Drs. Sydney R. Coleman, M.D. & Alesia P. Saboeiro, M.D.

Tribeca Plastic Surgery - 44 Hudson Street, New York, NY 10013

"Fat Grafting to the Breast Revisited: Safety and Efficacy"

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LIPOSUCTION DEFORMITIES

Manhattan and New York City Liposuction Surgery

Liposuction is the most commonly performed surgical procedures in New York and even the world. Structural fat grafting is an essential tool for all aesthetic surgeons performing liposuction because it provides the key to addressing iatrogenic liposuction deformities, the most common complication of liposuction.

Patients with deformities resulting from liposuction were first patients in my practice on whom I attempted fat grafting, so they are the patients with whom I have the longest experience.

Unlike the use of fat to rejuvenate the hand, successful treatment of body surface irregularities requires a three-dimensional visualization of the problems and solutions.

Aesthetic Considerations

Liposuction makes it possible for surgeons to change their patient's corporal proportions much more easily and safely than open surgical procedures would. With the introduction of liposuction more than 20 years ago, women can have their thighs, abdomens, and arms selectively contoured to rid themselves of "saddlebags", large buttocks, abdominal bulges, and hanging arms. Buttock creases can be re-carved to create "smiles" under the buttocks. In a relatively short time, liposuction became the most commonly performed surgical procedure in the United States, and perhaps in the world. As liposuction developed in the late 1970s to mid 1980s, a new clinical entity, the post-liposuction iatrogenic deformity, made its appearance. Any surgeon who performs liposuction will confront liposuction's most common complication: superficial surface irregularities. Some of these are exaggerations of preexisting irregularities, some are cellulite, and some are newly created. The thigh and abdomen are particularly prone to irregularities, and physicians have come to accept such indentations as an acceptable out come of liposuction.

However, post-liposuction iatrogenic deformities are not just limited to surface irregularities. Changing the relationship between a woman's thighs hips, and abdomen can result in an unnatural and even bizarre proportion. For instance, a dramatic decrease in the size of a woman's lateral thighs with out an appropriate decrease in waste size can result in a "boxy" and even masculine appearance. Flattening the lower abdomen without attention to the upper abdomen can add to this "boxy" appearance as well. Minor reductions in the volume of the buttock and/or lengthening and deepening of the buttock creases interrupt the continuous flow of the lateral and posterolateral thigh into the buttock. Such maneuvers often create a buttock that would be considered unattractive if it had occurred naturally.

In 1987, Dr. Coleman began treating iatrogenic liposuction deformities with fat grafting, primarily focusing on the surface irregularities. As he became more proficient at fat grafting, he began to address corporal proportion to restore a more natural aesthetic proportion after liposuction and to reestablish a feminine relationship between waist, hips, and thighs.

Liposuction is a powerful tool for alteration of the proportions to the body, but the consequences of removing elements of the body or adding artificial elements must be recognized. Careful planning with a clear vision of the overall result is paramount for aesthetic excellence.

Patients who present with corporal iatrogenic deformities have usually had negative experiences with aesthetic surgeons. How they perceive themselves is colored by those experiences, so it is often difficult to assess how realistic the patient is about her current appearance as well as expectations.

ABOUT THE CONSULTATION

Our consultation is designed to facilitate good communication, which we believe is the key to making successful choices. As a patient, you will spend a considerable amount of time with Dr. Coleman and/or Dr. Saboeiro; as well as with office staff preparing and planning for your procedure. The initial consultation consisits of two visits. Prior to your first appointment, you have some homework to do. Your assignment is to bring with you images of yourself, preferably not smiling, of when you were younger (20-30 years of age); as well as images from magazines of someone whom you find aesthetically pleasing. This is to aid in analyzing the shape and dimensions of the face and body that you desire to achieve.

When you come in for your initial consultation, you will receive a very informative education. This education explains Dr. Coleman’s LipoStructure technique, the ways he approaches aging & rejuvenation, shows comparisons of pre and post procedure results, as well as explains post procedural care. Next you will meet with our nurse and she will go over your cosmetic and medical history with you. Finally, you will have numerous photos taken of you at varying angles and lighting, which you will go over with Dr. Coleman at your second consultation.

The second consultation is the most important, since it is the appointment where you and Dr. Coleman develop a detailed plan for your procedure. It is at this appointment where you will view the photographs taken at your initial consultation. Dr. Coleman has spent an extensive amount of time analyzing these images in preparation for this appointment. Prior to reviewing the images, Dr. Coleman will go over your history again with you as well as explain the possible complications of surgical procedures. As you discuss your concerns and analyze your images, Dr. Coleman will map out a plan to use as a blue print for surgery. Once the plan has been completed, the patient care coordinator will review your procedure, fees and possible dates for you to schedule a procedure.