Big girls don't cry
MANILA, Philippines – This is one instance where big girls — or big boys for that matter — who have extra fat deposits need not cry. In a procedure called Autologous Fat Transplant with Adipose Derived Stem Cells, generously proportioned individuals have a distinct advantage over their more skinny counterparts.
“We take fat from the stomach, hips, and other areas and transfer this to parts of the area that need puffing out,” explains Dr. Manuel O. Fernandez Jr., chairman of the Philippine Board of Cosmetic Surgery. “The problem in thin people is where to get the fat. With the procedure, one clearly needs to have a little bit extra.”
However, Dr. Fernandez says that fat transplantation today has gone beyond what was traditionally done. “With the advent of stem cell technology, we can isolate stem cells from the patient’s own fat. These are then mixed with the rest of the fat that we inject to the areas that need to be filled.” In the past, the problem with fat transplants was that these didn’t last too long since the fat disappeared as it was reabsorbed into the body. But with the use of stem cells, the results last much longer — anywhere from five years and beyond.
“If you use it for a defect, or in an area not related to aging like the breasts or buttocks, the results tend to last many years, sometimes even for a lifetime,” confirms Dr. Fernandez. “The theory is that the number of fat cells is constant in adults. These enlarge when one gains weight, or shrink during weight loss. With stem cells, you don’t lose volume in transplanted areas.”
Apart from breast or buttocks augmentation, the procedure is used to contour deformities, puff up depressed scars such as those that result from trauma, a lumpectomy or the removal of a lump from the breast, and contour defects such as the occasional “waving” that results from liposuction. For women who have had mastectomies or breast removal, fat transplants are a safe option to regain their curves. In areas like the face where one loses fat with aging, fat injection or volume surgery to replace what was lost is a means to avoid looking gaunt. One can “either over-correct” to counteract the loss of fat, or the procedure can be safely repeated.
“The advantage of this procedure is that we can do it in real time in the operating room,” continues Dr. Fernandez who studied the technique in Italy. “Stem cell isolation is made relatively simple with a machine, so that we are done with the surgery within two to three hours.” This is unlike when the stem cells are derived from other sources to be cultured for a long time in a laboratory. In addition, there are no controversial moral or ethical issues to contend with, since the stem cells used are the patient’s own.
Those who are anxious about scarring have nothing to worry about either. The cuts to harvest and inject the fat are tiny — two incisions of approximately five millimeters length, and a slight nick to put the cannula and inject the fat in. Expectedly, healing time is quick.
While recent sensational cases of botched aesthetic procedures using synthetic filling substances have made the public wary, fat transplants are very safe. “The beauty of this technique is that we use the patient’s own tissue. This is precisely why it is called ‘autologous.’ There are a lot of filling substances being used and patients must be very careful about what is injected into their bodies. Only very few substancescan be used safely,” cautions Dr. Fernandez. Apart from the credentials of the aesthetic surgeon, it is also important to consider the safety of a hospital setting.
Is the procedure expensive? Surprisingly, the fat transplant procedure can be significantly cheaper than the usual methods and synthetic breast implants, for example, can turn out to be more costly. “In terms of comparative figures, if you go for an augmentation mammoplasty with breast implant versus autologous fat transplant, the latter would be cheaper by a third. The only drawback, however, is that one cannot specify to have oversized breasts right away. We can repeat the procedure after a year, assuming you have more fat to give,” consoles Dr. Fernandez. Enough studies warrant safety, so that the American Society of Aesthetic Plastic Surgery has approved fat transplantation to the breasts.
And thus, the tables have been turned. The thin individuals who want fat transplants to improve the look of their breasts, buttocks and other parts should try to gain some fat first. The substantially-sized folk have the advantage this time.
* * *
Autologous Fat Transplant with Adipose-derived Stem Cells is a procedure performed by Dr. Manuel O. Fernandez Jr. at the Makati Medical Center.
