I am just wrapping up the ASAPS 2011 (American Society of Aesthetic Plastic Surgeons) meeting in Boston. It was a great meeting with a lot of useful information. I had a great time catching up with colleagues and took in a Redsox game and Celtics/ Heat playoff game. As always, I am coming away from this meeting with a lot of great new ideas.
There are always a number of controversial and “hot” topics discussed at these meetings. A brief summary of some of these follows, I will try to post a more comprehensive discussion of each of these as time allows.
“Natural breast augmentation” or “lipoaugmentation”
Natural breast augmentation is the process of using a patients own fat to enhance the breasts. The safety and effectiveness are poorly understood. The consensus at the meeting was that it is still investigational and plastic surgeons and their patients are taking big risks doing natural breast augmentation.
Stem cell therapy
Stem cells are cells that have the potential to become any type of cell/ tissue given the proper signals for growth. In plastic surgery there is a lot of discussion about the role of these stem cells in fat grafting. “Stem cell augmentation”, “stem cell facelift”and “stem cell buttock augmentation” are terms that have been used in the media. In reality, what most doctors are claiming as stem cell therapy is actually standard autologous fat grafting (all fat has some stem cells). The process of harvesting and isolating stem cells is quite intensive and currently not approved by the FDA. “Stem cell therapy” likely has a future role in fat grafting as well as a number of more valuable applications (diabetes, cancer, and heart disease). At this point stem cell therapy is investigational only. My own sense is that stem cell therapy will never play a significant role in standard fat grafting as the risks and costs will outweigh the benefits.
Laser liposuction (smartlipo™) and liposuction technology
There was a lot of discussion about different liposuction technologies. Smartlipo™ got the most attention, as it is the largest of the laser liposuction companies. The major question is whether there is any advantage to laser liposuction over gold standard traditional techniques. There were a few positive opinions regarding laser liposuction. However, the general consensus was that the skill of the surgeon determines the outcome, regardless of the technology. There were a number of plastic surgeons who admitted that they purchased laser liposuction equipment but don’t use it because they felt it was no more effective but caused more complications. Currently less than 4% of plastic surgeons use laser liposuction.
I have certainly seen a lot of complications from smartlipo done elsewhere. I have tried laser liposuction. It was interesting, but no more effective in my hands.
We certainly get a lot of patients calling our office asking if we offer smartlipo™. The marketing is working, this is exactly what the company would hope for. The smart patient will choose a plastic surgeon based on their qualifications and experience and allow them to choose the methods that would work best for them.
In summary, writing this post makes me realize that I spent a lot of time this week thinking about fat. Using fat as a surgical tool and removing fat. Time for a cheeseburger!