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Liposculpture / Fat Grafting

Liposculpture / Fat Grafting 

Fat grafting, also referred to as fat transfer or fat injections, is the surgical process by which fat is transferred from one area of the body to another area. The surgical goal is to improve or augment the area where the fat is injected. The technique involves extracting adipose fat by liposuction, processing the fat, and then reinjecting purified fat into the area needing improvement.

Since the 1990's Plastic Surgeons have reliably used fat grafting as a way to improve and enhance the cosmetic appearance of the various areas of the face and body. 

Fat grafting process
The process of fat grafting involves three steps:

extraction of the fat from the donor area with liposuction
decanting, centrifugation, and processing of the fat
reinjection of the purified fat into the area needing improvement
In the first step, fat is extracted from a donor area using liposuction techniques. This is best accomplished by manual methods using thin liposuction cannulas with small holes. Laser or ultrasonic liposuction should not be used for the extraction as it may destroy the fat cells.

The fat is then processed with decanting and centrifugation to separate debris, excess fluid, and dead cells from the viable adipose fat cells. An alternate method is to wash the fat with a sterile saline solution. The fat that is discarded are the fat cells which will likely not survive in the graft and they can even create problems for the good cells.

In the final step, the fat is reinjected in small droplets throughout the subcutaneous tissue of the recipient area. This is to ensure good blood supply to every fat droplet so that the fat graft can survive.

The amount of fat injected is measured in cc's and ultimately varies according to patient case specifics and the area of the body where the processed fat is being injected.


Breast Reduction

Breast reduction surgery is an option for women who wish to make their breasts smaller, less heavy and more lifted.
If you're feeling distressed over the size of your breasts or wish to change your appearance you may be able to have a breast reduction. 

Why consider breast reduction

Some women have great difficulty with their large breasts, especially if they are out of
proportion to their overall figure. The symptoms and problems women may suffer from include:

‣ Pain in the back, neck, shoulder and breast
‣ Grooving of the shoulders caused by bra straps
‣ Inflamed reddened skin under the breast
‣ Difficulty finding a suitable bra that fits and supports the breast correctly
‣ Difficulty finding clothes that fit – often needing much larger size tops compared to bottoms
‣ Difficulty undertaking exercise owing to pain and discomfort caused by the movement of their heavy breasts
‣ A loss of confidence in their appearance and feeling people are staring at their bust.

Breast reduction surgery may help control these symptoms, if large breasts are the main cause. For example, back pain may be due to other causes.

The surgery

The procedure usually takes about two to three hours. Techniques for breast reduction vary, but the most common procedure uses an anchor-shaped incision that circles the areola, extends downwards and follows the natural curve of the crease beneath the breast. The glandular tissue, fat and skin are removed, and the nipple and areola are moved into their new positions. The skin is brought down from both sides of the breast and around the areola, shaping the new curve of the breast. Sutures dissolve under the skin and do not need removing.

Each nipple remains attached to the breast and its blood vessels by a stalk, known as a ‘pedicle’. The direction of the pedicle may vary, such as superior or inferior, but both ways preserve the blood supply to the nipple and areola.

In a small number of patients the nipples and areolas are removed completely and then grafted into a higher position. This is done if the breasts are very droopy with the nipples extremely low. It causes a permanent loss of sensation in the nipple and areola.

In some patients with good quality skin, the horizontal part of the scar may be avoided with a vertical scar breast reduction pattern, but this results in small pleats at the lower end of the vertical scar which may take some months to settle.

What can I expect after the operation?

What should I look out for?

Breast firmness and tenderness before any surgery are common in women, and can relate to your monthly periods. When your breasts have healed after reduction surgery these symptoms may return. It may also take some months for scar tissue in the breasts to settle, and at first the scars may feel lumpy and tender. It is advisable to become ‘breast aware’ – by getting to know what your breasts look and feel like so you know what is normal for you.

If you wish to book a consultation please contact us. 


Breast Augmentation

A breast implant is a prosthesis used to enlarge the size of a woman's breasts (known as breast augmentation, breast enlargement, mammoplasty enlargement, augmentation mammoplasty or the common slang term boob job) for cosmetic reasons.

An implant can also be used to reconstruct the breast (e.g. after a mastectomy; or to correct genetic deformities), or as an aspect of male-to-female sex reassignment surgery.

According to the American Society of Plastic Surgeons, breast augmentation is the most commonly performed cosmetic surgical procedure in the United States. In 2006, 329,000 breast augmentation procedures were performed in the U.S.

There are two primary types of breast implants: saline-filled and silicone-gel-filled implants. Saline implants have a silicone elastomer shell filled with sterile saline liquid. Silicone gel implants have a silicone shell filled with a viscous gel. There have been several alternative types of breast implants developed, such as polypropylene string or soy oil, but these are uncommon and not recommended.Breast augmentation, plastic surgery dublin, cosmetic surgery dublin, plastic surgery, cosmetic surgery

breast augmentationPROCEDURE

The surgical procedure for breast augmentation takes approximately one to two hours. Variations in the procedure include the incision type, implant material, and implant pocket placement.


Breast implants for augmentation may be placed via various types of incisions:

Inframammary - an incision is placed below the breast in the infra-mammary fold (IMF). This incision is the most common approach and affords maximum access for precise dissection and placement of an implant. It is often the preferred technique for silicone gel implants due to the longer incisions required. This method can leave slightly more visible scars in smaller breasts which don't drape over the IMF.
Periareolar - an incision is placed along the areolar border.
Transaxillary - an incision is placed in the armpit and the dissection tunnels medially.
Transumbilical (TUBA) - a less common technique where an incision is placed in the navel and dissection tunnels superiorly. This approach enables implants to be placed with no visible scars on the breast, but makes appropriate dissection and implant placement more difficult.
Transumbilical procedures may be performed bluntly or with an endoscope (tiny lighted camera) to assist dissection. This technique is not appropriate for placing silicone gel implants due to potential damage of the implant shell during blunt insertion.


Saline-filled breast implants were first manufactured in France in 1964, introduced by Arion with the goal of being surgically placed via smaller incisions. Current saline devices are manufactured with thicker, room temperature vulcanized (RTV) shells. These shells are made of silicone elastomer and the implants are filled with salt water after the implant is placed in the body. Since the implants are empty when they are surgically inserted, the scar is smaller than is necessary for silicone gel breast implants (which are filled with silicone before the surgery is performed). A single manufacturer (Poly Implant Prosthesis, France) produced a model of pre-filled saline implants which has been reported to have high failure rates in vivo.

Saline-filled implants were most common implant used in the United States during the 1990s due to restrictions that existed on silicone implants, but were rarely used in other countries. Good to excellent results may be obtained, but as compared to silicone gel implants, saline implants are more likely to cause cosmetic problems such as rippling, wrinkling, and to be noticeable to the eye or the touch. Particularly for women with very little breast tissue, or for post-mastectomy breast reconstruction, silicone gel implants are considered as superior. In patients with more breast tissue in whom submuscular implant placement is used, saline implants can look very similar to silicone gel.

Thomas Cronin and Frank Gerow, two Houston plastic surgeons, developed the first silicone breast prosthesis with the Dow Corning Corporation in 1961. The first woman was implanted in 1962. Silicone implants are generally described in terms of five generations which segregate common characteristics of manufacturing techniques.

First generation
The Cronin-Gerow implants were made of a silicone rubber envelope (or sac), filled with a thick, viscous silicone gel with a Dacron patch on the posterior shell.[17] They were firm and had an anatomic "teardrop" shape.

Second generation
In response to surgeons' requests for softer and more lifelike implants, breast implants were redesigned in the 1970s with thinner, less cohesive gel and thinner shells. These implants had a greater tendency to rupture and leak, or "bleed" silicone through the implant shell, and complications such as capsular contracture were quite common. It was predominantly implants of this generation that were involved in the class action-lawsuits against Dow-Corning and other manufacturers in the early 1990s.

Another development in the 1970s was a polyurethane foam coating on the implant shell which was effective in diminishing capsular contracture by causing an inflammatory reaction that discouraged formation of fibrous tissue around the capsule. These implants were later briefly discontinued due to concern of potential carcinogenic breakdown products from the polyurethane.[18] A review of the risk for cancer from TDA by the FDA later concluded that the risk was so small so as not to justify recommending explantation of the devices from individual patients. Polyurethane implants are still used in Europe and South America, but no manufacturer has sought FDA approval for sale in the United States.[19] Second-generation implants also included various "double lumen" designs. These implants were essentially a silicone implant inside a saline implant. The double lumen was an attempt to provide the cosmetic benefits of gel in the inside lumen, while the outside lumen contained saline and its volume could be adjusted after placement. The failure rate of these implants is higher than for single lumen implants due to their more complex design. The contemporary versions of these devices ("Becker Implants") are used primarily for breast reconstruction.

Third & Fourth generation
Third & fourth generation implants, from the mid 1980s, represented sequential advances in manufacturing principles with elastomer-coated shells to decrease gel bleed, and are filled with thicker, more cohesive gel. These implants are sold under restricted conditions in the U.S. and Canada, and are widely used in other countries. The increased cohesion of the gel filler reduces potential leakage of the gel compared to earlier devices. A variety of both round and tapered anatomic shapes are available. Anatomic shaped implants are uniformly textured to reduce rotation, while round devices are available in smooth or textured surfaces.

Fifth generation
Evaluation of "gummy bear" or solid, high-cohesive, form-stable implants is in preliminary stages in the United States but these implants have been widely used since the mid 1990s in other countries. The semi-solid gel in these type of implants largely eliminates the possibility of silicone migration. Studies of these devices have shown significant potential improvements in safety and efficacy over the older implants with low rates of capsular contracture and rupture.

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