you are interested in a breast augmentation procedure to correct asymmetry, finding a cosmetic surgeon experienced in breast augmentation surgery is incredibly important. An experienced surgeon will help you find the best procedure to meet your unique body goals.

Recovery, Safety, and Breast Implants: Grand Rapids’ Dr. Bengtson Weighs In

As a board-certified doctor with more than 20 years of experience, Brad Bengtson, MD, has seen many changes in the industry in the last two decades. Some of the biggest advances have come in terms of safety and recovery after a procedure is completed. Since the most popular choice for plastic surgery in the United States is breast implants, Michigan’s Dr. Bengtson noted that breast augmentation, in particular, has received a lot of that innovating attention.

American Society of Plastic Surgeons members reported performing 279,143 breast augmentation surgeries in 2015, according to the results of an annual survey released earlier in 2016. Breast implants have topped the list for years, and continue to do so, chosen by about 57,000 more patients than liposuction, the next highest procedure on the chart.

Historically, women who received breast implants experienced weeks of soreness, swelling, and even pain after their surgery, limiting their activities and requiring recuperation that started with significant restrictions immediately after their successful procedure. Breast implants also frequently led to bruising that stood out before it began to fade over time.

Increasingly precise methods for inserting breast implants have led to a reduction in post-surgery complications and side effects. Whereas women once could not even physically lift their arms over the heads until a significant amount of time had passed after getting breast implants, it is now not uncommon for patients to be able to do that very activity within hours.

Just as there is a variety of breast implants available—silicone or saline, round or teardrop shaped, textured or smooth—there is a range of techniques for insertion. Some doctors prefer particular incisions, though the choice of procedure details typically depends on each patient’s unique anatomy and goals.

There are some common factors that allow for faster healing and range of motion for patients. Dr. Bengtson stresses several of them in his Fast-Trak Recovery program, including:

  • education, since patients who are well informed about their surgery and breast implants best understand what to expect from the procedure and recovery (using the Vectra 3D imaging system can help to give patients a real-time look at what breast implants of a particular size could look like on their own body)
  • working with a knowledgeable patient to select the ideal size, shape, and texture of breast implants for her body
  • stretching and other exercises to help with flexibility and recovery after surgery

While these elements are important to helping with a patient’s recovery, the doctor’s skill forms an incredibly large part of how recuperation plays out after a woman gets a breast augmentation.

For the surgical portion of the Fast-Trak program, Dr. Bengtson meticulously prepares a pocket to receive each breast implant, spending time to ensure that the procedure is bloodless and carried out with intense precision. The more careful the insertion of the breast implants, the less likely a patient will need to recover for any significant amount of time. The Fast-Trak system is designed to give patients a 24- to 48-hour recovery window. In fact, the doctor recommends that his patients take a nap and then go out to dinner in the same evening after getting their breast implants.

The other key to breast augmentation-related health and safety is follow-up care, particularly in determining whether implants have ruptured. While a leak poses no significant health risks, women may visit a hospital for help if they suspect something is amiss and want their breast implants checked. Dr. Bengtson is unique in that he provides ultrasound imaging for his patients, allowing them to bring any concerns about their breast implants back to the doctor who inserted them.

Michigan-based plastic surgeon Dr. Brad Bengtson heads the Bengtson Center for Aesthetics and Plastic Surgery in Grand Rapids. To learn more about breast implants, including the Fast-Trak recovery program, call (616) 588-8880 or visit bengtsoncenter.com.

Key Takeaways from the 2015 ASPS Report About Plastic Surgery in St. Louis

Every year, the American Society of Plastic Surgeons (ASPS) releases a snapshot of all that has happened over the previous year about plastic surgery in St. Louis and around the country. If one thing is certain about the insights the ASPS releases each year, it’s that plastic surgery is consistently on the rise and popular across many demographics, with new procedures often rapidly gaining in popularity and traditional procedures finding new patients who enjoy the results of achieving the body look they desire.

In that regard, this year was no surprise.

Originally founded in 1931, the ASPS is a nonprofit organization of plastic surgery experts and surgeons. In fact, with more than 7,000 members, it represents the largest collection of board-certified plastic surgeons in the world. In its annual report, it has compiled plastic surgery statistics for more than two decades since its first report in 1992. With the mission of advancing quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice, and research in plastic surgery, ASPS surgeons like the medical professionals at West County Plastic Surgeons hold themselves to the utmost standards of professionalism and patient care.

According to the 2015 ASPS Report, plastic surgery overall was up year over year.  This includes both surgical procedures as well as cosmetic minimally invasive procedures. The ASPS found that 15.9 million Americans underwent plastic surgery and other cosmetic procedures in 2015, which represents a 2 percent increase over the previous year. Of those patients, 14.2 million received minimally invasive procedures (a 2 percent increase), while 1.7 million people opted for cosmetic plastic surgery (2 percent) and 5.8 million people had reconstructive procedures (1 percent).

Of the plastic surgery procedures that patients in St. Louis and elsewhere opted to undergo in 2015, the top five most popular procedures were:

  • Tummy Tuck (128,000) 9 percent increase year-over-year
  • Liposuction (225,000) 5 percent increase year-over-year
  • Nose Reshaping (218,000) no change
  • Eyelid surgery (204,000) 1 percent decrease year-over-year
  • Breast augmentation (279,000) 2 percent decrease year-over-year

Even despite the year-over-year decrease, breast augmentation remains the most popular cosmetic plastic surgery option among Americans, according to ASPS data, which has been the case for nearly a decade. In fact, breast augmentation procedures have increased 31 percent between 2000 and 2015. Breast lift procedures have shown an 89 percent increase since 2000 and even breast reduction in men has gone up 35 percent over the same time period.

Overall, men have opted for more cosmetic procedures than ever before, with the number of men having a cosmetic procedure increasing year-over-year since 2014 and 69 percent since 2000. Additionally, cosmetic procedures were on the rise across all ethnicities year-over-year.

Plastic surgery and other procedures have increased by 115 percent since 2000. Of course, patients today are choosing different procedures than they were back then.

“While more traditional facial procedures and breast augmentations are still among the most popular, we’re seeing much more diversity in the areas of the body patients are choosing to address,” ASPS President David H. Song, said in a press release about the new report. “Patients have more options than ever, and working closely with their surgeon, they’re able to focus on specific target areas of the body to achieve the look they desire.”

Breast lifts were among the most popular plastic surgery option among patients and have shown considerable growth since 2000. However, other procedures have increased dramatically in popularity as well over the same time.

  • Buttock lifts increased 252 percent
  • Lower body lifts increased 3,973 percent
  • Upper arm lifts increased 4,959 percent

And non-surgical options continue to be popular among patients who want a quick, minimally invasive way to restore a youthful and rejuvenated appearance. Aside from plastic surgery options, the top 5 most popular cosmetic minimally invasive procedures were

  • Botulinum Toxin Type A (6.7 million procedures)
  • Soft Tissue Fillers (2.4 million procedures)
  • Chemical Peel (1.3 million procedures)
  • Laser hair removal (1.1 million procedures)
  • Microdermabrasion (800,340 procedures)

If you would like to find out more about finding options for plastic surgery in St. Louis, consider contacting the award-winning medical professionals at West County Plastic Surgeons. With surgeons who serve on committees for the ASPS, they are not only up to date on the latest and most popular plastic surgery procedures and minimally invasive cosmetic treatment options, but they will treat patients with the utmost care and professionalism. Call (314) 996-8800 to schedule a consultation today.