Listen up plastic surgery enthusiasts. I just returned home from New York City where I attended one of the most interesting and innovative seminars I have attended in years called The Cutting Edge in Plastic Surgery 2011
There were so many innovative subjects discussed, it’s a challenge to choose, but here are the top six most interesting subjects of the seminar:
Stem cell face lifts and stem cell fat transfer grafts:
There is a lot of hype, and even more charlatans claiming to use “stem cell” technology in their advertising. However, there’s scant evidence that the average doctor, because of time, effort and the cost prohibitive-nature of the equipment, can use stem cells.
Simply grafting fat to an area is not the same as stem cell surgery. Beware of marketing ploys. Yes, there are stem cells in fat, just as there is in every other tissue in the human body. Even doctors doing the most number of fat grafting cases say that it’s not the stem cells that make it work. It’s the technique you use to acquire fat cells, prepare the fat and how you inject into the recipient areas that makes all the difference.
Fat grafting to the face:
I’ve seen some amazing results, but remember when fat is grafted from the body to the face, it acts like body fat. In other words, if you gain an excessive amount of weight, your face will become fatter. This was scary to me, because one presenter showed several patients that had done just that, and now they want the fat removed, which is not easy to do. And typically most people do gain weight with age.
Fat grafting to the breast:
Now, this is an exciting innovation. Fat grafting to the breast appears to be the future for breast surgery, especially breast reconstruction and in many cases cosmetic breast augmentation or for replacement of breast implants.
For those who want to go up 2-3 cup sizes, perhaps implants are the best option, but for others, the fat grafts feel as natural and as a normal breast, and in many cases, it looks more natural than implants. However, now a days, it seems that many people don’t seem to know what a natural breast looks like, especially after seeing the covers on magazines and the “stars.” As with any surgery, there can be risks, but with fat transfer there is no risk of encapsulation (firmness), rupture, or wrinkling. Of course, it requires some liposuction to acquire the fat, but many people will not object to that.
A paper entitled, “Framing the Eyes” was excellent. Most of us have performed “reduction” eyelid surgery over the years, and we removed the excess skin and fat. While some of this surgery may still be necessary in some patients, injecting fillers or fat in the hollows of the lower and even the upper lids simulates the youthful eyelids in many cases. Often correction of both upper and lower lids is necessary. When looking at an aging person from the side, you may notice that the brow becomes flatter and loses the underlying mound causing it to sag. This is easily corrected with fillers in about 10 minutes. And, framing the eyes with more volume makes a world of difference.
This requires a multiple treatment approach. The age spots can be reduced with good skin care (NewYouthSkincare.com), the IPL or Fraxel Dual. The volume can be increased with an injectable like Juvederm, Restylane, Artefill or even fat grafts. It’s the combination of treatments that makes the difference. Proper skin care will thicken the skin, which we all know becomes thinner with age. The brown spots on the hands, like everywhere else are usually age spots, but the pink ones may be premalignant, and these should be treated with a 5-FU cream, such as Effudex or Carac. The Fraxel Dual is also FDA approved for treatment of these premalignant actinic keratoses.
After it all said and done, traditional liposuction is still the gold standard. While all of the laser, ultrasound, and radiowave techniques may have a yet unproven effect on tightening the skin, the complication rate is much higher and more severe. Most of the plastic surgeons that presented papers have gone back to traditional liposuction, except those who are doing studies on the various modalities.