Fat grafting to the face is one of the best ways to rejuvenate your face to a more youthful look.   Patients seeking fat grafting, also known as fat injections,  are usually composed of two types:

• patients whose dermis has thinned due to the aging process and the face looks tired or sagging
• younger patients who have a volume deficiency in the upper areas of their face

In both cases, these patients have a loss of volume in the face . This makes the face seem tired and aged. Fat injections can restore the volume to your face to give you a youthful glow.

Examples of how fat can be used in the face

Ways that fat injections can be used to help you rejuvenate your appearance include:

• eliminate or reduce bags in the lower eyelids
• substitute for cheek implants if you are seeking a higher profile in your cheeks
• increase general volume in the mid face area with a natural distribution of fat
• substitute for a mid facelift

Regenerative properties of your own fat tissue

In addition to making your facial structure look younger, fat injections can also improve your skin.  More than a decade ago, researchers discovered that your own adipose tissue contains adult stem cells. These are cells found in your own fat that have regenerative properties. When the procedure is performed correctly, fat grafting can provide a new source of blood supply for your existing tissue and skin.   Thus, the fat not only adds volume to your face, but it also has these natural regenerative properties to make your face look more youthful.

In summary, fat injections are a natural way to make a more youthful you. To read more about regenerative fat grafting please see my video, Stem Cells from fat-Plastic Surgery’s New Frontier.

Ricardo L Rodriguez, MD

Board Certified Plastic Surgeon

Some women think of liposuction as a way to look slimmer. Indeed, most plastic surgeons also think of liposuction this way, using liposuction to shave off pockets of fat. While this may have been an ideal of beauty in the past, today’s concept of female beauty is more sensuous. This requires skill not only in taking out fat, but also in adding it where needed.

Fat Removal and ReInjection into the Hips

Let’s examine the before and after photos of a woman who wanted a curvier figure with more prominent hips. Prior to surgery (left side before photo), she had an apple figure, where a lot of the body fat is concentrated on the upper body. If one were to liposuction this patient to make her look slimmer, the result would be a slightly thinner version of the same body, no curves. A slimmer apple, so to speak.

However, if you combine liposuction (non-laser) with fat injections, an entirely different result is achieved.

Post operatively, you can see that I successfully changed her body type to not only look slimmer, but to look more feminine. Thus the apple shape was transformed into more of a pear shape. Fat was taken out from her central body and reinjected into her hips. Her new body profile has a narrower waist compared to the hip. It is what is referred to as a pear figure. The curvy pear figure does appear more feminine than her previous shape. Liposuction alone would not have been able to create this feminine profile.

The use of your own autologous fat to create a more feminine sculpted body is a great tool for enhancement. Fat grafting results are long lasting if proper techniques are used. Therefore, be sure to ask your surgeon if he expects long lasting results!  With proper techniques and post op he should have full confidence in a long lasting result.

To learn more about why fat grafting is long lasting when done correctly watch my video which explains why. If you have any questions, please post them to my blog.

Ricardo L Rodriguez, MD
Board Certified Plastic Surgeon

Patients often ask for post operative advice on the web. I think the web is a great information gathering tool, but in the post-operative period, it is not a good place to start.

Why is this?

Giving you advice on any medical conditions depends on many things. These include:

• intimate knowledge of what procedure was performed
• detailed familiarity with symptoms
• a physical exam

Clearly, none of these 3 conditions can be found in an internet correspondence. At best, you will be getting well-intentioned, but possibly misguided information. At worst, you could be delaying proper treatment.

The best person to answer questions about your surgery is the surgeon who operated on you.

It is in the doctor’s best interest to make sure all post operative issues are handled quickly. The only way that can happen is if you communicate with him. You should always try to contact your surgeon first, rather than go online to get answers. If your problem occurs outside of normal office hours, his answering service should be able to get in touch with him within the hour. Read More »

In many internet forums I often see the question asked:

Can I have another procedure with the brazilian butt lift?

The brazilian butt lift is a butt augmentation procedure which uses your own regenerative fat to enhance your buttocks. In my own practice, it is very common for patients to request a brazilian butt lift and a tummy tuck in the same operative session.  I have performed this combination of procedures for many years and I assure you they can be safely performed together.

One factor which allows me to do multiple procedures in the same operative session safely is that I use IV anesthesia instead of general anesthesia.  General anesthesia carries much higher risks for long procedures .  IV anesthesia allows you to breath on your own , thus dramatically reducing pulmonary anesthesia risks. With IV anesthesia, I can comfortably perform multiple procedures which require 8-10 hours of operative time.

The most common procedure that is performed with the brazilian butt lift is Read More »

As we age, our dermis thins, facial skin loosens, and wrinkles develop.  There are several alternatives to treat the aging face. If a patient is not interested in a face lift, but wants a long lasting result, the two alternatives are:

1. laser resurfacing
2. regenerative fat grafts

What is the difference between these two techniques? A LOT!  In summary, laser resurfacing technologies destroy tissue (which the body repairs), while fat grafting (fat injections) builds up and regenerates tissues. Most lasers shoot a high energy beam which vaporizes cells, whereas fat grafting techniques mobilize teams of repair cells to bring more blood supply and nutrients to your face.

I believe that stem cell enhanced fat grafting offers an advantage to lasers currently being used by plastic surgeons and dermatologists. Fat grafts are the most natural way to get a long lasting youthful rejuvenation of your face. Fat grafting is your own Fountain of Youth.

How do lasers work to tighten the skin?
With laser, a beam of energy is used to obliterate layers in the epidermis and dermis beneath your skin. The cells in those layers are totally vaporized. Once that layer has been destroyed the body sends a signal to repair. Your body repairs the tissue by forming a scar (or “building collagen”) in the destroyed tissue layer. The scar Read More »

Baltimore, Maryland

Getting snowed in has it’s advantages. Fifty inches in one week is enough for any human being. If you are a plastic surgeon fascinated with adult stem cells from adipose fat, it gives one time to transcribe your thoughts. One has more time to reflect, pontificate, and borrow ideas.

You’ve gotta credit Sarah Palin–the stuff you write on your hand–it’s important stuff.

Here’s the hand that describes the future elixir of heath care:

(Translation:adipose fat contains a higher population of adult stem cells than bone marrow. Stem cell therapies will move much faster to market if  the FDA allows your own autologous minimally manipulated stem cells to be considered as a ’tissue’ and not a ‘drug’.)

To learn more about adipose stem cells (ASC’s) and how they heal tissue and have the capacity to cure diseases visit our fat stem cell archives.

Staff Writer
CosmeticSurg.net

We do a lot of brazilian butt lifts. The brazilian butt lift augments and enhances your buttocks using fat from unwanted areas of your body. The procedure is a total body resculpting of your abdomen, flanks, and buttocks. The question I often get asked is “Doctor will I lose the effect of the brazilian butt lift if I lose weight after the surgery?”

The answer is: If the fat is processed and grafted correctly-you will not lose the effects.

To illustrate the point, I went back and looked at the photos of one of my patients who had the brazilian butt lift surgery, lost approximately 10% of her body weight after the post op period, and then gained all of the weight back at the end of the one year period.

In the video below , her pre-op is on the left. Eight months following the surgery, in the photo on the right, she lost a little over 10 pounds. You can see that her buttocks are still prominent ,and her new curves show off very nicely. Watch the video to see all of the details.

Even with her weight loss, her buttocks are prominent and she maintains the buttocks ’shelf’. If the procedure is done correctly, your new curves should stay with you. Properly processed fat Read More »

For months, we have been hearing the debate on ways to reduce healthcare costs.  Thus far, nearly everything introduced requires vast amount of government expenditures and seriously upsets people who actually like the health care plan that they currently have.  It is astounding that the most important way to lower health care cost rarely , if ever, gets discussed. Curious?–read on. How do we lower health care costs? As the Governor of Minnesota would say—prepare to be dazzled. . . . . .

The answer to lowering health care costs is to require all providers (doctors, hospitals, surgery centers, labs, anesthesia)  to disclose what things cost before the service is rendered. Yes, as a matter of informed consent, the cost of a routine medical service should be disclosed to the consumer.

If  this one mandate was made (to disclose pricing), health care pricing would be in the ‘free market competition’ and prices would start dropping like a rock. Consumers would start to shop for scheduled services and prices would come down, quickly. This is exactly what happens in a free market economy   and this is what has been happening in Plastic Surgery for decades.

Plastic Surgery is one of the few elective areas of medicine where most services are NOT covered by insurance. Thus, Plastic Surgery has always been subject to free market forces. Well guess what?–prices (adjusted for inflation) of most cosmetic procedures have gradually gone DOWN over the years , not up. Since there is a well trained supply of Plastic Surgeons in the U.S.,  pricing disclosure CREATES COMPETITION of these medical services and prices are forced down.

A facelift performed now is less expensive (inflation adjusted) than a facelift performed 20 years ago.  Since there is a high supply of qualified Plastic Surgeons performing Breast Augmentation procedures, breast augmentation prices keep going down. Since many medical specialties are now offering Botox,  there is a high supply, and  prices fall year over year because patients can price shop among the competition. However, highly specialized procedures, such as the brazilian butt lift or stem cell enhanced fat grafting, with limited supply of experienced surgeons delivering excellent results can command higher prices.

It’s good ole supply and demand and Larry Kudlow’s free market path to prosperity.

With Plastic Surgery, there are only a couple of insurance covered procedures, so let me walk you through health care’s current mode of pricing secrecy. Read More »

Here are my top predictions for cosmetic surgery trends in 2010:

1. Stem Cells from Adipose tissue- The year 2010 ushers in a new decade where science , beauty, and your own fat consummate a marriage that promises to deliver one of the most disruptive medical technologies of the century. Stem cells from our own autologous fat have the power to rejuvenate tissue , heal wounds, and cure diseases. Adult stem cells derived from your own adipose tissue is the new elixir of healthcare.
2. Fat injections -There will be a dramatic increase in cosmetic surgery procedures ultilizing fat injections. Fat injections are used to restore and revitalize tissue in your face, breast, hands, buttocks, and other areas of the body. Done correctly, fat injections are permanent.
3. Butt augmentation -For butt augmentation, fewer surgeons will use buttock implants due to their notorious complication rates. Instead, the Brazilian Butt Lift Technique of fat grafting becomes the main method of butt augmentation.
4. Stem cell facelift- After a well known Hollywood actress has the stem cell facelift , this autologous stem cell enhanced Read More »
   

   

   
   
   

Thanks to the lobbying efforts of the ASPS, Allergan, and plastic surgery portals such as RealSelf.com, women can continue to  improve their cosmetic appearance without taxation! For the past few weeks, the proposed 5% tax on cosmetic surgery became known as the Botax. The cosmetic surgery tax would have discriminated against women, since more than 90% of all cosmetic surgery is performed on women.

A last minute amendment to the new Obamacare Health Care bill, HR 3590, dropped the 5% cosmetic surgery tax , but included a 10% tax on tanning services. This tan tax was put in as a substitute for the initially proposed 5% tax on cosmetic surgery. If this bill becomes enacted into law, the tan tax will become effective  for tan services rendered after July 1, 2010.
Specifically, the tan tax is applicable to tanning booths which use ultraviolet radiation in the frequency of 200 nanometers to 400 nanometers. Exempt from the tan tax is ‘phototherapy services’ .

The exclusion of tax on cosmetic surgery is a win for women and we salute our lobbyist for a job well done!  While we are happy about our own outcome, we can’t help but wonder if this new tax will stifle the tanning industry.

Here is the amendment included in the bill: Read More »

Congrats to Molly Plummer, of Maxx Factor quartet, who will be competing tomorrow night in NBC’s first annual Sing-Off. The competition is a voices only, a capella competition and will be broadcast on NBC throughout the Holidays. Eight groups from around the country were selected for the competition. Molly is our financial coordinator at CosmeticSurg . Dr. Rodriguez and the entire staff at CosmeticSurg wish Molly good luck!

I see this question all over the Internet: Are fat graphs permanent? The answer is:

When done correctly, fat grafts are permanent. When done incorrectly, they don’t last and you will need a redo.

So, how do we do them correctly? First, the physician must employ correct techniques ; and second, the patient must follow the post op recovery restrictions.

For the surgeon, the following techniques should be performed:

• Right extraction pressure with low suction
• Various types of laser lipo will kill the fat cells –these techniques should not be used for extraction
• Fat cells should not be washed
• Proper centrifugation techniques
• Proper isolation and injection techniques to ensure that the good fat is enriched with some of your own stem cells. Fat must be reinjected in small quantities to allow blood supply to grow into the new fat grafts.

After the surgery, the patient must not put pressure on the graphs for a period of 2-3 weeks. In the example of the brazilian butt lift, patients should ideally not sit on the new fat grafts for 3 weeks to allow a full ‘take’.

When the above techniques and protocols are used, my fat grafts have been permanent.

Ricardo L Rodriguez, MD

Other posts on fat grafting:

Fat injections-are they permanent?

How long do fat grafts last?

Why do some women get more breast cleavage with breast augmentation than others? There are many reasons, but one of them is a function of your chest wall type.

Some patients have a chest wall shape that is not really straight. Those patients either have a concave, hollow chest, in which the chest slopes towards the middle, or they may have an outward curved chest wall, or bird like chest, in which the middle part of the chest is the highest part like the women in the video still shown below.

These conditions are medically referred to as:

• Pectus excavatum- the concave breast, which is sunken in the middle
• Pectus carinatum- the bird like , or outward curved chest wall

Some of my patients have a mild degree of one of these chest forms. They may not even realize it. To determine if your chest wall has a mild form of either of the two, Read More »

The proposed bill would levy a 5% tax on cosmetic surgery procedures. Consider this: According to the American Society of Plastic Surgeons 2008 Statistics, women had 91% of all the cosmetic surgeries performed.

So, let’s see—this bill would be discriminating against women!!!

Page 2045
SEC. 9017. EXCISE TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.

(a) In General- Subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by adding at the end the following new chapter:

`CHAPTER 49–ELECTIVE COSMETIC MEDICAL PROCEDURES

‘Sec. 5000B. Imposition of tax on elective cosmetic medical procedures.

‘SEC. 5000B. IMPOSITION OF TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES.

‘(a) In General- There is hereby imposed on any cosmetic surgery and medical procedure a tax equal to 5 percent of the amount paid for such procedure (determined without regard to this section), whether paid by insurance or otherwise.

‘(b) Cosmetic Surgery and Medical Procedure- For purposes of this section, the term ‘cosmetic surgery and medical procedure’ means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which–

‘(1) is performed by a licensed medical professional, and

‘(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease.

‘(c) Payment of Tax-

‘(1) IN GENERAL- The tax imposed by this section shall be paid by the individual on whom the procedure is performed.

‘(2) COLLECTION- Every person receiving a payment for procedures on which a tax is imposed under subsection (a) shall collect the amount of the tax from the individual on whom the procedure is performed and remit such tax quarterly to the Secretary at such time and in such manner as provided by the Secretary.

‘(3) SECONDARY LIABILITY- Where any tax imposed by subsection (a) is not paid at the time payments for cosmetic surgery and medical procedures are made, then to the extent that such tax is not collected, such tax shall be paid by the person who performs the procedure.’.

(b) Clerical Amendment- The table of chapters for subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by inserting after the item relating to chapter 48 the following new item:

‘Chapter 49–Elective Cosmetic Medical Procedures’.

If you are having breast augmentation, you should have the opportunity to select the breast implant that will give you the look you want. Although implant volume (cc’s) is important, the shape of the implant is just as important.

Implant shape has two components. One is the base, or how much space the implant occupies on the chest wall. The other is projection, or how much the implant stands out from the chest wall. For example, a 350cc implant can be moderate profile or high profile.

• Moderate Profile Implant : The moderate profile implant will occupy a larger diameter of your chest wall, it is wider and taller. It will not project outward so much, as it is distrubuted in a flatter, wider fashion.  This implant is often chosen by patients who want fullness to the side of the breasts. In the video snapshot below, this profile is that implant to your right.
• High Profile Implant: The high profile implant will occupy a smaller diameter on your chest wall as it is narrower but it also stands out more from the chest wall. This implant is often chosen by women who are slender and want more projection outward, instead of fullness on the side of the breast. In the video  below, this profile is the implant to your left.

I prefer that the patient starts the process by first selecting the type, or profile of the implant. Then, after the shape of the implant is determined, Read More »