Subtraction is Easy. Proportion is Not.
For decades body contouring has been done with liposuction, abdominoplasty and other methods of “subtraction”. What has become more common is to look at the entire body and see if there are areas that could benefit from MORE volume. Traditionally fat that was removed was discarded. Waistlines, saddlebags, abdominal bulging all were improved by this, but some areas were left deflated. Instead of throwing that fat away, why not use it to help inflate and shape the breasts, buttock or even face? It is your fat and so there is no risk of rejection. Since it is not a synthetic filler, it won’t degrade.
One of the benefits of my reconstruction experience is that certain techniques and tools are created to address specific aspects of limitations to breast reconstruction results. A lot of these same issues exist in our cosmetic patients and this technology can translate to our aesthetic practice. Fat grafting is an excellent example. The science and technology has now allowed us to place fat in an area and have a much more successful and symmetrical result. We now expect to get over 50% of the fat to survive and the body absorbs the rest. Once fat is transferred to another area, the body must circulate new blood vessels to the fat so that it will survive. The amount of fat must be judged so that the area is not overwhelmed and too much of the fat is lost. Once the fat cell is established, it should survive just like the rest of your fat cells and, so it doesn’t just “go away”. Fat is not as powerful a shape medium as a breast implant for example, but it allows us to put fat exactly where we want it, as opposed to an implant which has fixed dimensions. The only people who aren’t candidates for the surgery are those without enough subcutaneous fat. I’m sure you’ve got one or two skinny friends that you can think of.
SB is a 37-year-old female who has two children and is not planning to have any more. She presented for body contouring and breast reshaping. This has been referred to as a Mommy Makeover. It is basically a catchy term that implies breast and body procedures are done simultaneously with one surgery, one anesthetic, and one recovery. After I listened to what bothered her, and I examined her, I felt like she would benefit from an abdominoplasty and liposuction of the hips. I didn’t really feel like she needed a breast lift as she had requested, but I thought she’d benefit from fat injections to the breast using the fat from her hips. This allowed me to help “reinflate” the breasts and correct some of her volume asymmetries. It especially helped me give her more fullness in the upper and medial part of the breast without using an implant and with NO SCARS on the breast! The surgery took four hours. She was driving carpool after one week and going on long walks in the neighborhood on Day 10. She now looks forward to wearing lower cut blouses, bikini tops, and cocktail dresses.
BW is a 44-year-old mother of three who is an avid runner and loves to exercise. She presented for complaints of neck and shoulder pain when running and she attributed this to her large breasts. While she wasn’t humongous, she was definitely disproportionately large for her frame and one breast was about 30% larger. She also had excess fullness in her hips and abdomen that she has not been able to get rid of, despite her avid schedule. I performed liposuction and a breast reduction/lift on her. The fat that was removed was then placed in her upper buttock to address her “flat butt” (her words!). Although only about 5 ounces were placed on each side, it was enough to add some fullness centrally. Lulu Lemon yoga pants are now her favorite thing to wear, but this time without the long cover up top. She is thrilled with her results and glad that her excess fat could go to a good cause!
MK was a 50-year-old female who had lost a great deal of weight. This resulted in severe deflation and sagging of her breasts as well as a lot of skin excess around her waistline. A few years prior I had performed a breast reduction and lift, and she was very happy. When she represented this year, she wanted to do body contouring and wanted to discuss her face. Although she could have also had a facelift, the body contouring was a higher priority and the length of doing all this at once was just too much. Rather than disregard the face altogether, I presented her the option of doing fat injections to her face using the fat that would be removed from her hips during the liposuction. She now has a much more youthful look with more fullness in her cheeks and around the corners of her mouth. Most importantly, however, is that she now has fullness in her lips again and she is ecstatic. She has a very natural look and the fat added to her face has improved the texture and quality of her skin. The surgery took 4 ½ hours and she was back at work in two weeks.
So, if you are having surgery to correct one thing and fat is going to be removed, consider using it somewhere else to really enhance your result- “Waist not” want not. Recycle your fat!
Contact us today if you would like to learn more about Austin Plastic Surgery Institute or to schedule a consultation.
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