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ASK OUR EXPERT: Why is breast fat transplantation more expensive than implants?

Friday, May 16th, 2014

QUESTION:  Why is it that breast augmentation through fat transplantation is more expensive than breast augmentation done with implants? 

ASWER:  In order to augment the breast with implants, one needs only to select a desired volume for the implant, place the implant in a pocket, typically created behind the pectoral muscle and…voila…there is a new breast in the size the person always dreamed of. 

In contrast, augmentation of breasts with fat transplantation is quite laborious.  The surgeon needs to first harvest the fat via liposuction.  Then the harvested fat must be prepared for transplantation.  Once prepared, the fatty tissue is carefully and strategically placed in many areas throughout the whole breast in order to accomplish a relatively small increase in breast size of approximately 3-4 ounces.  This procedure is time consuming for the surgeon because he/she needs to place this fat through many repetitious passes with a special instrument that deposits the fat within the tissue in small amounts and allows it to be able to be incorporated by the breast into living tissue. 

Therefore, the operative time for a regular augmentation through implants is approximately 1-1/2 hours, while to do a breast augmentation through fat transplantation, the operative time required is approximately 3-1/2 hours.  So the procedure becomes longer and more expensive for both the surgeon and the patient.  In addition, for a patient looking for larger volume improvement like that produced by breast implants, https://www.cosmeticplasticsurgery.com/cosmetic-surgery/breast-enlargement.cfm  the procedure would need to be repeated several times in order to accomplish a larger volume.

 G. D. Castillo, MD, FACS

Director of Cosmetic Plastic Surgery

ASK OUR EXPERT: FAT TRANSPLANTATION

Wednesday, April 30th, 2014

 

Question:  Can Dr. Castillo take fat from my hips or stomach and put it into my breasts? 

Answer: The short answer to that question is yes; though, it is not as simple as it sounds. 

Fat transplantation to the breasts has been done for many years, starting in earnest around the mid 1980’s by many cosmetic surgeons. At that time, we did not have answers to important questions like:

  1. What, if any changes would fat create in breast tissue?
  2. Will these changes be misdiagnosed as disease and/or cancer in the future?

  Due to the lack of information available at that time, the use of fat transplantation to increase breast volume was never truly accepted or recommended.  However, early results indicated that it did work.

 Today we know that we can remove fat from anywhere in the body and transplant it to anywhere in the body with results that will accomplish

  1. an increase in volume
  2. an improvement in the skinFor example, if fat is transplanted underneath scar tissue, the scar tissue tends to remodel and turn into better skin.  In so far as increasing volume, fat transplantation needs to be done with quite a bit of care and by an experienced surgeon because if fat is placed in large lump quantities,  not only will the procedure be ineffective but it  is likely to create issues. Fat needs to be transplanted in very small amounts and in many areas within the breast and surrounding tissue in order to accomplish an increase in the volume of the breast. We can increase the volume of the breasts by approximately 120 cubic centimeters maximum. This is related to a limitation with the rate in which the body will incorporate this fat into the tissue. Fat that is placed in a new area needs to be colonized by small blood vessels and made into living tissue in whatever area it was transplanted.  This can only happen when it is transplanted in small amounts that are small enough to be able to be sustained by the microcirculation of the area.

Fat transplantation is best utilized for patients who are seeking small adjustments to their breast proportions.  If you desire to go from an A to a C cup size breast, fat transplantation will not give you your desired outcome.  To increase breast volume in a more significant way is better accomplished with breast implants. https://www.cosmeticplasticsurgery.com/cosmetic-surgery/breast-enlargement.cfm.

G.D. Castillo, M.D., FACS

Director of Cosmetic Plastic Surgery

https://www.cosmeticplasticsurgery.com/cosmetic-surgeon/

 

Options For The Aging Face

Thursday, March 6th, 2014

During the American Academy of Facial Plastic and Reconstructive Surgery Meeting in San Diego, it was stated that the AAFPRS had recently released a new study that found 39% of women were most worried about sagging cheeks or under eye bags, while 33% of women were most worried about lines and wrinkles.  28% of women were most worried about the “turkey neck” effect.

Being a women (and working with an incredible mentor and internationally-renown facial plastic surgeon for years; G.D. Castillo, M.D.) these stats come as no surprise to me.  Of course we women worry sagging cheeks, under eye bags, wrinkles, and the dreaded t-t-t-turkey neck.  It’s normal to want to be the best version of ourselves!  Stop for a minute and think about the women in your life who make a real effort to look their best, exercise, eat healthy.  Those people get things done!  They enjoy life! They are advancing in their careers, moving forward in their personal lives, involved in the community. They are movers and shakers. Looking good and feeling good about how you look is a true life motivator.

I cannot think of single women I know who is excited about the arrival of the next sign of aging. We are always scanning the mirror at home or in the car to make sure we look good – checking for lettuce in our teeth, smeared lip stick, dark circles that might need camouflaging… you know the drill.  For those  who say that’s simply being vain, well, maybe, but in my opinion a little vanity is a great thing. I think it means you care about how you represent yourself.  To me that is self respect.  Something we should all have because we all deserve it.  After all, if we don’t respect ourselves, who will?

I remember when my youngest daughter was about four years old.  She always had a way put a positive spin on things, always encouraging and complimenting others. We were on the floor playing a matching game when she looked at me and said “Wow mommie, the hair right here on the top of your head is shiny white.  Mommie, you are doing a great job at that!”  Cute as that was, you better believe my head was covered in chocolate expresso hair color with in the hour!

We all know aging is inevitable but that doesn’t mean we have to accept it gracefully with no attempt to slow the process.  This blog is called “Anti-Aging” with Grace after all.

Well not to worry (besides worrying just causes frown lines and then everyone thinks your angry all the time).  With the advances in technologies and the growing experience in plastic surgery and skin rejuvenation at your disposal, you have both surgical and non-surgical options available to wash your worries and your wrinkles away!  

SAGGING CHEEKS:

  • Non-surgical options

1. Dermal fillers can be used to restore volume loss in sagging cheeks.

  • Surgical options
  • 1.  A facelift – Fortunately, today facelifts are really customized for the individual’s needs.  There are Mini-facelifts, which is a limited facelift generally indicated in someone with early signs of aging (late 30’s to late 50’s) and are most effective in people with facial aging rather than neck aging.  Mid-facelifts, which elevate of the mid portion of the face. This type of facelift is needed in patients that have either facial sagging or lacking facial volume in the second 1/3rd of the face. Traditional facelifts are the treatment of choice for those who have of both the sagging of the cheek and the neck area.***Keep in mind that when sagging tissue is present, non-surgical results will not compare to the results of surgical removal of tissue, which is the hallmark of any kind of surgical facelift.

UNDER EYE BAGS:

  • Non-surgical options –
  1.  Try cutting out salt and preservatives from your diet for one month.  Observe over the month whether or not the bags disappear or reduce to a tolerable state. Salt / preservatives are found in prepared foods such as those you purchase from a deli or restaurant and in canned or boxed foods and can be responsible for puffy under-eye bags. If you see considerable improvement, you may be able to avoid partaking in the options below just by avoiding salt and preservatives.
  2.  Dermal fillers Hyaluronic acids (Restylane, Perlane, and Juvaderm) can be used fill in depressed curves that form between the cheek and the bag to provide a more natural, youthful contour.
  3.  CO2 Micro-fractional laser resurfacing can help to tighten the lower eyelid skin but it will not improve excess fat deposits.
  • Surgical options

       1.   Lower Eye Lid Surgery (Blepharoplasty) – This may include the removal of fat from the lower lid area or the transplant of fat to the area depending on the needs of the patient.

FINE LINES AND WRINKLES:

  • Non-surgical options
  1. CO2 Micro-fractional laser resurfacing is a minimally invasive treatment that typically produces the best non-surgical results for fine lines and wrinkles.  It will also remove brown spots and other pigment and texture changes that often present along with lines and wrinkles.
  2. Botox® can be used to smooth out lines and wrinkles of the forehead, between the brows, and around the eyes.
  3. Dermal fillers such as Juvederm®, Perlane®, Restylane®, orRadiesse® can be used to replace volume and fill in lines and wrinkles.
  • Surgical options
  1. CO2 full face laser resurfacing, (not to be confused with CO2 Micro-Fractional Laser resurfacing) can smooth out lines, wrinkles, tighten the skin, increase collagen, improve poor texture and pigment issues, and unwanted spider veins. If you are experiencing structural sagging a facelift or cheek lift may be done simultaneously.
  2. Facelift– As individuals age, they tend develop lines an wrinkles caused by loose skin and lax underlying muscle structure. A Rhytidectomy or facelift is designed to remove loose skin and tighten lax underlying structures which result in a lasting, more youthful appearance.
  3. Fat Transplantation can sometimes be used to replace volume loss of the face, relieving the lines that have developed due to loss of facial fat that can happen during the aging process.

TURKEY NECK:

  • Non-surgical options –
  1. Beyond managing your weight and avoiding the yo-yo weight effect along with protecting your skin from UV radiation to preserve collagen and elastin, your best bet is a trip to the O.R.  Once you develop a turkey waddle, there is not much in line of non-surgical options that provide true improvement.
  • Surgical options –
  1. Neck lift – This procedure is often combined with a cheek lift. The typical neck lift or neck/cheek lift consists of a modified type of facelift in which the main emphasis is to tighten the muscle structure and remove as much excess neck skin and fatty tissue as possible, resulting in a smooth, youthful contour of the neck, jawline, and lower face.
  2.  Chin implant surgery – also known as a mentoplasty is needed when a patient has a short mandible or recessed chin. The lack of adequate bone structure tends to accentuate jowls and loose, sagging skin around the neck.
  3. Neck liposculpture – This may be all that is needed to correct a double chin or turkey neck.  During this procedure, fatty tissue is removed via liposuction and the musculature of the neck is tightened to create a defined jawline. In some instances, neck liposculpture may be combined with a chin implant to correct a recessed chin. Patients can return to work within 3 to 4 days.

Yours Truly,

Roxanne Grace Hammond

Skincare and Laser Specialist

Cosmetic Plastic Surgery

 

 

 

 

 

Roxanne Hammond, RMA
Skincare and Laser Specialist
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY  

https://www.cosmeticplasticsurgery.com

LIKE US ON FACEBOOK:

http://www.facebook.com/DrCastilloCosmeticPlasticSurgery
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ask Our Expert –

Monday, September 24th, 2012

BALANCING BEAUTY

QUESTION:  When I read anti-aging articles, they often refer to facial balance.  Can you explain what that means?

ANSWER:  I belive what they are referring to is a “basic formula” used to describe a well-balanced face, proportionately speaking.  This balance is seen when the face’s prominent features, meaning the brows, eyes, cheeks and lips are proportionate to each other.   The eyebrows should be aligned with eachother with a slight arch toward the outer or lateral portion of the brow.  When looking at the eyes, there should be a 1/2″ between the upper lid and and the eyebrow.  The lateral or outer corner of the eye should angle up just a touch.  Prominent cheekbones are a sign of beauty.  They should be full and high set.  An oval shape that tapers itself back as you follow then back toward the ears is most desirable.  Last but not least are the lips.  The lower lip should be 2/3 larger than the upper lip.

Create balance with dermal fillers.
Lasts upto 18 months.

In the hands of an expert injector and Cosmetic Surgeon such as Dr. Castillo (not your neighborhood spa), Botox Cosmetic® and dermal fillers such as Juvederm®, Radisse® or Perlane® can be a quick, effective way to improve the lack of proportion in the face.  Botox Cosmetic® or Dysport® can be used to improve the arch of the lateral brow.  This technique can also add some distance between the brow and upper lid helping to restore or create that missing balance.  Dermal fillers or fat transplantation can be used to give fullness the cheeks, creating a more prominent and defined cheekbone. Dermal filler or fat transplantation can also be used to plump up the lips, and to give better definition.

Though all these facial features can be improved by the above mentioned techniques, it is important to remember the goal; proprotional balance. It is the the key to looking natural and maintaining a youthful appearance.  If too much focus is placed on one of these prominent facial features, you will once again be out of proportion often resulting in an “over-done” less youthful appearance.

Balance is the key to life…and apparently to physical beauty as well!

 

Yours Truly,

Roxanne Hammond, RMA
Skincare and Laser Specialist
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY  https://www.cosmeticplasticsurgery.com

LIKE US ON FACEBOOK: http://www.facebook.com/DrCastilloCosmeticPlasticSurgery
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

 

 

 

Fat Transplantation – A Popular Topic

Friday, December 18th, 2009

Fat Transplantation has become a very popular and intriguing topic over the past few months. More and more patients enter our office with questions about whether or not fat transplantation may be a solution for their volume loss and signs of aging.  Media coverage has also exploded onto this topic, touting it as a “new” and successful procedure.

The media is correct. In the hands of an experienced cosmetic plastic surgeon, we are indeed seeing a nice, long lasting result for those who have lost volume in areas such as the face, breast and buttocks.   However, this procedure is hardly new to those physicians on the leading edge in a cosmetic surgery practice.  In fact, fat transplantation has been in high use for decades as it parallels the beginning of liposuction.  I have been utilizing fat transplantation in my practice since the 1980’s.

So, why has the media suddenly taken interest in this procedure? The interest and notoriety of procedures is a little bit like that of celebrities-it comes and goes, has peaks and valleys and is likely related to news media events that are highly popular.  Such is the current interest in fat transplantation. The primary reason for the resurgence of interest in fat transplantation has to do with changes in technique.  With a slightly better understanding of stem cell research and years of technique evolution, this procedure continues to be refined.

In the beginning, fat transplantation was done by placing moderate to large amounts of fat into different areas of the body.  The results were okay, that is, there was some fat that survived this rudimentary method of transplantation; however, the results were not consistent enough to be able to accomplish wide acceptance by both physicians and patients.

In the late 90’s, popularization of fat transplantation in the medical literature in general and cosmetic surgery in particular revolved around the idea that for fat transplantation to be successful the fat needed to be placed in very small amounts in multiple areas.  That meant that fat needed to be injected with instruments that created very little bleeding. Therefore, we used blunt cannulas for the injections.  The fat needed to be placed in very minute amounts into many areas, and so there was the development of a technique whereby multiple passes were created in one area, depositing very small amounts of fat in each one of those passes.  This resulted in a more successful and consistent outcomes for all experienced practitioners.

Today, some questions still remain, like “Does the fat need to be prepared prior to the injection or not?”  This question is still to be resolved in the future.  Most practitioners today will harvest fat from a common area, mainly stomach and/or thighs, will  prepare it by centrifuge at low speed, that is, it will be placed in rotation separating the serum from the fat.  Once this is accomplished, the serum is discarded.  The fat is placed into very small syringes and then injected as soon as possible.  While the fat can be under deep freeze and injected in the future, it is much more effective; that is the rate of “take” is much higher, when the fat is injected immediately.

One needs to place a lot of fat in the area to be remodeled because approximately 70% of the fat will be reabsorbed by the body and only 30% of the fat will take and be part of the graft.  Fat is primarily used to fill out areas of the body and face by taking fat from an area that has excess, preparing it and utilizing it to fill out areas that need volume or rejuvenation. Fat transplantation is most commonly used to create a more shapely body region such as the buttocks or breasts.  Fat is extremely useful in filling the contours of the face that deflate with age.  Such facial areas may be deflated, sagging cheeks, corners of the mouth, lips, or smile lines. It’s most successful in removing divots, depressions and over a period of time, successful in remodeling wrinkling.

More recently, studies are showing that there seems to be an effect from fat transplantation, which is beyond filling depressed areas. Fat contains stem cells, which are primary cells that are able to regenerate tissue.  These studies indicate that when fat is placed underneath the skin, it can remodel the skin, reversing signs of aging and creating a more uniform result.

Because the fat is grafted using the patient’s own fat, the risk of allergic reaction is eliminated. Fat transplantation is done both under local anesthesia and under sedation or general anesthesia.  Patients can expect bruising and swelling for 7-10 days, and patients can expect to return back to work in  7-10 days.  While to some people this may be a new procedure, it has been part of the arsenal of procedures that the plastic and cosmetic surgeon has had at his or her disposal for over 25 years.  We are very encouraged by advances made with this procedure over the years, as it is a reliable and cost effective option for our patients.

G.D. Castillo M.D., Fat Transplantation Expert

G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY
Become a Facebook Fan of CPS @  http://www.facebook.com/pages/Cosmetic-Plastic-Surgery/65943304419
https://www.cosmeticplasticsurgery.com
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington