liposuction

Non-Surgical and Surgical Body Contouring: Setting Realistic Expectations

Body Contouring Expectations

As we kick-off the summer months and have officially reached bathing suit season, it is natural that many of us take a look in the mirror and think about how we might change our body.  In addition to keeping a healthy diet and exercising regularly, there are now more choices than ever in how we might achieve our goals. But with so many choices, both surgical and non-surgical options, choosing what body contouring procedure is best for you can be difficult.  How can you know which is best, and how can you make sure that your expectations are realistic?

 At the Annual Meeting of the American Society for Aesthetic Plastic Surgery (ASAPS), held this year in Montreal, Canada, plastic surgeons from around the world discussed exactly these kinds of questions. This year, I participated in back-to-back panels on body contouring, and thought that the folks here in Atlanta would be very interested in hearing what the experts are saying about the various body contouring procedures and the kind of results that can be expected.

The first panel, which I chaired, was on non-surgical body contouring, and how it compares with liposuction. Anesthesia is not required for these non-surgical procedures and usually one can return to full activities virtually the same day. Such procedures include cryolipolysis, radiofrequency, and different types of external ultrasound. These technologies all work differently but are designed to accomplish the same thing – remove unwanted fat without surgery. Cryolipolysis, better known as CoolSculpting®, does this by freezing the fatty tissues; radiofrequency treatments heat the tissue under the skin; and ultrasound uses sound waves to break up fat cells.

After the panel discussed issues for an hour, several “take home” messages were clear to the doctors. First, non-invasive body contouring procedures do work and are well tolerated by patients, but the results can be significantly less dramatic than those from liposuction. Second, to get the desired results, most patients need repeat treatments of the same area. And third, not everybody is a good candidate for non-surgical fat reduction. The best patients for non-surgical body contouring are at an overall good body weight, have firmer, elastic skin and have a limited number of areas to treat. Patients who will do better with liposuction or a tummy tuck include those who are older or have less skin elasticity, women post pregnancy who may need a tummy tuck, or those with larger, more diffuse fat collections.

The second panel was on abdominoplasty, otherwise known as tummy tucks.  Despite the new non-surgical technologies that are emerging, the number of tummy tucks done each year in the United States continues to grow. There are several reasons for this continued growth in the number. First of all, tummy tucks really work, and the results can be among the most dramatic of the body contouring procedures. Second, there have been significant improvements in the way abdominoplasties are performed. These include better ways to control pain after surgery (for example with pain pumps and long lasting local anesthetics), the eliminated need for drains in many patients, and better control of scarring. Third, as many are working hard to control their weight and keep their body in shape, they realize that neither non-surgical treatments nor liposuction will tighten their loose skin, something that is at the core of abdominoplasties.

So as you look in the mirror, how do YOU make sure that you choose a body contouring method that is best for you, and what should you expect? The most important thing is to have a consult with a physician who can offer you the entire spectrum of options – non-surgical, liposuction, or tummy tuck. Listen to what they say. In some cases, patients will have loose skin of the abdomen and weak muscles after pregnancy, and in these cases, nothing short of a tummy tuck will give significant results. In other cases with isolated, small fat pockets, non-invasive CoolSculpting® may be an excellent option. And still in other cases where there are many body areas a patient may want to treat, liposuction may be more effective and cost less in the long run than non-surgical treatments. Ask the doctor about how your skin will change after the procedure, what your recovery will be like, how many treatments will be necessary, and how the treatment options compare. Working with a cosmetic surgeon who has experience with all the options is the very best way to set expectations that are realistic for you.

There is a great old saying that “if the only tool you have is a hammer, the whole world looks like a nail”. In the world of body contouring, nothing could be more true. Many centers that offer non-surgical treatments can’t offer you liposuction or a tummy tuck, so guess what? They’ll offer you what they have. Even worse, in many cases you might not even be evaluated by a physician who is trained in all the different techniques, so they can’t help guide you to compare realistic expectations between the options. And for those who are not good candidates for non-surgical technologies, this can be a prescription for disappointment.

At the Emory Aesthetic Center, we not only offer the full spectrum of body contouring options – from CoolSculpting® to liposuction to abdominoplasty (tummy tuck) – but we also require that all patients interested in body contouring have a consultation with one of our board certified physicians to discuss exactly these issues. We want you to love the results of your treatment, and we will work with you to help you find the best body contouring option for you and to set realistic expectations.

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About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

Liposuction versus CoolSculpting®: Which is Right for You?

Lipo vs CoolSculptingLiposuction and CoolSculpting® are two very different procedures that are designed to reduce unwanted fatty deposits. So with both procedures producing the same outcome in the end, how are you to decide which is best for you? Like so many things in cosmetic medicine, it depends . . .Let me break down the differences between the two so that you can make the best decision for you.

Liposuction was developed in the 1980’s and has been around a lot longer than CoolSculping. There are now many types of liposuction including Suction Assisted Lipectomy (SAL) – the original technique but still a great one; Ultrasound Assisted Liposuction (UAL) that uses sound waves to break up the fat, Power Assisted Liposuction (PAL) that uses vibration, Laser Assisted Liposuction (LAL) that uses laser energy, and Fluid Assisted Liposuction (FAL) that works like a water jet. Despite the different approaches, all of these techniques can work well, and none is clearly superior over the other, despite marketing claims to the contrary.

Liposuction is a surgical procedure and can be performed under local anesthesia, under sedation, or with full general anesthesia. The type of anesthesia you will need depends on the area(s) to be treated and the amount of fat that needs to be removed. In general, the more areas that you treat, the more sedation or full general anesthesia you will need. The incisions for liposuction are small, typically less than 1/4 inch, so there isn’t much scarring. There is, however, a recovery period that lasts for a few weeks – bruising and swelling are most common. Patients can usually resume light exercise after a few days.

As opposed to liposuction, CoolSculpting® is a non-invasive procedure that doesn’t require anesthesia at all. The CoolSculpting system includes a disposable gel pad that is placed over the treatment area. A cooling head is then placed over the gel pad and suction is activated. The machine has a base that cools the liquid flowing through the headpiece and pulls the fatty area into the head, therefore, freezing the fat. After an hour or so (or two hours for a non-suction treatment type) the cooling head is removed and the frozen area is massaged briefly. Although there can be some discomfort when the tissue is first pulled into the cooling head, this becomes numb once the cooling starts and the massage doesn’t hurt. Like liposuction, it takes a few weeks to see the final result, and although there really isn’t much pain, like liposuction, the treated area can feel a little tender for a while.

Liposuction is the more aggressive treatment of the two, allowing more fat to be removed in a single session. Because CoolSculpting removes less fat per treatment, patients may need several sessions of CoolSculpting to get their optimal result.

Patients who are thinking about other cosmetic surgical procedures may be better candidates for liposuction than CoolSculpting since they would already be under aesthesia. In addition, the combination of liposuction with an excisional procedure (think tummy tuck with liposuction) is very powerful and can deliver dramatic results. Another example of when liposuction is preferable is when a patient might want to add volume to an area and they want to do so with their own fat. Liposuction can be used to harvest fat for fat transfer to another site. Liposuction is often preferred when there are many body areas that the patient wants treated, as these can be done all at one time, rather than over many different sessions with CoolSculpting.

CoolSculpting can be a great option for smaller fatty deposits. It is also a great choice for patients that are keen to avoid surgery, either for personal preference or because of health issues that may increase the risk of surgery.

Patients always wonder which is more cost effective – liposuction or CoolSculpting. This is another it depends situation. If a patient is treating a single small area that will probably be effectively treated with two sessions, then CoolSculping makes a lot of sense and may be cheaper. However if there are multiple sites to treat, and some of these will need three or more CoolSculpting sessions to get full resolution, then liposuction may be the less expensive of the two.

In the long run the choice of which is best for you depends on you – how you feel about it, what issues are the most important, and how aggressive you want to be in removing the fat. If avoiding surgery is super important to you, and you’ll accept less dramatic results in order to do so, then CoolSculping might be your best option. On the other hand, if you’d rather get as much fat off as possible, and would rather do this in one session instead of several, then liposuction may be your best bet. Let the board certified cosmetic surgeons at the Emory Aesthetic Center help you figure out what approach is best for you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Realistic Liposuction Results: What Can I Expect?

Liposuction ResultsUnderstanding what any treatment can do . . . and even more importantly, what it can’t do . . . is critical for you to know when considering the best cosmetic procedure to address your individual needs. This is particularly true for liposuction, as the tremendous popularity of the procedure has spawned some misconceptions and unrealistic expectations. In the right patient liposuction is a wonderful procedure with small scars, quick recovery, and dramatic results. However, in the wrong patient liposuction can lead to disappointment, and if pushed beyond appropriate limits, can even lead to deformity requiring surgical repair.

One of the most common misconceptions about liposuction is that it can help you loose weight. Liposuction, in general, is not an effective weight loss tool. In order to keep the procedure safe, there are long-standing recommendations to limit the amount of liposuction done on an outpatient basis. Very large amounts of liposuction can be associated with the development of loose skin in the treated areas.

Another misconception about liposuction is that it can tighten loose skin, especially if it is “laser liposuction” or “ultrasonic liposuction”. For sure the skin will retract some after any liposuction technique due to the skin’s inherent elasticity, however meaningful tightening typically doesn’t occur, despite marketing claims. Although rare, I’ve had to help a couple of patients in which their surgeon pushed an energy-based liposuction (laser or ultrasound) too far in hopes of tightening the skin. Doing this can lead to an irregular appearance to the skin, lumps, and even burns and visible scarring. The long and the short of it is, if you have significantly loose skin and want it to be smoother and tighter, liposuction by itself is probably not the procedure for you.

Cellulite – that frustrating, pitting appearance of the thighs or buttocks – is another area that patients sometimes expect liposuction to help but it really doesn’t. Currently there aren’t great treatments for cellulite that give consistent and dramatic results (again, despite the marketing!). Sometimes patients have pits that are associated with loose skin but don’t have real cellulite, and in these cases a body lift – not liposuction alone – can help these areas. Here’s a test you can do at home — lift up on the skin above the pitting area. If the pits smooth out dramatically, then the pits are probably related to loose skin in the area and you might be a candidate for a lifting procedure. If you lift and the pits just stare back at you, then a lift is probably not for you.

We’ve just reviewed the things that liposuction doesn’t do, but the great news is that liposuction of the right amount and in the right patient is safe, effective, and gives predictable results. The patients that do the very best with liposuction are at a good weight but have certain stubborn areas that just won’t go away with diet or exercise. The best candidates also have tighter, more elastic skin. Often, but not always, that means that younger patients are better candidates for liposuction.

However if you have some loose skin, don’t despair. Liposuction can still be a powerful tool to contour your body when combined with an excisional procedure. For example, let’s say you have some fatty collections in the love handle area and in the front of the tummy but you have loose skin in the lower part of the tummy. In this case you may be a great candidate for liposuction combined with an abdominoplasty (tummy tuck). Liposuction can smooth and contour the flanks and can thin the upper abdomen while excision of the fat and loose skin of the lower tummy will tighten everything up.

Another area where it is good to set expectations relates to recovery. Patients always want to know how they’ll feel after liposuction, how long it takes for the pain to fade, and how long until the swelling is gone and they see their final result. In general, liposuction is less painful and with a quicker recovery than excisional procedures, like a tummy tuck. Patients are often able to return to work after only a few days, and although they have some soreness for a couple of weeks, they are able to function well. Usually patients can resume light exercise within 2 weeks. There will be swelling, although often even swollen areas look better than before surgery. The majority of the swelling is gone by 3-4 weeks, although subtle amounts of swelling can take 3-6 months to resolve. You may also develop some bruising, and if so, this typically fades away within a couple of weeks.

Liposuction is the most common aesthetic surgical procedure performed in the United States, and with good reason: liposuction works and it works well. It works best in patients who are good candidates and who are not trying to have liposuction do more than it is capable of delivering. The board certified physicians of the Emory Aesthetic Center are happy to consult with you about what are reasonable expectations of liposuction in your individual circumstance, and help develop a treatment plan specific to you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Tummy Tucks 101: Answers to Frequently Asked Questions

tummy tuck 101Tummy tucks – also known as abdominoplasties – have grown significantly in popularity over the past 15 years, and they are now one of the most common procedures performed by plastic surgeons. Part of the reason why tummy tucks have grown in popularity over the years is our increased focus on health and fitness, but another big reason is that tummy tucks can provide dramatic results. There have been recent advances in the procedure that offer better pain control and a better recovery. Now may be a good time to take a fresh look at some of the most common questions that patients ask us about abdominoplasties.

“Do I need a full tummy tuck, or can I have a smaller scar – say with a “mini” tummy tuck or just liposuction?”

There is not just one type of tummy tuck – abdominal contouring can include a variety of approaches depending on one’s individual situation. It is often helpful to think of a tummy tuck in terms of where the problem is. Is there too much loose skin, is there too much fat, or have the muscles been stretched or separated by pregnancy? If your skin is relatively tight then you may be a good candidate for a reduced scar approach, such as liposuction (tiny scars), an endoscopic abdominoplasty (1-2 inch scar), or a mini-abdominoplasty (a scar about the length of a C-section). On the other hand, if there is a lot of loose skin that you will need tightened, that will require a longer scar. If there is too much fat, then liposuction can be combined with the removal of skin – a very common situation. If the muscles are separated, then some sort of tummy tuck with muscle repair is needed, however the incision can be short or long depending on the skin.

“Do I have to have a drain after a tummy tuck?”

Historically the answer to that question was “yes”; however, new techniques have eliminated the need for drains in many cases. We now can use special stitches – known as progressive tension sutures – to seal the tissue together so that there is no need for a drain. The progressive tension technique has another advantage as well; it often allows us to remove a bit more skin than we could otherwise. Although I currently can’t prove it, I also suspect that the sutures help make the scar from the tummy tuck better because they reduce the tension on the skin during healing. Patients love it when they don’t have to have drains.

“How much pain will I have after a tummy tuck?”

Historically tummy tucks were one of the more painful operations that plastic surgeons performed, especially when repair of the muscles was required. Over the past several years, the development of some new ways of controlling pain has helped this situation a lot. First came the development of pain pumps – these are devices that push a local anesthetic through a small tube and into the area of surgery. These were very helpful and many surgeons still use them, but it requires a tube coming out of the skin. More recently there has been the development of a long lasting local anesthetic which can give significant pain control for up to 3 days, and it doesn’t require a tube. Good pain control clearly makes the recovery more pleasant. It also means that less narcotic pain medicine is required; therefore, there is less chance of a reaction to the medication. In addition, it may make the surgery even safer by allowing patients to move around more easily and to be more active.

“How long is the recovery after a tummy tuck?”

Well, the answer depends on several factors and to what level of recovery you are thinking about. If you don’t need the muscles repaired, it is likely that your recovery is going to be easier and quicker. Most patients having a full tummy tuck (with muscle repair) find that they are generally able to drive a car within a week, depending on their pain level (remember you don’t want to drive when on narcotic pain medicine). Many patients can work remotely from home, and find that they are able to log on to their computers, answer emails, or even have a conference call after only a few days, although they won’t feel like going in to work for maybe 2-3 weeks post surgery. Light exercise (e.g. walking or gently peddling on a stationary bike) can start by this time as well. By 6-8 weeks, most patients would consider themselves fully or nearly fully recovered, although it is worth remembering that the nerves will continue to heal, the scar will continue to fade, and the swelling will continue to go down for several months.

“Will the results last?”

Yes! As long as your weight remains stable over time, abdominoplasties are typically a ‘once and done’ procedure, never needing to be repeated. Of course your skin will age a bit over the decades, but it usually never gets back to the looseness that you may have experienced before surgery.

“After pregnancy, my tummy needs help, but my breasts do, too. Can you work on both at the same time?”

Not only is the answer “yes”, but combining a tummy tuck with a breast lift or breast augmentation – popularly called a “mommy makeover” – is very common. Moms love their little ones, but it is great to get their bodies back, too!

Will a tummy tuck help my stretch marks?”

That depends on where the stretch marks are located, but the answer is usually “yes”. A full tummy tuck removes most of the skin in the lower abdomen, and any stretch marks in this zone will be removed along with the loose skin. Stretch marks outside of that zone are not really going to be helped.

The board certified physicians at the Emory Aesthetic Center keep up with the latest developments in abdominoplasty. We are happy to work with you to help create a plan that is best for you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Takeaways from Dr. Eaves’ Body Contouring – Getting Ready for Summer Live Chat

Body ContouringThank you to everyone who joined us for the Body Contouring – Getting Ready for Summer live chat hosted by Emory Aesthetic Center surgeon, Dr. Felmont Eaves. Dr. Eaves discussed body contouring options to help shape the body for summer and tighten excess or loose skin. He described both surgical and non-surgical procedures – including liposuction, tummy tucks, arm and thigh lifts.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we will answer them below for your reference.

If you missed this informative chat, be sure to check out the full list of questions and answers located on our chat transcript. You may also visit the Emory Aesthetic Center website for more information on therapies and solutions to get your body ready for the summer.

Question: What are new procedures for arm lifts?

Felmont Eaves, MDDr. Eaves: Arm lifts continue to evolve as we are doing more of them all the time. Arm lifts can be categorized into short scar techniques, full length techniques, and minimally invasive techniques. The short scar technique leaves a scar that is limited to the axilla (arm pit) and can help looseness in the upper part of the arm closest to the shoulder. But this technique isn’t as effective if the looseness goes far down the arm. In this case a full-length arm lift is recommended, although this does leave a long scar on the inside of the arm. For some patients, if skin laxity of the arms isn’t severe, liposuction alone may give a very nice result with a tiny scar. While there are some companies advertising significant arm tightening with non-invasive procedures, I haven’t seen impressive results with these yet.

Question: I have a normal BMI. How drastic can I expect the results of CoolSculpting to be?

Felmont Eaves, MDDr. Eaves: CoolSculping can certainly make some nice changes, but the results tend to be more subtle than that achieved by liposuction (or excisional surgery). However in patients that have excellent skin elasticity and limited fat deposits, it can do a great job of addressing what you want. It really takes an examination by someone who is familiar with all types of body contouring techniques (non-invasive, liposuction, and excisional surgery) to help you figure out which is best for you.

Question: I have a scar on my stomach from a childhood surgery. Can you fix this?

Felmont Eaves, MDDr. Eaves: That’s a good question. If you are talking about making a scar looking better, then yes, a scar revision can help. Even further, if you have a scar in the lower part of your stomach (below your belly button), that scar might be totally removed with a tummy tuck (although you’ll get a new tummy tuck scar – but it will be better positioned and hidden within the panty or bathing suit area).

Question: Can you get a 6-pack look with a tummy tuck?

Felmont Eaves, MDDr. Eaves: It is possible, but not usually. Having a real “6-pack” requires two things – well developed abdominal muscles (specifically the two muscles in the middle, known as the rectus abdominus muscles) and a very low body fat percentage. When we perform a tummy tuck, we thin out the fatty layers of the abdomen, however it is important to keep the thickness of the tissues in harmony with surrounding areas of the body, otherwise it may look odd. A tummy tuck won’t build up the abdominal muscles.

 

 

 

Ask the Doctor: How Do Fat Transfers Work?

Fat TransfersPatients often ask “How do fat transfers work, and do they last?” It is a very good question, and pertinent, too, because fat transfers have become very common in cosmetic surgery over the past several years. Fat transfers have assumed an important role in facial rejuvenation, breast augmentation surgery, buttock enhancement, and the secondary treatment of body contouring deformities, so it is important to understand what is going on.

Fat transfer is a lot like the old real estate saying: It’s all about location, location, location. Most of us have extra fat in areas we don’t want, and the beauty of the fat transfer is that we can remove some of this unwanted fat and relocate it to where we want to enhance volume. Even though this concept is quite simple, the actual way the procedure is performed has taken cosmetic surgeons many years to develop. We are still constantly improving and enhancing our techniques as we get a better understanding of how these techniques affect the survival of the fat in the new location.

The first step in fat transfer is to collect the fat from the donor site. The most common location where we harvest fat is the tummy, but we can use many potential sites, including the love handles, the thighs, and the back of the arms. The fat is collected by liposuction, either using a syringe system or a system with a fat collection chamber. The fluid obtained during liposuction (the aspirate) is then treated to remove excess fluid from damaged fat cells so that concentrated fat is ready to inject. There is significant variability in how surgeons prepare the fat for transplantation. This prepatory step can be as simple as gently straining the aspirate, may involve washing the fat, or may involve centrifuging the aspirate. The prepared fat is then loaded into syringes for injection.

The injection of the fat cells into its new “home” is done using fat grafting cannulas, these are generally small and designed to be gentle on the fat cells. The surgeon injects the fat into many tunnels and layers, as you want the fat to be widely dispersed in the tissues and not to “pool” in one area. Pooling leads to a decreased “take” of the transplanted fat. To explain this further, I like to use the analogy of planting seeds. Like seeds, the fat grafts need to get nutrients from the bed in which they are planted in order to survive. If you plant a full bag of seeds into a single hole in the ground, the seeds in the middle of the “pool” would not be able to get their roots into the dirt and would eventually die. That’s how it works with transplanted fat – if you put too much in one place, the cells in the middle will die and will be absorbed by the body.

When fat cells survive in their new location, they are there forever, and will be of stable size (unless you gain or loose a lot of weight). Cosmetic surgeons love to argue sometimes about the best way to harvest, prepare, and transplant the fat in order to optimize graft survival, and although we’ve made tremendous progress (fat transplantation is now highly effective and reliable – probably in the range of 70% survival), I don’t think we know all the answers yet. Be cautious if you feel you are being sold a “magic solution” for fat grafting, as these are often not backed up by good clinical evidence, at least currently.

One more word of warning relates to “stem cell fat grafts.” Stem cells are a current hot topic in medicine, and indeed stem cell science has tremendous potential to change the way medicine will be in the future. All tissues – including fat harvested for transfer – have stem cells anyway. However there is currently no compelling science to support the clinical claims of any special stem cell fat transplantation techniques in aesthetic surgery, and there is a lot of deceptive advertising to entice unknowing patients. In fact, both the American Society for Aesthetic Surgery and the American Society of Plastic Surgeons have issued a joint statement emphasizing this point.

The physicians at the Emory Aesthetic Center keep up with the latest developments in fat transplantation, and we’d be happy to help you figure out how they can work for you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Get Ready for Summer! Join our Live Chat on Body Contouring

Body Contouring ChatWith the warmer weather fast approaching, it’s time to start trading in those hats and gloves for shorts and swimsuits. To help get your body ready for the summer, join Emory Aesthetic Center plastic surgeon, Dr. Felmont Eaves, on Tuesday, March 10, 2014 from Noon – 1PM as he discusses body contouring options that can help improve the shape of your body and tighten excess or loose skin. Dr. Eaves will walk you through both surgical and non-surgical options – including liposuction, tummy tucks, arm or thigh lifts and surgery after weight loss. If the normal effects of aging or childbearing have made you wonder if a cosmetic body contouring procedure is right for you, you won’t want to miss this chat.

Dr. Eaves will answer all of your questions to ensure you are confidently ready to take the next step such as:

  • What are the different types of body contouring options offered to me?
  • What types of results can I expect to see?
  • Are there non-surgical options to firming my body?
  • What can a body lift surgery do for my figure?
  • How long is the recovery time after a liposuction?
  • Does a tummy tuck or body lift leave scars?
  • What is the benefit of having my body contouring procedure performed at a place like Emory Aesthetic Center?

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Chat Details:

Date: Tuesday, March, 10, 2015
Time: 12 noon – 1pm EST
Chat leaders: Dr. Felmont Eaves
Chat Topic: Body Contouring: Getting Ready for Summer