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Fat grafting for breast augmentation

Posted Jun 18 2009 1:03am 1 Comment

Out of all the fillers (collagen, hyaluronic acid, & other) we use in Plastic Surgery, perhaps nothing is as good as your own fat for augmenting soft tissue. It's used in nasolabial fold (the creases alongside your nose which deepen with age), around the eye, in the lips, for buttock augmentation, and to correct "dents" from liposuction. The problem has to do with success rates running below 50% by most estimates.

Manhattan Plastic Surgeon, Dr. Syd Coleman, is the undisputed "king of fat grafting" and uses it above and beyond the indications most of the rest of us will do. He has described very refined techniques and presents results that are not reproducible for mere mortals. An article in the recent Plastic & Reconstructive Surgery journal described a series of fat graft breast augmentation cases of Dr. Coleman's, an area that has been taboo for years over concerns of issues of mammography artifacts.

Back in 1987 the American Society of Plastic Surgery (ASPS)issued a stong position against this procedure. The ASPS has wisely issued a new strong caution with this. From the lovely, Roxanne Guy, MD, current President of ASPS:
“Patients considering breast augmentation need to know that fat grafting for this indication is not recommended at this time, unless one is part of an ongoing clinical research study. Even though fat grafting techniques have become more refined and breast cancer detection methods have become more sophisticated with time, creating a great deal of excitement about the potential of fat grafting, we simply need more data before we can recommend that this procedure be generally used to augment breasts.”


At a panel at one of our meetings on controversies in Plastic Surgery last week, fat grafting outside Internal Review Board oversite was described as "human experimentation". Despite a number of small series describing this in reconstructive surgery, I'd tend to agree that this kind of fat grafting is something a little ahead of the issues that need to be studied.
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After 6 months of offering stem cell therapy in combination with the venous angioplasty liberation procedure, patients of CCSVI Clinic have reported excellent health outcomes. Ms. Kasma Gianopoulos of Athens Greece, who was diagnosed with the Relapsing/Remitting form of MS in 1997 called the combination of treatments a “cure”. “I feel I am completely cured” says Ms. Gianopoulos, “my symptoms have disappeared and I have a recovery of many functions, notably my balance and my muscle strength is all coming (back). Even after six months, I feel like there are good changes happening almost every day. Before, my biggest fear was that the changes wouldn’t (hold). I don’t even worry about having a relapse anymore. I’m looking forward to a normal life with my family. I think I would call that a miracle.”

Other recent MS patients who have had Autologous Stem Cell Transplantation (ASCT), or stem cell therapy have posted videos and comments on YouTube. www.youtube.com/watch?v=jFQr2eqm3Cg.

Dr. Avneesh Gupte, the Neurosurgeon at Noble Hospital performing the procedure has been encouraged by results in Cerebral Palsy patients as well. “We are fortunate to be able to offer the treatment because not every hospital is able to perform these types of transplants. You must have the specialized medical equipment and specially trained doctors and nurses”.  With regard to MS patients, “We are cautious, but nevertheless excited by what patients are telling us. Suffice to say that the few patients who have had the therapy through us are noticing recovery of neuro deficits beyond what the venous angioplasty only should account for”.

Dr. Unmesh of Noble continues: “These are early days and certainly all evidence that the combination of liberation and stem cell therapies working together at this point is anecdotal. However I am not aware of other medical facilities in the world that offer the synthesis of both to MS patients on an approved basis and it is indeed a rare opportunity for MS patients to take advantage of a treatment that is quite possibly unique in the world”.

Autologous stem cell transplantation is a procedure by which blood-forming stem cells are removed, and later injected back into the patient. All stem cells are taken from the patient themselves and cultured for later injection. In the case of a bone marrow transplant, the HSC are typically removed from the Pelvis through a large needle that can reach into the bone. The technique is referred to as a bone marrow harvest and is performed under a general anesthesia. The incidence of patients experiencing rejection is rare due to the donor and recipient being the same individual.This remains the only approved method of the SCT therapy. For more information visit http://ccsviclinic.ca/?p=838
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