Menampilkan postingan dari Maret, 2013


What is Fat Grafting? Fat grafting or fat transfer consists of harvesting fat cells from one part of the body (abdomen, hips, etc) via liposuction and then injecting these fat cells into another part of the body (face, buttocks, hands, breasts). Fat grafting is a technique that has been around for a long time and is commonly used by most plastic surgeons in at least one or two avenues.

What can Fat Grafting be used for? Fat grafting can be used for both cosmetic and reconstruction surgery. We commonly use fat grafting as a means of facial rejuvenation, whether alone or in conjunction with a traditional face lift. In this way it works similarly to fillers by helping to give volume to places such as the nasolabial folds, marionette lines, cheeks and lips. Fat grafting is also used commonly to add volume to the buttocks or to help achieve the desired round shape of the buttocks. In our practice we also very commonly use fat grafting as part of our implant based breast reconstruction. We use…

Malar Bags

There are 3 separate entities lower eyelid bags, festoons and malar bags.

Lower eyelid bags refers to protruding fat or redundant muscle in the lower eyelid itself above the level of the bone rim under the eye.
Lower Eyelid Bags
Festoons refers to redundant folds of skin with or without muscle in the lower eyelid.


Malar pouches, bags or saddlebags are a prominence below the level of the bone rim under the eye due some combination of swelling or edema, drooping eyelid muscle (orbicualris oculi muscle) and fat under the muscle herniating through the muscle. The lower edge of the malar bags is defined or limited by the zygomatico-cutaneous ligament which has also been called the malar septum. This ligament stops the discoloration of a black eye from spreading down into the cheeks. There is a lot of misinformation on the web regarding malar bags, even on online question boards answered by surgeons.

The presence of malar bags can be related to previous eyelid or nose surgery indepen…

Breast Reconstruction with Aeroform Tissue Expander

It seems like all the latest breast reconstruction techniques like Neopec come from Australia. Now the Australians have come up with a rapid way to expand chest skin after breast cancer mastectomy to allow placement of a breast implant and thereby reconstruct the breast (see my blog Reconstruction After Breast Cancer Surgery). Usually a saline balloon or expander is surgically placed and the surgeon then progressively fills it with salt water that is injected on a weekly basis to stretch the skin. This can take up to 6 months. Now they have devised an expander that contains a cylinder of compressed carbon dioxide gas. The patient controls the release of the gas into the expander with a handheld remote control and slowly expands on a daily basis.

Preliminary data reveal that using the Aeroform Tissue Expander the expansion can be completed in 17 days instead of 6 months. Enrollment in FDA clinical trials have begun in the US and the manufacturer is predicting a 2014 FDA clearance for ge…


As you may have realized from our previous post about sizing for Breast Augmentation, deciding to have a Breast Augmentation is just the beginning of a series of decisions! One of these (very important) decisions is whether to use Silicone Gel Implants or Saline Implants.

left: silicone, right: saline
The majority of our Breast Augmentation patients could go with either Silicone or Saline implants and get a desirable result, however, there are certain patients that we would recommend one vs. the other. Saline implants are more prone to rippling and wrinkling and therefore should be avoided in patients with very little breast tissue as this rippling and wrinkling could be felt and sometimes seen, especially underneath the breasts and laterally along the side of the breast closest to the underarm. Saline is also heavier than silicone and therefore causes more pull on the tissues. This can be a problem if you are going with a very large implant as it can stretch out the tissues leading to…