Breast Augmentation in Orlando, Florida
July 9th, 2011
This last week we performed our first fat grafting procedures where we were able to store additional fat harvested during the same liposuction procedure. Previously when performing fat grafting or liposuction, extra fat was discarded. Now having stored the fat in our Liquid Gold tm mini-fat bank, we can add additional fat as needed with a simple outpatient local anesthetic procedure, without the need for an additional liposuction procedure in the operating room. One patient was a facial rejuvenation volume enhancement procedure and the other a procedure to add additional volume only in the lower part of the breasts where the patient felt that the implants alone did not give her the exact shape she desired.
This procedure can also be used for breast augmentation without implants, and for breast reconstruction.
Fat was harvested using Body-Jet® and then further purified using PureGraft® before micrografting
One cannot simply store fat in a refrigerator, as some doctors have done, so be wary of fat banking that is not performed in a fully FDA registered and compliant facility. The fat must be processed and frozen in a very specific way. The Liquid Gold tm fat bank is the first installed, FDA registered, Cytori Stem Source ® mini-fat bank in the world. Cytori’s proprietary cryopreservation processing procedure has been shown to maintain at least 90% viability of stored fat. Fat viability is the most important consideration of any tissue preservation process as simple refrigeration of fat has been shown to result in total loss of fat viability. Similarly the actual procedure followed during the freezing process is critical so that maximum cell survival during the freezing and thawing process is ensured. The Cytori process has also been shown to maintain maximum viability of the stem and regenerative cells (ADRC’s) found in fat, this is very important as ADRC’s are probably responsible in large part for the survival of fat grafts after grafting, and these cells can also have potential uses in the future. Studies are presently underway worldwide for example using these exact cells to treat heart attacks.
Posted in Adipose Derived Regenerative Cells, Body-jet®, Breast Augmentation, Breast Augmentation with Fat, Breast Implants, Breast Reconstruction, Cytori Stem Source, Fat banking, Fat Grafting, Liposuction, Local anesthesia, Pure Graft, Stem Cells | No Comments »
June 21st, 2011
There are a number of situations where combining fat grafting with breast implants can improve the results of breast augmentation. I have used fat grafting for patients who are overall pleased with their implants, but would just like to enhance certain areas of their breasts. A common example is someone who has had her breast implants for a few years and who has lost some of the fullness in the upper area of the breast. Fat grafting to this upper pole area is a perfect solution particularly for someone who does not want to change to larger implants. Fat grafting is also a great solution for women who want more cleavage, placing the fat just over the part of the implant towards the middle of the chest. Fat grafting can also be used to correct assymetries, and to cover rippling in very thin patients.
Posted in Breast Augmentation with Fat, Breast Implants, Fat Grafting, Implant Rippling | No Comments »
April 10th, 2011
As fat grafting for breast reconstruction and breast augmentation becomes more popular, more and more plastic surgeons and cosmetic surgeons are adopting this technique. Unfortunately for predictable and safe results it is not adequate to simply perform liposuction and just reinject the fat directly into the breast or anywhere else where fat grafts are used, such as the face, buttocks and hands. Each step of the process from harvesting the fat, to preparing the fat for reinjection, and then reinjecting the grafted fat, must be performed using very specific techniques for the best and most predictable results. Even though there is not only one approach, it is important that the approach used pays strict attention to basic principles for each step. On my Adrecyte Regenerative Center blog, I have written the first of a series of articles describing the principles and practice of meticulous fat grafting, in order to ultimately achieve the most predictable results. To follow this discussion and gain more information about the art and science of fat grafting go to my blog http://www.adrecyte.com/science/why-all-fat-grafting-is-not-the-same-part-1/
Posted in Body-jet®, Breast Augmentation, Breast Augmentation with Fat, Breast Reconstruction, Fat Grafting, Liposuction, Regenerative Medicine | No Comments »
March 19th, 2011
In order to further refine and improve our results with fat grafting for breast augmentation we have Body-jet® water assisted liposuction as a component of our fat grafting process. Unlike traditional liposuction methods, body-jet® uses a gentle jet of water to simultaneously dislodge and remove fat from the body, while being gentle on the blood vessels, nerves and surrounding tissue. The gentle fat removal provided by body-jet® helps protect fat that is being harvested for fat grafting procedures such as breast augmentation, breast reconstruction and facial or hand rejuvenation with fat. To minimize trauma to the fat being removed for fat grafting, the suction pressure is reduced. Keeping suction pressure as low as possible has been shown to result in the highest percentage of viable fat cells for grafting. At the Bougainvillea Clinique we take the process of fat harvesting one step further by combining body-jet with Puregraft® to further purify the fat. The Puregraft® process removes unwanted water, oil and blood from the fat without damaging the fat cells as can occur with other techniques such as spinning or centrifugation. The resulting fat for grafting is the cleanest and purest we have seen yet.
The body-jet® procedure uses the same technology advertised by various names such as Aqualipo®, Water-jet and Naturalfilltm
Posted in Aqualipo®, Body-jet®, Breast Augmentation, Breast Augmentation with Fat, Breast Reconstruction, Fat banking, Fat Grafting, Liposuction, Pure Graft | No Comments »
February 9th, 2011
The Bougainvillea Clinique is the first facility in Central Florida to introduce Tickle Lipo™ to our patients. Tickle Lipo™ is the first liposculpture device based on accepted nerve conduction science, that actually enhances our ability to effectively perform liposuction under local anaesthesia or local anaesthesia with sedation.
The Tickle Lipo™ device uses infrasonic nutational vibration to activate vibration sensitive nerve fibres. This results in blocking of the pain fibres. This effect is known as ‘The Gate Control Theory’ of nerve transmission.
Tickle Lipo™ generates far less heat than other technologies, as it emulsifies fat for easier more gentle removal. This results in increased safety, less discomfort during the procedure, and faster recovery.
From the surgeon’s perspective, the Tickle Lipo™ provides increased control and sensitivity, to facilitate smoother and more precise body sculpting. This increased precision allows the surgeon to more confidently treat delicate areas such as the knees, arms, calves, and neck.
Another reason, we have adopted Tickle Lipo™ is to enhance our ability to gently harvest fat under local anesthesia for other uses such as breast augmentation, facial rejuvenation, and stem and regenerative cell processing. Harvesting fat with minimal damage to the fat cells is the first critical step required for successful and predictable fat grafting. We now frequently recommend fat grafting as an alternative to breast implants for breast augmentation, or to be used over implants to add volume where it is needed, to help conceal visible implants and implant rippling, and even to help treat hardening or capsular contracture. Fat grafting is also an excellent alternative for breast reconstruction.
Posted in Awake cosmetic surgery, Breast Augmentation, Breast Augmentation with Fat, Capsular contracture, Fat Grafting, Implant Rippling, Liposuction, Local anesthesia | No Comments »
January 26th, 2011
Published clinical experience in over 2,000 patients who received autologous fat grafts showed no evidence of increased risk of development, metastasis or recurrence of breast cancer in contrast to some laboratory data. The newly published review entitled “Oncologic Risks of Autologous Fat Grafting to the Breast” in the January issue of the American Society of Aesthetic Plastic Surgery’s Aesthetic Surgery Journal discusses the data disparity between the clinical and certain laboratory-based scientific literature regarding fat grafting procedures to the breast. This includes procedures in which the graft has been enriched with adipose-derived stem and regenerative cells (ADRCs).
The article, authored by John Fraser, Ph.D. and Marc Hedrick, M.D. of Cytori Therapeutics and Steve Cohen, MD, one of the leading plastic surgeons in the U.S., critically evaluates the theoretical concerns raised by fat grafting procedures to the breast (particularly in women who have undergone treatment for breast cancer).
The authors review the data from 10 published clinical papers in which fat grafting was used for breast augmentation and reconstruction. None of the studies discovered any evidence of any increase in breast cancer risk, breast cancer recurrence or in the ability to detect cancer with routine studies such as mammography. The review also indicated that mammographic changes seen after fat grafting were similar to changes seen after other procedures such as breast reduction, and often, as with calcifications, occurred even less frequently with fat grafting procedures than with other procedures.
The review discusses possible reasons why some of the laboratory studies connecting fat grafting with breast cancer are very different from the clinical situation which reveals no increased breast cancer incidence or recurrence, and encourages continued long term follow-up and ongoing study.
Tags: Adipose Derived Regenerative Cells, ADRC's, Breast Augmentation with Fat
Posted in Adipose Derived Regenerative Cells, Breast Augmentation with Fat, Breast Reconstruction, Fat Grafting, Stem Cells | No Comments »
January 21st, 2011
Health regulators in the Netherlands have cleared Cytori to begin an important European trial using adipose derived regenerative and stem cells (ADRC’s) in people who suffered acute heart attacks. These are the same cells we use at the Bougainvillea Clinique to enhance our fat grafting procedure for breast augmentation and reconstruction. Cytori also makes the PureGraft® system we use for our fat micrografting procedures.
Previous research has shown that these cells can repair damaged heart tissue and prevent the irregular heartbeats and heart failure that often follow serious heart attacks.
ADRC’s and fat grafting have already been approved in Europe for use in breast reconstruction surgery and wound repair and to treat Chrohn’s Disease complications.
Over the past decade, much time and money has been spent on seeking ways to use stem cells, which have the special ability to renew themselves, as treatments for a wide range of injuries and diseases, and even for growing entire organs from scratch. However, most of those efforts remain in experimental phases.That’s partly because stem cell production has been hampered by biological challenges. In the United States, political controversy over embryonic stem cells has added to the difficulties.
Cytori hopes to enroll up to 360 patients through 35 testing centers mainly in Europe. The patients will be treated within 24 hours of having a heart attack. Success will be measured by the replacement of dead heart muscle cells with living ones.
A 2010 pilot study involving 14 patients from the Netherlands and Spain showed that the therapy was safe and well-tolerated. Scans of the 10 patients who received the cell therapy showed significantly less heart muscle damage than the four who received standard therapy for a heart attack. An analysis of the pilot study data also revealed that abnormal heartbeats were lower in the group treated with cells.
Posted in Adipose Derived Regenerative Cells, Breast Augmentation with Fat, Fat Grafting, Pure Graft, Stem Cells | No Comments »
January 15th, 2011
If you would like to improve the appearance of your breasts if you already have implants, fat grafting may be an option. Fat grafting can be added over breast implants to improve upper pole fullness and cleavage, cover rippling from implants, and even help improve hardening or capsular contracture. Other situations where fat grafting can be useful are to even out the size of the breasts or improve the shape and symmetrical appearance of the breasts. We have done procedures now for exactly these situations using fat grafting with Pure Graft® technology for more predictable results..
Tags: Breast Augmentation, Breast Augmentation with Fat, Capsular contracture, Implant Rippling
Posted in Breast Augmentation, Breast Augmentation with Fat, Breast Implants, Capsular contracture, Fat Grafting, Implant Rippling, Liposuction, Pure Graft, Uncategorized | No Comments »
December 19th, 2010
There is an excellent article in this month’s Self Magazine regarding poorly trained physicians or physicians who do not have hospital privileges for cosmetic surgery procedures touting awake local anaesthetic procedures as a more cost effective and even superior way to have cosmetic surgery. Some of the points made in the article I have made before.
Awake local anesthesia procedures may benefit the doctor more than they do you. To quote Dr. Joseph M. Gryskiewicz of the American Society for Aesthetic Plastic Surgery (ASAPS), ” It has to do with doctor’s not needing to involve an anaesthesiologist.” General anesthesia adds expense to a procedure, nevertheless appropriately trained cosmetic surgery specialists such as plastic surgeons usually offer general anesthesia at least as an option and most prefer to work in facilities that are regulated appropriately to ensure high safety standards. In fact membership in ASAPS requires that surgeons work in accredited facilities. Awake plastic surgery has become a way for doctors who lack hospital privileges – but who want to cash in on the plastic surgery market – to exploit a loophole by performing the operation in the privacy of their offices which do not have safety regulations enforced for anything but local anaesthetic. Dr. Gryskiewicz says, ” This is just a gimmick by people who can’t operate their way out of a wet paper bag.”
The article goes on to explain that many physicians who advertise themselves as board certified, may be board certified in specialties that have little or no relation to plastic surgery in their training.
Awake breast augmentation is specifically described as a ‘carnival sideshow event’ by Dr. Michael McGuire a director of the American Board of Plastic Surgery. Although plastic surgery and breast augmentation can be performed under local anaesthetic, some of the reasons touted for it make no sense and in fact may be downright unethical, dangerous, or even be considered malpractice by some. For example in most awake breast augmentation procedures touted, some level of oral or intramuscular sedation is given prior to the procedure, as doing the procedure with 100% local anesthetic without any form of sedation is very difficult. The problem with this is two-fold. First the level of sedation cannot be safely controlled; so if the sedation is not enough to make the patient comfortable, increasing doses cannot be given to the patient without increasing the danger of over sedation or in fact inducing an uncontrolled deep sedation or even general anesthetic type situation. So the physician cannot guarantee that either you will have enough sedation to feel totally comfortable, nor can he guarantee that if he does provide enough to make you totally comfortable, he will not overdose you, with potentially life threatening results.
The second problem is that physicians promoting this procedure tout the benefit of being able to allow the patient to see the augmentation procedure and actually provide input as to the size and shape etc. This is misguided as asking the patient to make decisions while under any sedative effect is both unethical and in fact could be considered illegal. It is no different to expecting someone to make surgical decisions under the influence of alcohol. It is in fact considered malpractice to obtain or change a patient’s surgical consent after any sedation is provided, so why then is it okay to request their input into a surgical procedure after they have received sedation.
A final point is the misconception that general anethesia is unsafe, and that local anesthetic is free of complications. In fact in reviewing more than a dozen cases of awake surgery gone wrong, Dr. McGuire noted that patients received excessive amounts of lidocaine that went beyond safe limits.
So to emphasize what I have previously stated, when your surgeon offers local anesthetic, be sure he offers it to you as choice, not an absolute requirement for him to be able to perform the surgery. At the Bougainvillea Clinique and our adjacent Aesthetic Surgery Center of Winter Park we are able and fully certified to perform procedures under local anesthetic, local anesthetic with oral or intravenous sedation, and general anesthetic. As I am a board certified plastic surgeon with full hospital privileges, you can be sure that the type of anesthesia is ultimately your choice, based on the type of procedure and your anxiety level. Remember just because something can be done under local anesthetic, does not mean it should be done under local anesthetic.
The Aesthetic Surgery Center of Winter Park is certified by the Agency for Healthcare Administration, the same agency that certifies free standing surgery facilities and hospital facilities. This goes beyond the certification offered even by most plastic surgeons, who most frequently have their facilities certified by office accreditation agencies only.
I encourage you to read the Self article so that you can be as sure as possible about Who your surgeon is, Where your procedure is performed, How the procedure is performed, and even Why the surgeon is offering you the procedure.
Posted in Awake cosmetic surgery, Breast Augmentation, General anesthesia, Local anesthesia | No Comments »
December 19th, 2010
Breast augmentation with fat is more time consuming than breast augmentation with implants, and therefore more expensive. On the other hand if you want to have liposuction done for body contouring purposes, breast augmentation with fat may be quite cost effective. This is particularly the case if one considers possible future procedures to replace failed implants, or correct other problems that can occur with implants. Reinjecting some of your fat for breast augmentation or enhancement, or even storing some of the fat in the tissue bank for future use, may actually make breast augmentation with fat quite cost effective. Storing your own fat may even have the potential to treat diseases or problems you may have in the future. For example treatment of chronic heart problems and even acute heart attacks with Adipose Derived Regenerative Cells and stem cells(ADRC’s) taken from your own fat has shown exciting promise in recent clinical studies.
Of course your fat can also be used as a filler for facial procedures, or to enhance a facelift, the so called stem cell facelift procedure.
Posted in Adipose Derived Regenerative Cells, Breast Augmentation, Breast Augmentation with Fat, Breast Implants, Fat banking, Fat Grafting, Liposuction, Stem cell facelift, Stem Cells | No Comments »
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