A Board Certified Plastic Surgeon in Scottsdale
Posts tagged fat grafting
The Ear and Facelift Incisions: I.
0
The Ear and your Facelift Incisions.
Scottsdale – Understanding the anatomy of the ear is important for anybody considering facelift surgery.
The human ear becomes important in several facial plastic surgery operations because the incisions for facelift, go around the ear. In fact, by using the ear landmarks, a plastic surgeon can effectively camouflage the incisions, so they become hardly noticeable. A facelift is a very special plastic surgery operation, where patients desire natural looking results and hardly noticeable incisions.
Let’s learn about human ear anatomy!
In the Diagram: The Ear and your Facelift Incisions, we see the model’s ear strategically colored to demonstrate the points. The green color is over the Helix of the ear. The pink color is demonstrating the anti helix. Please not that the bottom of the antihelix, is often times referred as the anti tragus.
We also see the lobule colored in yellow. The lobule is very important for facial rejuvenation surgery. We make a very special effort to restore the normal anatomy of the ear lobule, in order to camouflage the fact that a cosmetic surgery patient has had a facelift.
In the top front of the ear (colored in white), we see the root. The root attaches to the face and transitions nicely to become the helix of the ear. The root is another critical portion of the design of any facial plastic surgery.
The concha or bowl of the ear is colored in gray. The concha is variable in size and depth and may be enlarged or prominent in the prominent ear. We also see the tragus colored in blue. When a cosmetic surgeon plans a facelift or neck lift operation, he has to carefully consider the tragus. The incision can go on the tragus itself or in front of the tragus. To learn more about facelift incisions an how a plastic surgeon uses the ear anatomy to make these less noticeable, stay tuned for tomorrow’s blog.
A Primer on Buttock Shapes: Part I.
01 year ago
by Dr. Aldo
in Brazilian Butt Lift
Buttock Shapes.
Scottsdale – It is true, at some point in our lives, we will all think about our butts!
Isn’t important to know what shape your buttock is? This article is for those who have a desire to better understand the aesthetics of the gluteal region and plastic surgery of the buttocks.
At this point in time, there is still a lot of work being done to document all the aesthetic points associated with the butt. No one, including myself, especially in a short blog, has been able to cover all the facts.
So, this is a primer that can help the plastic surgery patient who is looking for more information about buttock surgery. It is a beginning and will be updated on the blog with future articles on butt aesthetics and plastic surgery techniques developed specifically for the buttocks.
The most recent work on buttock aesthetics has been out of Miami, Florida, which has also served as the buttock surgery capitol for some time now. This body of work has helped tremendously to clarify some of the points I am going to discuss here today.
Common Buttock Shapes.
The 4 Basic Gluteal Shapes affecting Buttock Plastic Surgery.
There are four 4 basic shapes: The A shape (top left), the V shape (bottom right), the round (top right), and the square (bottom left). However, these general shapes may not classify every single buttock type seen in the world. The most attractive shapes visually appear to be the A and the round. Square butts and V shapes are the least attractive in that respective order.
Buttock Surgery at a Plastic Surgeon’s Office.
Other shapes, which are actually variations of the main four, are seen commonly in a board certified plastic surgeon office. Of course, we cannot simply talk about the buttocks without considering the surroundings. We must consider the relationship of the lower and upper back, the hips and outer thighs, and how these relate to the buttocks. In many cases, the surrounding fat pockets reduce the aesthetics of the buttocks and any cosmetic surgery for the buttocks should consider carefully reducing or removing these surrounding fat pads. To learn more about your buttock shape and how it affects the planning of buttock surgery, please stay tuned for tomorrow’s blog.
Update II. The 25th Breast Surgery and Body Contouring Symposium
1 year ago
by Dr. Aldo
in Body Plastic Surgery
Santa Fe, NM – Yesterday (Friday) was indeed another great day the 25th Annual Breast Surgery and Body Contouring Symposium. Saturday’s discussion and instructional plastic surgery courses were far better. I can easily say the meeting is a 10 out of 10.
I really came to this meeting to find any and many updates on the latest plastic surgery techniques. The topics for the day?
It all started with tummy tuck, lipo, and tummy tuck and liposuction. In the middle, we heard about bodylift after major weight loss, arm lift, and thigh lift. Then we finished the day with buttock augmentation and buttock lifting.
I have to tell all, this meeting was truly eye-opening. I saw wonderful results from techniques similar to those I use, but will likely begin fine-tuning my own cases to continue to achieve better and safer results with body contouring and cosmetic surgery.
Based on what I have learned, what am I going to add?
I am going to add a 5 mm liposuction cannula for my future plastic surgery cases. This size of cannula adds a little more fat for fat harvest and fat injection, especially when it come to buttock augmentation. I plan to use this in zone 4 of the back when I perform Brazillian Butt Lift. I have always been a strong advocate of small lipo cannulas, the biggest I routinely use is a 4 mm, because these improved the results. In fat grafting surgery, I clearly saw the advantage of having a 5 mm exploded basket tip cannula for fat harvest.
What else? I was impressed about incision location options for the lower body lift. I currently use an incision which is low. I prefer that because plastic surgery clients in Scottsdale, Arizona also prefer a lower incision which is easier to hide. The advantage of the higher incision relates to the contour which is achieved. A higher incision allows the patients to have more of an hour-glass contour, which is quite attractive.
It was another good day for the basic science and technique of fat harvest and fat injections. The discussion Saturday focused on the various techniques employed by different surgeons for fat grafting. It is easy to note that no one seems to use the same technique and everyone discussed was slightly different from the next.
The day in the main lecture area was wrapped up with buttock augmentation via fat grafting. The symposium was sponsored by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.
Update from the 25th Breast Surgery and Body Contouring Symposium
11 year ago
Santa Fe, NM – I wanted to take this opportunity to let patients know about my experience at the 25th Annual Breast Surgery and Body Contouring Symposium. This is my first visit to this plastic surgery symposium which is sponsored by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.
I arrived Thursday evening and missed all the live plastic surgery presentations. I was pleasantly surprised, however, to find the most invigorating discussion occurring on Friday. The schedule included an updated presentation on silicone gel breast implants, including some early numbers on the form-stable gel breast implants, currently undergoing FDA trials.
Thursday was also a good day for the basic science and technique of fat harvest, stem cells, and fat injections. The discussion was focused primarily on fat grafting as it applies in reconstruction of the breast after mastectomy. The portion of this medical conference involving the use of stem cells in the future was really quite exciting.
The day in the main lecture area was wrapped up between the component with liposuction and revision lipo with and without ultrasound. At the time, late in the day, I was looking forward to the body contouring instructional course I signed up for earlier. I chose to go with the brachioplasty after major weight loss course, as it peaked my interests the most. I certainly did get to see a different approach for arm lift than what I routinely use.
Overall, I gave my first day at this plastic and cosmetic surgery conference a 9 out of 10, so far…. I am indeed looking forward to hearing all the discussion about plastic surgery after major weight loss on Saturday!
Updates on Brazilian Butt Lift Photos.
01 year ago
by Dr. Aldo
in Brazilian Butt Lift
Scottsdale – Please check out the new before and after photo gallery in Brazilian Butt Lift. Just updated this week!
The Brazilian Butt Lift is popular in Arizona.
The Brazilian butt lift is a popular technique used to enhance the shape of the buttocks. The benefits of buttock augmentation by fat injection include a more natural appearance, as the newly sculpted buttocks uses fat from your own body. Brazilian butt lift can make your buttock look more round, fuller and attractive. Complete sculpting of the body and buttocks is best accomplished with liposuction and fat injection. This combination of techniques allows for the greatest amount of contouring possible.
Women want better buttocks! Fat Grafting is an option!
Many women are unhappy about the size and shape of their buttocks. Many have full size fat deposits in other parts of the body and yet the buttocks may appear flat and unshapely. We remove fat where you do not want it and inject it in to the buttocks during the same surgery.
Fat is an ideal filler for the buttocks.
Fat is an ideal material for transfer because it is soft and is usually plentiful in the body. As the fat goes in, the volume desired can be dressed to size. Buttock enhancement by fat grafting is preferred by most patients to enhance the body to natural-looking proportions. The Brazilian butt lift is appealing because small incisions are used which result in less scarring and a quick recovery.
Fat Grafting can transfer large amounts of fat to enlarge the buttocks.
Fat injection involving large amounts of fat tissue into the buttocks requires greater knowledge of art and technique. Good candidates for Brazilian butt lift are healthy people who desire a better gluteal shape. You should have a fair to moderate amount of fat to donate for injection. The Brazilian butt lift takes between 3 to 4 hours to perform. However, when more fat that is removed through liposuction, and more is injected, the procedure could take longer than the estimated time. The recovery is similar to liposuction and patients can return to full activities about 2 weeks after surgery.
Fat Grafting Fab(ulous) Five Facts.
01 year ago
Human Fat Cells: The ideal filler?
Scottsdale – What makes fat grafting so attractive to many people planning to undergo facial plastic surgery? These are the top 5 reasons many people are choosing fat transfer:
1. Fat is readily available in most plastic surgery patients.
2. Fat is easily obtained using reliable cosmetic surgery techniques for harvesting fat.
3. Fat is inexpensive.
4. Fat is bio-compatible with the donor.
5. Fat can be harvested and re-injected repeatedly, as needed.
Review: Assessment of Gluteal Fat Grafts with MRI.
02 years ago
Scottsdale – Many people desire fuller round buttocks. One popular procedure that has a high success rate involves the use of lipoinjection technique, sometimes referred to as the Brazilian Buttock Lift. With this surgery, fat tissue is removed from the body using a specialized technique to preserve the fat cells. Because of their low metabolism, fat cells can survive outside of the body for a short period of time. Meanwhile, the fat cells are prepared for re-injection. I have used this technique since 2002 with excellent success.
I advocate fat grafting over implants for several reasons. First, it is your own tissue and it is more natural looking and feeling than implants. Second, there is the additional benefit of loosing fat from other parts of the body and donate your fat; you get thin in heavy areas and gain volume into a flat buttock. Third, implants are not life-time devices and have unique complications. Patients can avoid implant related complications using fat grafts and have a better opportunity to achieve long-lasting results. An article from the journal Aesthetic Plastic Surgery, discusses an objective method to assess fat cell survival after lipoinjection using MRI.
The article has some problems. First, it only includes 10 patients with MRI examinations. This number of patients is usually too small for us to use this data and apply it across a larger number of patients. Second, the follow up period is too short, only 3 months. A longer follow-up period would have been better to assess longevity of the results. Third, the average injection volume is relatively small amount, 350 mililiters per buttock. On the positive, we clearly see evidence of viable fat grafts within the gluteal muscle and an increase in the size of gluteal circumference. The authors noted some significant findings that validate what patients and surgeon see clinically. For instance, at 2 weeks after surgery, the circumference of the buttocks was increased about 1 to 3 centimeters and greater than the circumference seen at 3 months after the procedure. This likely represents the phenomenom of fat reabsorption and resolution of post-operative swelling.
The most valuable information in the article has to do with the relation of gluteal volume seen on MRI before and after surgery. The average volume increase from before to 3 months after was from 687 ml to 765 ml. The increase in circumference, on average, was from 94.7 before to 95.5 centimeters after gluteal lipoinjection. Importantly, the researchers estimated that an average of 28 percent of the injected fat volume is reabsorbed at 3 months.
It is important for patients contemplating this surgery to know that swelling and recent surgery will make your buttock look bigger in the first few weeks when compared to 3 months later. The research estimates that about 30% of the fat will go away by 3 months from surgery. I recommend an over-correction for that reason on all my patients. Basically, if the patient’s ideal volume increase is 700 ml, then I inject 1000 ml knowing that approximately 30% of the volume will go away due to reabsorption. As long as the patient has the fat to donate, we can use as much of it to counteract the effects of reabsorption. If you examine the volumes used in patients on my photo gallery at www.myfaceandbody.com you will notice the range is between 600 to 1000 ml. In some cases I have injected as much as 1400 ml in a single operation.
New Study: Fat grafting shown to improve skin quality.
02 years ago
Scottsdale – Fat grafting in plastic surgery is not new, but a new study published in the September issue of Plastic and Reconstructive Surgery outlines results which demonstrate a positive effect of fat grafting on human skin. The study was conducted in France. According to the researchers, the aim of this study was to investigate the histologic modifications of the skin after fat tissue grafting on an animal model.
In the study 30 nude mice, divided into three groups, were used. All 30 mice received human fat tissue on one side. On the opposite side, 10 mice received nothing (negative control group), 10 mice received cell proliferation medium, and the remaining 10 mice received only subcutaneous tunneling. After 8 weeks the investigators analyzed the tissues via biopsy of the skin and subcutaneous tissue. Dermis thickness was measured. To differentiate human from mice collagen fibers, human and murine (mice) collagen type I antibodies were used.
The results found human fat tissue was in all animals and appeared normal, with abundant peripheral neo-vascularization (establishing a new blood supply). Examination under the microscope, showed abundant extracellular matrix around the injected human fat tissue. This was primarily type I collagen fibers of mice origin as a result of the murine fibroblast stimulation by the grafted human fat tissue. Dermal thickness after fat grafting was significantly greater. The researchers excluded inflammation as a cause of the increased thickness because no modification was detected in our control groups.
For years, plastic surgeons have been reporting improved skin quality after fat grafting. However, a biologic mechanism has not been fully elucidated to account for these observations. This study demonstrates the biologic steps which lead to improved skin quality. Based on the findings, it is safe to say that the generation of collagen in the overlying skin produces several positive effects. Overall, this study shows that fat tissue grafting stimulates a neo-synthesis of collagen fibers at the recipient site and makes the dermis thicker. However, I agree with the investigators that long-term effects remain undetermined and need further investigation.
