New Study Recommends Autologous Fat Grafting for Calf Augmentation and Reshaping

Fat GraftingImplant-based calf augmentation is the conventional procedure for improving the appearance of the legs and correcting discrepancies in appearance between legs due to deformities, infections, or trauma. According to a new study published in the Aesthetic Surgery Journal, the official publication of the American Society for Aesthetic Plastic Surgery (ASAPS), calf augmentation and reshaping with fat grafting is a better option as it provides many benefits over the traditional method. The main points of the study are as follows:

  • The researchers evaluated 13 patients who underwent calf augmentation and reshaping with autologous fat grafting over a 5-year period.
  • Ten of the patients chose to undergo bilateral calf augmentation, and three cases were performed for congenital leg discrepancies.
  • Fat grafts for the procedure were taken from a number of areas such as the abdomen, lateral thigh, medial thigh, waistline, flanks, upper back, and hips.
  • The patients also underwent liposuction at the knee to improve contour regardless of the site from which fat was harvested.
  • An average of 157 cc of separated fat was transferred per leg, with about 60% and 40% transferred into the medial and lateral calf, respectively.
  • Four patients (31%) who wanted more volume had a second round of autologous fat injections.

At an average of a 19.6 months of follow-up, durable augmentation and enhancement in calf contour was acknowledged in comparison with standardized preoperative and postoperative photographs.

A local anesthetic was injected prior to the fat transfer procedure in order to utilize the least amount of effective anesthetic volume. This also helped to precisely place the fat into the muscle, enabling less sedation and speedy postoperative recovery.

The corresponding author of the study says, “Autologous fat augmentation offers a number of advantages over calf implants, including liposuction in adjacent areas to improve calf contour, smaller incisions, additional augmentation through subsequent fat grafting, durable results, lack of foreign body reaction, and precise patient-specific adjustments not possible with off-the-shelf implants.”

Dealing with Excess Skin after Bariatric Surgery

Bariatric SurgeryExcess skin is a common problem after bariatric surgery. Men and women may achieve the targeted weight loss a few months after the surgery, but many are disappointed with their appearance due to the sagging skin that remains. Getting rid of that excess skin is important not just for aesthetic reasons – it can cause rashes and chafing, leading to a lot of discomfort. While maintaining a proper exercise routine and a healthy diet can help, for many men and women this may not be sufficient to get rid of all the excess skin. This is where liposuction plays an important role.

After bariatric surgery, give your body time to recover and stabilize on its own. Skin elasticity is a key factor when you lose weight, including long it will take for your skin to tighten up afterwards. Plastic surgeons now provide effective body sculpting treatment using advanced technology that provides smoother contours by tightening lax skin. There are various types of procedures, each designed to address folds of excess skin and body tissue in specific areas.

  • For many people, the abdomen is the main area of concern. A tummy tuck is the recommended solution. The procedure removes the extra skin and tightens the muscles to make the entire stomach area look better and tighter.
  • The chest area is the next in the list. For women, a breast lift could provide the solution. The procedure involves removing excess skin and repositioning of nipples if needed. Men can get excessive chest tissues removed with gynecomastia treatment.
  • Saggy upper arms are another major concern after weight loss. Arm lift surgery is designed to resolve those batwings. The procedure gets rid of the hanging skin and trims and reshapes the arms.
  • Sagging skin in the face and neck is a common issue after dramatic weight loss. A face and neck lift can address eye bags, jowls and cheek pouches and result in a smoother, attractive facial appearance.

Plastic surgeons generally recommend staging these procedures. Body contouring after bariatric surgery can provide good results, though you should have realistic expectations. It is important to lead a healthy lifestyle to enjoy optimal results. Quit smoking to enhance the outcome. To reduce wrinkles, dryness, and skin atrophy, include sufficient protein, fruit and vegetables in your diet. Drink plenty of water and healthy fluids. You can also try out toning exercises to firm the muscles and get your body back in shape.

Improving Your Body Without or With Minimal Cosmetic Surgery

Minimal Cosmetic SurgeryEverybody dreams of having the ideal body. Cosmetic surgery can help you look your best, but most of us are put off when we hear the work ‘surgery’. The good news is that there are many innovative, cosmetic treatments available today that can effectively address your trouble spots – with minimal risks and recovery downtime. Let’s take a look at these exciting options, which may involve minimal or no surgery.

A Trim Abdomen

Do you want a flatter stomach? While a tummy tuck can address that excess fat and loose skin and result in a trim mid-section, there’s a new a non-surgical approach called Vanquish that works equally well. This painless procedure uses radio-frequency (RF) energy and can help eliminate 60 percent of the fat cells in just four treatments.

Shapelier Breasts

Significant augmentation would require breast implant surgery. But if you are for subtle improvement with natural looking results, minimally invasive fat grafting could be the answer. This procedure uses your own fat from another part of the body for the augmentation. There is hardly any scarring as the fat is removed via a minimally invasive liposuction procedure and injected into the breasts. A lunchtime breast lift is another option that provides temporary enhancement, ideal when there is a special occasion or event coming up.

An Attractive Posterior

With celebrities showing off their shapely derrieres in pictures posted online, buttock augmentation has become one of the most requested cosmetic procedures among women. There is no need for butt implants to achieve this goal with the Brazilian butt lift. This non-surgical procedure is also based on fat transfer, the procedure that uses fat from one area of the patient’s body to enhance another.

A Youthful Looking Chin

Zap that double chin with Kybella. This path-breaking FDA-approved injection can provide greater definition to your natural jaw and neckline by literally dissolving submental fat – the excess fat in the chin area. Recovery is also quicker than with chin liposuction.

A Sculpted Silhouette

If you thought that liposuction is the only answer to a sculpted body, you’re wrong. A new noninvasive option, CoolSculpting, is making news for its safety and effectiveness. FDA-cleared, this procedure contours the body by freezing away unwanted fat for good without surgery or downtime. The dead fat cells are eliminated via the body’s naturally processes.

While these novel cosmetic treatments are a great alternative to surgery, getting the best results would depend on the provider. Established plastic surgery practices in New York City offer these non-invasive procedures. Choose an AAAASF-accredited NYC plastic surgery practice with experienced plastic surgeons for an optimal outcome.

Study: Combining Hysterectomy with Cosmetic Surgery for ‘Hanging Abdomen’ is Safe

HysterectomyA hysterectomy or the surgical removal of a woman’s uterus is recommended to treat problems associated with menstrual periods, pelvic pain, fibroids, tumors and other related conditions. One of the issues that patients who have undergone the surgery face is hanging abdominal skin. According to a recent study published in Plastic and Reconstructive Surgery® it is safe for women to also have a cosmetic procedure to remove hanging abdominal fat and skin at the same surgery without increasing the risk of complications.

Panniculectomy is a type of abdominoplasty performed to remove excess fat and skin from the area and does not involve muscle tightening. This procedure can considerably reduce the appearance of a protruding abdomen

Using a national surgical database, the researchers identified more than 25,000 women who underwent hysterectomy between 2005 and 2012. In this group, 174 underwent panniculectomy at the same operation. Thirty-day complication rates were compared for those who did a combination procedure and hysterectomy alone.

Those who underwent a combination procedure were more likely to be obese, and to have diabetes and a history of heart or lung disease. The surgical time for the combo was about four hours, compared to two hours for hysterectomy alone.

On comparing both groups, the researchers found that:

  • Those who underwent a combo procedure had a higher rate of blood clot-related complications called venous thromboembolism (VTE): 3% versus 1%.
  • These patients were more likely to stay in the hospital for three days or longer: 48 percent versus 29 percent.

However, comparison of the matched groups of patients with similar characteristics, revealed that

  • There was no significant difference in VTE risk between the two groups.
  • The difference in wound complications, surgical site infections, medical complications, or total complication rate was negligible.

Commenting on the findings, the lead author said, “This is among the best evidence to date regarding 30-day risk profiles, and the data suggests that the complication rates are comparable for patients undergoing combined hysterectomy and panniculectomy versus hysterectomy alone.”

Many plastic surgery procedures can also be combined. For instance, tummy tuck can be combined with liposuction of the flanks and lower back to enhance the outcome. Though combining procedures would require more extensive surgery and anesthesia time than singular procedures, it has been seen to enhance patient satisfaction with the outcome and less time lost from work. The key to safe treatment and optimal results, however, depends on choosing a plastic surgeon with experience in the specific combination of procedures desired.

Resuming Normal Activities after Plastic Surgery

Plastic SurgeryMany people are now utilizing the possibilities that plastic surgery offers to improve on their features, look more youthful, and boost their confidence. One of the questions that potential candidates ask is “How long will recovery take and when can I get back to exercise and normal activity?” Let’s take a look at the healing time and conditions associated with some popular cosmetic surgical procedures.

  • Liposuction: This procedure, which removes the surplus fat deposits in difficult spots, is usually completed within a short time when performed using SmartLipo Triplex, VASERlipo or BodyTite. These minimally invasive techniques use local anesthesia and some people even get back to work right after the treatment. Light physical activity can be initiated within a week to ten days. You would need to wait at least three weeks to resume intense running or strength building exercises.
  • Breast augmentation surgery: Implants, fat transfer or a combination of these are the options available to enhance the bust line. You would need to take complete rest for a week to ten days. After that, you can start with light exercises like walking and gradually move on to more intense exercises – based on what your body can tolerate. However, workouts involving the pectoral muscles should be avoided during the first month of recovery.
  • Tummy Tuck: This procedure is performed to trim the midsection by removing excess fat and skin, and tightening the muscles. Recovery can take time, especially depending on how extensive the surgery was. You may be asked to do some walking every day in the first week and more in the following weeks, which would help prevent blood clots and ease swelling. In most cases, patients resume exercising only after 3 weeks, but the time can be longer. You may have to wait at least two months to resume aerobic exercises.

These are typical recovery times and in reality, the time would vary based in individual conditions. Nevertheless, getting an idea about the recovery period and what you can and cannot do, before you have the treatment will ensure that you are prepared for what lies ahead.

The ‘Ideal’ Approach to Breast Augmentation

Breast AugmentationWomen seeking breast enhancement now have several options to choose from to meet their goals safely and effectively. While women can now have their breasts enlarged using their own tissue, augmentation with saline or silicone gel implants is still the most popular option. Each of these options had their pros and cons, fueling the quest for a solution. Now, the answer seems to have arrived with the FDA-approving the IDEAL implant in November 2014.

The IDEAL implant is designed with a unique internal structure that controls the movement of the saline inside and provides a natural feel. Moreover, it eliminates many of the undesirable features of saline and silicone devices.

Innovative Construction

This saline-filled IDEAL implant is meant for use in women 18 years of age and above for primary breast augmentation or revision augmentation. So what makes it different from the original saline and silicone implants? The answer is its internal structure is such that it blends the desirable features of its counterparts. This new implant has an inner shell around the inner chamber, which contains the inner saline filler, and an outer shell around the outer chamber, which holds the outer saline filler. One to three baffle shells nest between these shells.

Good Satisfaction among Patients and Physicians in Clinical Trial

In the clinical trial, 502 women received the Ideal Implant. It was found that the type and occurrence of adverse events in the trial were similar to those in other breast implant trials. The incidence of capsule contracture was low and both patients and surgeon expressed high satisfaction. The results of the trial were as follows:

  • 83% of the physicians were “definitely satisfied” with outcome after primary augmentation and 77.9% with revision augmentation results
  • Among the patients, 78% were “definitely satisfied” with outcome after primary augmentation and more than 76% with revision augmentation outcomes
  • The complication rates in the two year period were 42.2% for primary breast augmentation and 50.5% for revision augmentation
  • 17.1% of primary augmentation patients and 24.3% of revision augmentation patients (p.24) suffered grade II/III/IV capsular contracture
  • Spontaneous deflation was noted for 5% of primary augmentation and 3% of revision augmentation patients

The operative procedure for the Ideal Implant insertion is similar to that for the original saline implant. The only exceptions are that there are two fill tubes for the two lumens and there is no need for overfilling.

The plastic surgeon who invented the IDEAL implant says, “It offers a natural feel without silicone gel, and the safety of only saline inside for peace of mind. Since silicone gel implants have a high rate of silent rupture, a woman cannot tell if her implants are intact or ruptured without an MRI scan; while, with the Ideal Implant, a woman can simply look in the mirror and be confident that her implants are intact.”

Not Just Moms, Dads are Getting Makeovers Too

MakeoversMommy makeovers are now a popular trend, with more and more women looking to restore their pre-pregnancy figure and youthful looks. Pregnancy causes several undesirable physical changes and it is no wonder that women seek to resolve them with cosmetic surgery. The mommy makeover includes a combination of procedures such as a tummy tuck to tighten loose abdominal skin and muscles, and breast surgery to correct sagging or drooping breasts or improve breast volume.

A man’s body is not impacted physically impacted by the birth of a child as a woman’s body is, but bringing up a child can be stressful and alter their schedule, including their exercise regimen. Stress may also result in weight fluctuations. All this can take a toll on a man’s appearance.

That’s why an increasing number of dads are now looking to rejuvenate their looks with a ‘dad lift’ or ‘daddy makeover’. The treatments they opt for are generally not invasive and most men opt for touch-up procedures and Botox injections to tackle premature wrinkles to restore a more youthful facial appearance. Dad lifts may involve a combination of a tummy tuck, liposuction treatment and a facelift. Liposuction is a good option for those who have decreased metabolism and gain stubborn pockets of fat which don’t easily go away with dieting and exercise.

The latest statistics from the American Society of Plastic Surgeons (ASPS) show that the number of men having plastic surgery is on the rise.

Male plastic surgery rates have significantly increased since 2000 and the notion that cosmetic procedures are just for women no longer exists… Men are seeking to regain a more youthful look, improve their self-image and feel better about their appearance. It is great that plastic surgeons have procedures to meet and often exceed their expectations,” says ASPS President Scot Glasberg, MD.

Is There a ‘Best’ Time of the Year to Have Cosmetic Surgery?

Cosmetic SurgeryIf you are thinking of have cosmetic surgery, planning by the season or time of year can optimize the outcome, say plastic surgeons and those who have undergone a procedure. This applies even for people who are inspired to go in for a makeover or aesthetic enhancement to look their best at a special event like a family wedding or holiday celebration. All said and done, the end of summer seems to be the best time to have plastic surgery.

Many cosmetic surgeons report the most enquiries – and patients – during the fall and winter months. Recovery time at home is a major setback when it comes to planning a procedure. In addition to getting time for rest and recovery, avoiding direct sunlight is important after you have had a procedure. The cold, winter months would give you the chance to stay at home and recover, especially if you are considering procedures such as breast augmentation, liposuction or a facelift. Even if you step out of your home, wearing layers of clothes or accessories to conceal changes would seem normal during these months.

Having these procedures at the end of or early months of the year will help you recover smoothly and get ready for the summer with summer parties, weddings and vacations. This is the time for beachwear, revealing summer clothes and sportswear, which naturally makes this the season when most people want to look their best. Teens also opt to have rhinoplasty or a nose job in the summer before they get back to school. This allows enough time for healing. For people thinking of gifting a loved one with a cosmetic surgical procedure like Botox or a skin treatment, the end-of-year holidays are the best time.

The end-of-year holidays are also a great time for moms to pamper themselves with a mommy makeover, for instance. This is also the best time to take a break from a stressful job or life and go in for a rejuvenating procedure. Of course, having the treatment in a surgical practice that is close to where you live matters in terms of convenience and support from family or friends for recovery.

How Does the IDEAL Implant Work?

IDEAL ImplantThe IDEAL implant is the latest innovation in the field of breast augmentation. This novel implant is uniquely designed to meet the goals of aesthetics as well as safety. It is saline filled for safety and comes with an innovative internal structure that provides a natural feel, but without any silicone gel. The design allows flexible choices with regard to implant placement such as under the gland or muscle as well as volume adjustment and location of the incision.

This is how the FDA-approved IDEAL implant works to provide an optimal outcome:

  • Its internal structure comprises a series of silicone implant shells of increasing size nested together with saline solution filling the spaces in between.
  • It is designed with curved edges, which conforms to the chest wall and simulates the way natural breast tissue is shaped.
  • The chances of wrinkling and folding are minimized as the internal structure controls the movement of the saline solution.
  • When held upright, the internal structure supports the upper portion of the implant, avoiding the collapse – there is no bouncing, scalloping and wrinkling.
  • The amount of saline needed to fill the implant can be adjusted to correct for differences in the size of a woman’s breasts.
  • The implant is placed in the submuscular or subglandular pocket after which inner and outer lumens are filled with saline.
  • It is inserted through a relatively small incision and then filled with saline through two self-sealing valves.

These unique features make the IDEAL implant the ideal choice for breast enhancement and revision procedures. In addition to providing a youthful, natural looking shape and projection, it addresses many concerns associated with other implants:

  • Nested shell design minimizes chance of rippling and bouncing
  • No risk of undetected silicone rupture
  • Rotation does not affect appearance

For women who want to achieve natural-looking results with saline-filled implants and enjoy the confidence that her implants are intact, the IDEAL implant is the right choice.

Study: Gynecomastia in Mid-puberty is a Frequent but Usually Transient Condition

GynecomastiaGynecomastia is a commonly occurring and distressing aesthetic concern among teenage boys and men. The buildup of excess fat and tissue in the chest is not just a cosmetic issue and it most often causes anxiety, depression and low self-esteem. Plastic surgeons offer effective gynecomastia treatment which involves removing the excess fat using advanced laser-enabled liposuction technology. The procedure can effectively address the condition and result in a well-contoured, manly physique.

Overly large male breasts are believed to be caused by a decrease in the amount of the hormone testosterone compared with estrogen. Other factors associated with the condition include the use of certain drugs, heredity, obesity, and Gilbert’s syndrome.

However, according to new research, gynecomastia in pubertal boys is not due to estrogen/testosterone imbalance but due to increased levels of insulin like growth factor-1 (IGF-1) and pubertal growth. The researchers say that their study shows that gynecomastia in mid-puberty is a frequent but usually transient condition. The findings of this study by a Denmark-based team were recently published online in the Journal of Clinical Endocrinology & Metabolism.

The researchers evaluated 106 healthy Danish boys aged 5 to 16 years to determine the rate of physiologic gynecomastia and possible etiologic factors. The median age at first evaluation was 9 years. The boys were examined every 6 months during the period 2006 to 2014.

The study found that 49% (52) of the boys developed gynecomastia during follow-up at a median age of 13 years and most frequently during mid-puberty. The key findings are as follows:

  • Of the 52 boys, 14 (27%) developed intermittent gynecomastia (at irregular intervals).
  • Of these14 boys, six had two or three examinations without gynecomastia lasting a median of 2 years, while the other eight had just one intermittent exam without gynecomastia.
  • Growth patterns differed significantly between those with and without gynecomastia: peak height velocity was at 13.5 years for those with the condition and 13.9 years for those without.
  • Boys with gynecomastia had high levels of estradiol.
  • Serum testosterone was also elevated in boys with the condition, leaving the estradiol/testosterone ratio unaltered.

The researchers noted that IGF-1 along with estrogen is necessary for the growth of breast tissue, and that the effect of growth hormone on breast growth is stimulated through IGF-1, which is synergized by estradiol.

According to the lead researcher, the aim of the research was to give a comprehensive physiological explanation for this common phenomenon. This they believe, will help boys who are affected to understand why they have breast tissue and others do not. They say that their study shows that physiological gynecomastia is a frequent condition appearing in mid-puberty and in most cases transient – lasting less than one year.

Medscape Medical News reports that he said, “…Hopefully this will help the boys not to worry that much or feel less anxious going through puberty”.