New Surgery Spotlight: Blepharoplasty with Fat Injection

The October Surgery Spotlight program is now live on PSEN. This month our exclusive HD video program features Julius W. Few, MD demonstrating Blepharoplasty with Fat Injection.

Dr. Few is the Founder and Chief Medical Director at The Few Institute for Aesthetic Plastic Surgery, located in Chicago, IL.  Additionally, he serves as a Clinical Associate Professor for the Division of Plastic Surgery at the University of Chicago. Dr. Few specializes in providing aesthetic plastic surgery, while preserving the unique ethnic features of his patients’ face, breast, body, and skin.

Surgery Spotlight is a monthly video-based activity produced by the PSEN. This series of surgical videos aims to put you in the operating room with the demonstrating surgeon. Each stage of the procedure is presented, from the surgical markings to final suturing. The full-length surgical videos be purchased and viewed for CME credit, or a shorter version can be viewed for free on PSEN.

To view the full video and earn CME via a short post-test, click here.

To view only the video and not earn CME, click here for Part I, Part II or Part III.

The Aesthetic Meeting 2011

The American Society for Aesthetic Plastic Surgery (ASAPS) held its annual meeting this year in Boston, on May 6-11, 2011. PSEN was there, providing surgeons with demos of the new educational network in its exhibit hall booth, and interviewing surgeons on the clinical highlights of the meeting. You can watch the news video of the meeting above.

ASAPS recorded many of the panels and presentations of The Aesthetic Meeting, which you can purchase access to via their site. The Aesthetic Society has also allowed some of those sessions to be hosted in the PSEN Presentation Library.

Watch the following free lectures in the Presentations area of PSEN:
Live Marking Demonstration — Blepharoplasty & Browlifting — The Skin, The Fat and The Finesse
Analyzing & Precision Planning of the Asymmetric Breast
Social Media — Why Is It So Critical?

ASAPS Annual Meeting Reflection: What’s Hot

Written by Joseph Gryskiewicz, MD, PSEN Aesthetic Assistant Editor

Plastic surgery advanes are occurring faster than an “unstoppable” freight train. Probably the hottest of the hot topics is fat……no, not fat removal, as much as fat injection. Adult stem cells (ASC’s) are being studied as a potential way to enhance the survival and results from lipo transfer. Dr. Kataro Yishimura, of Japan, is using the stem cells of fat taken from the hips or tummy for breast augmentations. He will be presenting over 500 breast augmentations done solely by transfering the patient’s own fat cells. As Dr.Robert Singeraptly warns elsewhere in this insert, there is little data to support stem cells as the progenitor for growth. Is this even approved by the FDA? Should it be? Does injected fat cause calcifications which could impair accurate readings of future mammograms in these patients? Could this hide early breast cancer? Worse yet, could the transferred stem cells soup up cancer ready cells igniting a malignancy? There are more questions than answers at this point. A national registry through our reasearch socities hopes to answer these questions as time goes on. To take this a step further to the face, one could ask if there is even such a thing as a “stem cell” facelift? More science and less market hype needs to be added to the stem cell test tube mix. Several European centers are injecting tissue fillers rather than fat for breast augmenation…….I wouldn’t jump on that band wagon either.

Let’s talk about removing fat. Melting your fat by “freezing” your subq tissue is referred to as cryolipolysis [pronounced any way you prefer]. This method has promise for some selected localized areas such as love handles. Using external laser light to reduce fat is a cruel hoax in my opinion. Laser assisted liposuction doesn’t seem to me to be any better than regular liposuction, although some feel they have proven otherwise in “tight” clinical studies. Many surgeons believe traditional liposuction is still the gold standard.

If you like the idea of transfering your own tissue for enhancement, take a look at the “Vampire Lift.” Your own blood is spun in a centrifuge, the plasma rich growth factors are harvested and injected into your face for rejuvenation. Yes, it works; works well because long term clinical studies both here and in Japan have demonstrated durable tissue filling. Now we need a multicenter randomized clinical trial to pound the final nail into the coffin to silence the unbelievers.

On that same note of tissue fillers, safer, “non-sharp” needles have just been introduced in the U.S. for tissue filler injections to prevent the rare occurance of skin loss. Hand rejuvenation using tissue fillers is rapidly catching on. Advanced laser techniques are now availble to treat filler complications such as painful, persistent lumps.

Brigadier General W. Bryan Gamble, plastic surgeon and Commander Dwight David Eisenhower Army Medical Center will in the future describe various advances spawned by recent military conflicts. War Stories: Military Technology and Surgery Complications and Solutions will be reviewed. He will merge into the very latest on tissue regeneration which can help replace lost tissue and the latest in burn therapy which is saving many more soldiers’ lives.

Aesthetic surgery to sculpt and shape the male and female genitalia is becoming more accepted bit-by-bit. Be sure you find someone with lots of experience. Buttock augmentation is one of the last frontiers but is only done by specific individuals world wide.

ASAPS Annual Meeting Reflection: What’s Ahead?

Written by Joseph Gryskiewicz, MD, PSEN Aesthetic Assistant Editor

I am particularily excited about the prospects in the future for cryogenically stored fat for smaller procedures. The day is coming when a patient can donate a teaspoon of his/her own fat, store it in a fat bank CD, and cash it in for a future procedure where gallons of their own tissue would be available for instant withdrawl. Cryopreservation of fat or adipose-derived stem cells (ASC’s) is being done in Europe and future prospects for a transatlantic migration here are on the horizen.

How about the possibility of removing fat without invasive surgery in the future? The two competing external fat removal devices may be soon cleared for safety and efficacy for lunch hour treatments. This drive through experience will remove rather than add weight. How about injecting a fat dissolving compound into your tissue? There is such a compound and it is in final (Phase 3) clinical trials in Europe. The jury is still out on how well it works and in what areas. It is my impression it works pretty good on localized fullness in the neck area, and merely works so-so or not at all elsewhere. There are many variables to be sorted out such as dosing and level and frequency of injections. Don’t count on it to get rid of your saddlebags.

In the area of Military Medicine, General Gamble, who trained in plastic and reconstructive surgery at Walter Reed Army Medical Center sees total limb replacement with both mechanical as well as by surgical transplants as possibilities. It will be fascinating to see in 50 years what stem cells will be achieving to grow new body parts and reverse aging.

New tissue fillers are pointed our way. Almost 100 different types of fillers are used throughout Europe. We have only scratched the surface because of tighter FDA clearance. Thinner, more moldable fillers will soon enable you to have more precise and rapid treatment of fine wrinkles. Finer micro threading techniques to apply these thinner fillers will become commonplace. Even additional botulinum formulations are on the horizen including one that can be rubbed directly on the skin rather than injected.

Cellulite is a bane for many women, and I see recent laser advances as solving this problem. Cellulite is characterized by thinning of the skin, deeper fat lobules that extend upward into the skin and then tethering fiber bands grow between and separate the fat lobules. Various devices, requiring multiple treatments have been cleared by the FDA for temporary improvement of the appearance of cellulite. Dr. Barry DiBernardo will speak on a single treatment with a pulsed laser which improves the appearance of cellulite. The improvement persists for at least 1 year with minimal adverse effects.

Finally to all you mom’s out there, if you have the crepe paper skin around your tummy button then hold on for a few more years. Skin tightening technologies that really work are being used in Europe and should migrate here in the next few years.