Hello Dr. Bermant,
Would like to know your opinion on the common abdominoplasty tummy tuck, with breast enhancement of saline or silicone , verses abdominoplasty tummy tuck with fat transfer breast enhancement.
I have seen the fat transfer is growing and with your experience in this field, would like to know if your for the new surgery or not?
Thank you very much for your time.
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
Welcome to our discussion group.
Early in my career I worked with combined breast and stomach surgery generally preferring natural living fat with a blood supply as a flap, not a graft.Breast built from vascularized fat such a a free flap or TRAM was much more natural in movement, but technically demanding. Fat grafting has a bad survival rate. Grafted fat becomes firm and not fat like. Here is some scared firm fat grafts I removed from a male chest that was firm like gland and held the skin to the muscle rigidly making a horrible deformity on movement.
The issue is how a breast looks with animation. Firm fat grafts and breasts implants just do not have a natural look to the living breast. The breast should look good in more than a few select still pictures. They also need to look good with arms up overhead, flexing the chest muscles, bending over, and playing activities, sports, and living life.
Check out my Standard Female Breast Reduction Pictures
, Standard Breast lift Pictures
and Standard Breast Reduction Videos
and Standard Breast Lift Videos
both are more critical in contour issues and how the tissues move.
The issues of current implant and fat graft technologies are that I have yet to see any supporter demonstrate how their work looks in other than still images. There are sometimes movies, but the movies are of still images. In real life the look can be distressing for the patients of other surgeons who came to me for help. The only videos I saw were in the MA rated films where actresses seemed not to care to have the distortions, creases, and non human tissues show up during their movements. I abandoned breast implants many many years ago as I realized this critical issue and as of yet have not seen anything I would have considered using before my retirement.
I have discussed before my dislike of combining the stomach and breast / chest in on operation for elective surgery other than reconstructive breast. Female Breast Lift Forum - Tummy Tuck and Breast Lift Before Retirement?Male Chest Lift Forum - Can Tummy Tuck and Chest Lift Be Done Same Surgery?
We achieved incredible comfort levels for our patients. I could not have imagined years ago doing a Tummy Tuck and a patient only needing plain Tylenol for comfort. But I could not do that for the extended regions of breast and stomach. Tummy Tuck Comfort
with my Tumescent Tummy Tuck
But this forum was founded on the principle of proof. If someone has a better way, we have the resources here for someone to share their skills, links, and video documentation. Verbal hand waving is frequently the norm, "it looks great" is quite a bit different than seeing it. If I could I would then love to go beyond that so that it would feel like normal tissue and have a method to share that type of evidence. We are a long way from that, but limited still photos are just not sufficient. My methods continued to evolve over my career. I am trying to show the methodology that permitted me to critically analyze the problem and state of art of my solution. The goal to to go beyond where I left off.
Hope this helps,
Michael Bermant, MDLearn More About Tummy Tuck Abdominoplasty Surgery