This week’s ACA Question of the Week addresses an increasingly popular combination of procedures that patients are seeking. Dr. Pane found this question interesting because it allowed him to discuss the risks and benefits of combining cosmetic surgeries, as well as evaluating what factors may make a patient a good candidate for combination procedures. The question asks: “I’m 23, 5’2” and 145lbs. I’m seriously thinking about breast augmentation and Brazilian butt lift, but I don’t want to use butt implants. I have mainly gained weight in the midsection and thighs. I had an athletic shape and am trying to get that back. Am I a good candidate for both surgeries?”
Dr. Pane started by saying that he agrees with the patient that artificial or prosthetic implants in the buttocks are generally not the best solution for most patients, especially when the patient has enough subcutaneous fat on the sides or front of the abdomen or thigh area to make harvesting and transferring the adipose tissue a practical option. In this case, given the patient’s height to weight ratio, he said he’s skeptical that the patient has enough subsurface fat to make fat transfer feasible. Another potential problem may be how the skin of the breasts reacts to the transfer or if prostheses are placed versus using fat transfer on this area as well, which is difficult to evaluate without a full clinical examination.
He also observed that in the state of Florida, there is only so much fat that can be harvested through liposuction at one time unless the procedure is performed in an ambulatory surgical center, a law that was put in place for patient safety reasons. However, assuming that there is a sufficient quantity of subcutaneous fat to perform the Brazilian butt lift and standard implants are used, the liposuction and fat transfer would occur first and then the patient would be turned over and the breast augmentation done. His concern about this is that recovery would be “tricky,” because the patient would have to lie on her side.
The reason for this is because applying pressure to the buttocks by lying prone on one’s back can compress and flatten the harvested adipose tissue, causing it to shift, lump and “bunch,” leaving the buttocks with a rough instead of smooth texture. Likewise, lying facedown can irritate the site of the breast augmentation, leading to irritation and possible shifting of the implants in addition to other, possibly more severe complications such as fluid buildup or “seroma,” subsurface bleeding and pooling or “hematoma,” infection, additional trauma to the area and increased discomfort for the patient.
It is important to remember that even with pictures and a fairly detailed precis of one’s height, weight, medical history and so on, there is no substitute for direct examination of the areas the patient wants to adjust. Clinical evaluation examines the skin and underlying structures, as well as giving the surgeon a clearer picture of what is and is not possible for a given patient and what other options might be available if the desired procedures cannot be done in the way they wish or in tandem. Working from this, the patient and surgeon can decide jointly what the best option is for a given situation, because no two people are precisely alike, no matter how similar they may appear on paper or even physically.
Another important factor is to consider the skill and experience of the surgeon. Dr. Thomas Pane, ACA’s founder, is board certified in both general and cosmetic surgery. Board certification is a rigorous evaluation of a surgeon’s practical and theoretical knowledge of an area of practice, and ensures that only those who have the proper experience and ability achieve certification in their field. Because of the certifications Dr. Pane holds, patients can be confident that he not only knows how to perform various cosmetic procedures properly, but that he knows what to do when things go wrong, as can happen during any surgical procedure.
To learn more about the possibilities cosmetic surgery may offer, or for questions and concerns about aftercare for various procedures, please contact us by phone at (514) 422-4116, on our website at https://acplasticsurg.com or on our Facebook page. Your question may hold an answer for other people who share your interests and concerns, and may even be ACA’s next Question of the Week, answered live on a Google Hangout by Dr. Pane in person. An informed patient is the best kind, because these are the patients who are most likely to get the maximum benefit from their procedures and love the body they end up!