Breakthroughs in plastic surgery are helping more patients achieve the look they desire. Body contouring and facial cosmetic surgery are capturing a great deal of interest.
“The newest hot-button things are fat transfers from other parts of the body into places where genetically you are programmed to lose it,” said Dr. Bill Dowden with Dowden Plastic Surgery.
While the idea of fat transfer has been around since the late 1980s, it has finally caught some steam. The benefits are apparent to surgeons. “It helps restore the shape and the harmony to the face,” Dowden said. “It replaces things that your body has naturally lost and restores the youthfulness of the area.”
The procedure is clear cut. “We use fat transfers to soft-tissue deficits where people have had tissue torn off in an accident or removed for cancer,” Dowden said. This includes women who have had a breast removed due to cancer or who had reconstruction because they have had radiation therapy. “[The surgery] helps heal areas that react unfavorably to radiation,” said Dowden.
Although people do not request fat transfer by name, they usually ask to look younger and fitter, and this procedure may help. “Sometimes you find people with wrinkles or sags,” Dowden said. “They find they have areas of volume depletion, or an area that was once full and youthful is now flat.” When fullness is restored, the wrinkles and sags go away.
Fat transfer is considered the original filler. It takes approximately an hour to do most of the face. “We usually do it with the patient awake, and we can do large areas at one time,” Dowden said. Fat transfer has some benefits over other types of filler. “It is probably equivalent in cost to the seven syringes of injectable material that is used for things like Restylane or Juvederm,” Dowden said. “It is designed to live on forever, so it is a permanent type of volume enhancement.”
Facelifts are another popular plastic surgery option. One specialized facelift is the subperiosteal facelift. When people have big round circles under the eyes, the circles can be fixed through an incision in the mouth and one in the temple. “A subperiosteal facelift lifts up the cheek pad but at the level against the bone to fix the circle under the eye,” Dowden said. “Other facelifts are not able to do that. It is a hybrid [procedure] that very few people know how to do.”
Doctors need to recognize facelifts are broken down into many parts. “In a practice, if the physician is only able to do one type of facelift, he [or she] will not get the results that he [or she] needs day in and day out,” Dowden said. “He [or she] has to be versatile and have at his [or her] fingertips the opportunity to do a number of different facelifts.”
One of the biggest precautions doctors have for patients is that many of the mechanical, non-invasive devices such as those designed to “melt fat” or “shrink” your skin have yet to show how efficacious they are. “Even for the average physician trying to incorporate these into their practice, they are not often as successful and we have all been disappointed in them,” said Dowden. Physicians considering venturing into this area should know these devices are marketed as new but may not be great. “You may have seen people talking about the stem-cell facelift or the vampire facelift and other catchy things,” Dowden said. “Our society (the American Society of Plastic Surgery) has looked at these and believes the ability, the proof, the reason these things work is lacking.” Procedures should be evaluated in well-designed, controlled trials to evaluate their effectiveness and safety before being implemented into routine practice.
By Jamie Lober, Staff Writer