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Wednesday
Oct282009

Young Medical Spa: Further Developing the Breasts

When the first laser lipolysis device was approved by the FDA it started a whole new revolution in the medical spa industry.

Many physicians who invested in the technology believe it saved their practices from succumbing to the downfall of the economy. Soon after the approval, an array of new lipolysis technologies began to develop over time. Wavelengths were altered to find the optimal "melting point", ultrasound technology was applied, high-powered water jets were developed - all in the name of technological advancement. At that time I wondered, "What the industry could possibly develop to top this?".

It wasn't long until I received my answer! Enter, the Natural Breast Augmentation procedure utilizing fat transfer under local anesthesia! Hard to believe this procedure wasn't perfected sooner! Take the fat from one body area and put it in another - perfect! Up until this point, there was a lot of controversy regarding fat transfer. In fact, for 20 years it was denounced by U.S. plastic surgery societies as being a "dangerous" procedure. Unfortunately, this declaration was based on the technology and techniques utilized over 20 years ago. Heck, even our laptops are obsolete after 3 years!

Dr. Todd K. Malan of the Innovative Cosmetic Surgery Center in Scottsdale, AZ developed new techniques which resulted in the lifting of this "ban" in March of 2009. Many dispute the success rate for the survival of the fat after the transfer. However, with the latest technological advancements in fat harvesting, adipocyte survival rates have proven to be 85% to 90%. With the addition of adult stem cells to enhance the fat transfer and breast splinting technology, adipocyte survival rates have shown to be even higher. In fact, Dr. Malan states that when the fat transfer is concentrated with adult stem cells harvested from the patient's own fat, and is injected into the fat that is already within the breast, the result can equal a permanent increase of 250cc to 500cc in overall breast size equating to a 1 to 2 cup size increase.

Of course there are many facets to this procedure not covered in this post. I just applaud innovative technology when I see it for my own eyes. So much so, that Young medical spa (our medspa) is now performing this procedure after being trained by Dr. Malan himself and others like Dr. Jeffrey Caruth of Plano Aesthetics in Plano, TX. Technology is wonderful, isn't it?

I wonder what the industry could possibly develop to top this?

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Reader Comments (6)

It's really Dr. Sydney Coleman of NYC who is most responsible for the recent development of fat grafting techniques and applications here in the U.S., and he deserves the credit for any reappraisal of fat grafting to the breast. He developed the instruments, refined the techniques and wrote the papers and the textbooks on the subject.

Give credit where it is due.

10.29 | Unregistered CommenterTF

TF,

ARe you doing any of this? What are your thoughts as a plastic surgeon?

10.29 | Unregistered CommenterLH

I feel the initial post by Paula is a bit flippant, and has IMO, an anti- plastic surgeon bias. Paula, there's a good reason why fat grafting to the breasts has been controversial, and it has absolutely nothing to do with any turf battle, but rather to do with patient safety.

The concern about doing fat grafting to the breast is the problem of "fat necrosis", which is inevitable in a portion of the fatty material injected. As we know, the subsequent scar tissue that forms can feel exactly like a breast cancer, and can be very hard to distinguish on routine mammography. That turns into a lot of worry and anguish for the patient, with potential biopsies and fancy imaging tests needed to sort things out. If a patient has a hard lump in the breast 6 or 8 months after fat grafting to the breast, what are you going to do, wave your hands and say, "oh don't worry about that hard lump in your breast"? I don't think so. Remember, failure to diagnose a malignancy is a top cause of malpractice suits!

If you look at the Japanese plastic surgery literature, where they have fat-derived stem cells mixed into the fat graft, their results are much better, with less fat necrosis. They recommend a maximum of about 200 cc injection per treatment, and this is done in hundreds of meticulous micro-injections. Their procedures take about 6-8 hours each.

It would be interesting to know if the people referenced above are using the Japanese technique of collagenase and centrifugation of aspirated fat (not lasered) to get the extra stem cells? Success in Fat grafting is very technique dependent!

LH: I do not do this procedure for cosmetic breast augmentation. I'm waiting to see more data.

10.29 | Unregistered CommenterTF

TF,
Duly noted in regards to giving credit where credit is due to Dr. Sydney Coleman! This is one of the things I love the most about our forum, for not only do you get to learn about what someone else is doing, or what problems they may be experiencing, or new procedures, equipment or technology, you also get the added advantage of intelligence and history from our community of professionals. My post was not written as a "turf war" opinion, but rather a "how wonderful it is to be in this industry" opinion.

I am in awe of how far we have come as aesthetic professionals and continue to encourage discussion, knowledge and history through my blogs.

We've been doing fat transfers to the breast for some years now, inspired by Dr. Coleman's work.

This new wave of advertisement for this procedure (because that is all it really is) is proving to get patients asking questions about it and become seriously interested.

We don't adhere exactly to Dr. Coleman's protocol at this time, nonetheless we believe we obtain great results.

MH

10.29 | Unregistered CommenterMH

This is definitely an interesting discussion.I strongly agree with MH on points absolutely vital.Having a professional experience of 23 years,having worked in tertiary level teaching hospitals nationally and internationally ,now in private practice,iam convinced that there is no short cuts and we have to wait for the froth to settle before we sip the beer.
There was this anecdotal report from india many years ago of a surgeon ,who used heterologous fat (from unrelated donors) using it for augmentation and vouching for its safety.Interesting it may be ,i would never think of doing this.validation is important,even after validation one should use common sense and comfort level before trying a new procedure just because it has caught the fancy of times.Time tested effective procedures stand the test of time,the rest die a natural death.
Having said that ,i believe in primal body cell that are vital for repair and possibly regeneration,iam sure that stem cells have taken the fancy of the times,but there are definitely many such factors which are dimmed by the attention on stem cells .I have reasons to believe that bone marrow is one such source of repair and regeneration,I have pioneered the use autologous bone marrow for repair and regeration since last decade .I also believe that there is a great potential commercially also,Bone marrow&Fat are the future and probably the present,judicious use is the key.

Dr.Ayyappan MBBS MS MChDNB MNAMS(PlasticSurgery)
09898640656
Sr.Consultant Cosmetic & Plastic Surgery
iapan@rediffmail.com

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