How is fat grafting used in Breast Reconstruction Surgery? 

 

Fat grafting is a way to transfer fat cells from one part of the body to another part of the body, in this case to the breasts.  The fat is collected via liposuction, processed, and then injected into the desired location. The fat can be harvested from any area with excess or undesirable fat.  Typical locations include the abdomen, flanks or love handles, and inner thighs and knees.

 

The fat can be utilized in multiple different ways.  First and foremost it is used to smooth out any contour irregularities or asymmetries in the breasts.  Similarly, it can be used to camouflage the edges of the implant or improve the appearance of rippling from the implant.  Fat grafting can also be used to enhance the volume of the breast, either by itself or in combination with an implant. If a large volume of fat is required, multiple fat grafting surgeries may be required.  It is possible to create a breast entirely with fat grafting depending on the amount of fat you have available and the size of breast you desire. Fat grafting can also be utilized to improve contour irregularities associated with lumpectomies.

 

Fat grafting is done at second stage or revisional procedures, not at the time of mastectomy. Usually fat grafting is performed in conjunction with other procedures so the length of the procedure depends upon what other procedures are being done.  In general, fat grafting takes anywhere from 45 minutes to 1.5 hours.

 

Dr. Elswick performs fat grafting in breast reconstruction cases as well as cosmetic surgeries. It provides beautiful natural results and is appealing to the individual who wishes to use their own body tissues to rebuild and restore their body. Call today to schedule your consultation.  248-524-0620

 

Dr. Sarah Elswick

Plastic, Reconstruction and Aesthetic Surgery :

 

What is Goldilocks Breast Reconstruction?

 

Traditionally Goldilocks Breast Reconstruction was used to describe a type of breast reconstruction where the skin and fat left after a mastectomy was rearranged in such a way to create a breast.  The tissue from the lateral breast and chest wall can also be recruited to provide additional volume. This technique works well in women with large breasts who want smaller breasts postoperatively and fits the adage of “not too big, not too small, but just right” – Goldilocks and the Three Bears story.

 

There are multiple applications of Goldilocks Reconstruction:

  • The reconstruction can be performed in the traditional aspect, rearranging the patient’s own tissues to create a new, smaller breast.  If desired, the patient can undergo one or more episodes of fat grafting to enhance the size or shape of the breast.
  • The reconstruction can be performed in combination with a tissue expander and/or implant for women with large, droopy breasts desiring better breast shape with a more youthful and “perky” appearance.
  • The reconstruction can be performed in patients who do not want reconstruction but want to limit or prevent the concavity that can be caused by a mastectomy.

 

This surgery is done at the same time as the mastectomy.  The surgery usually takes 1.5-2 hours depending on whether you are having single or double mastectomies.  This is in addition to the time it takes to complete the mastectomy. Patients are usually hospitalized for one night after a mastectomy with Goldilocks Reconstruction.

 

During the consultation I will evaluate your specific case and present all the options that are available to you.  We are committed to helping you close the loop on breast cancer and have confidence to move forward. Call today to schedule your consultation. 248-524-0620.

 

Dr. Sarah Elswick, MD

Plastic, Reconstructive and Aesthetic Surgery 

Considering facial fillers? Don’t forget your Chin!

 

Our chin is an area that we don’t often think about when we are talking about aesthetic injections like Botox® and filler but it should be.  As we age the mentalis muscle can become hyperactive creating a dimpled, pebbly, orange peel (peau d’orange) look to the chin. It can also begin to turn the chin downward.  Injecting Botox into the mentalis muscle relaxes the muscle smoothing out the skin on the chin and releasing the chin back upward for a more balanced look to the face.  

Some people just genetically have a “weak chin”.  This is when the lower jaw is either less developed or less projecting compared to the upper jaw.  This creates an unfavorable or unbalanced facial appearance. Injecting dermal fillers can really enhance the chin and change the overall appearance and balance to the face and jawline.  Juvederm Voluma® is a very cohesive filler that creates volume and lasts up to two years. It is a great choice for this area of the face.  

In some cases we cannot create enough volume to balance the appearance of the upper and lower jaw with filler.  For these people, surgery is an option. There are several silicone chin implants that can be permanently placed by Dr. Schenden or Dr. Elswick in our surgical suite.   This surgery is called genioplasty.  

Call to schedule a complimentary consultation with me to see which the right procedure is for you.   248-524-0620

Kristen Lotz, PA-C

Aesthetic Injector

What is direct to implant breast reconstruction surgery?

Knowing your surgery options for breast reconstruction is critical for making the right decision.  This week I want to talk about direct to implant reconstruction. In direct to implant surgery the permanent implant is placed at the time of mastectomy, avoiding the need for a tissue expander.  This surgery is also referred to as “single stage” breast reconstruction. I prefer, however, not use this term due to the fact that many women still require a revisional surgery to optimize breast shape, scars, or symmetry.

Candidates for direct to implant reconstruction include women with small to moderate size breasts that want to have the same breast size or smaller breast size post-operatively.  Large implants can cause strain on the breast skin after the mastectomy which may lead to implant failure. As the reconstructive surgeon I would closely with your breast surgeon to ensure you receive the best treatment available.  The reconstructive

 surgery usually takes 1-1.5 hours depending on whether you are having single or double mastectomies.  

 

During the consultation I will evaluate your specific case and present all the options that are available to you.  We are committed to helping you close the loop on breast cancer and have confidence to move forward. Call today to schedule your consultation. 248-524-0620.

 

Dr. Sarah Elswick, MD

Plastic, Reconstructive and Aesthetic Surgery

 

What’s the new trend in Lip filler? 

In recent years when it comes to Lip filler, the request has been the bigger the better. With every trend comes a bandwagon and then it tempers. Although the volume and style injected has changed, the demand for Lip filler is not slowing down anytime soon.

Patients have been requesting a more natural result and lip injections is still one of the primary filler requests I receive.  My belief is to assess the patients face shape, other features in comparison, and definition as well as a full pout is important to most patients. 

The products I use and technique administered varies for each patient.   Different hyaluronic fillers produce different results. I’ll choose Restylane® if my patient wants more structure or has “smoker lines”.  For the patient that wants a pillowy pout, Juvederm® is my product of choice. 

Lip filler can last anywhere from 9-12 months but by 4-6 months, most of my patients feel they are deflating and require a refill.  Interested in learning more? Call today to schedule your complimentary consultation. 248-524-0620

 

Raquel Merlini

Registered Nurse and Aesthetician

What is a tissue expander?

Intro to series, Breast reconstruction surgery has several different approaches.  Due to this and the complexities of the surgery patients typically have lots of questions and may feel overwhelmed.  Dr. Elswick would like to offer a blog series on answering several of these questions to help patients increase their knowledge and make informed decisions.  She is passionate about breast reconstruction surgery and works one on one with her patients to ensure every question is thoroughly answered before moving forward.  

 

We have several questions already in mind to answer but welcome additional ones from you. Our first question is: 

 

What is a tissue expander?

 

A tissue expander is one of the more commonly used devices in breast reconstruction.  A tissue expander is a temporary “spacer”, similar to a balloon, which allows the plastic surgeon to preserve the volume and shape of the breast.  It is shaped like a breast and has a “tear drop” appearance when viewed from the side. The outer shell of the tissue expander is made of silicone.  

 

There are different sizes of tissue expanders, so it can be individualized to fit your body and reconstructive goals.  Unlike a breast implant, a tissue expander has a port that is connected to the inside cavity. The port is identified with a magnet and accessed through your skin so the expander can be filled post-operatively with either air or fluid.  A tissue expander is used as a temporary device to help create a nice pocket to hold the final implant while also expanding or stretching the breast skin to create the desired post-operative size and shape. When the tissue expander fills are complete and the skin and incisions have healed, the tissue expander is removed and replaced with a permanent implant (three to six months after your expander surgery or radiation).

 

Attached is a photo of a tissue expander. During your consultation, I will have one available for you to physically see and touch to help you better understand the device.  Please call my office located in Troy, Michigan to set up your consultation. 248-524-0620. Together we can restore your body and confidence. 

 

Sarah M. Elswick, MD 

Reconstructive, Plastic and Aesthetic Surgery 

Jeuveau™ is here!

A new aesthetic treatment to treat aging skin. 

 

There is a new product on the market!  The aesthetic world is growing and developing new products every day and our practice is always excited to offer these to our patients. .  There are currently four neurotoxins on the market. You may ask what a neurotoxin is. This is a product that helps relax the muscle to soften the appearance of wrinkles and fine lines.  Botox® and Dysport® are examples neurotoxins.  

We welcome the addition of a new company to this group Jeuveau (#Newtox).   Jeuveau is a FDA approved neuromodulator whose effect is to relax the muscles in the areas of injection.  The administration technique is the same as our other products. The results will be similar with softening facial wrinkles and fine lines to provide a more youthful appearance. 

As an injector it’s exciting to have another tool to use in order to best serve my patients and their needs. Call today to schedule your complimentary consultation and let us help you restore your youthful experience. 248-524-0620

Raquel Merlini, RN

 

Filling the Temples

Adding Volume to the Temple area can add youth~ 

 

The temples are an area that most patients don’t think of correcting. Our faces naturally lose volume when we age.  The temple volume loss is not often noticed because we tend to focus more on the lines and folds around our mouth and cheek volume loss.  Although they are often overlooked, when we do address them, the results are very satisfying!

 

A youthful face is full and round or oval in shape.  When we lose volume in the temples we lose support to our eyebrows and they start to turn down.  The hollow in the temple also can clip the tail of the brow changing the shape of our eyes. Replacing this volume gives an instant youthful look.  It lifts and elongates the brow making the eye look more open and less tired.  

 

Dermal fillers provide an instant, effective reversal of temporal volume loss.  Thus restoring fullness and a more natural, youthful appearance. This area can take a fair amount of product to fully correct but the product tends to last a lot longer in this area because there is very little movement.  Everyone will notice that you look younger but no one will figure out why!

 

We offer complimentary consultations on all our aesthetic injections. Call today to schedule your appointment and see how changing one small area of your face can restore your youth.  248-524-0620

 

Kristen Lotz, PA-C

Michael J. Schenden, MD PC 

Lunchtime procedures due have some restrictions 

 

Wrinkle relaxers such as Botox ™/Dysport™ and Dermal Filler injections are considered “lunchtime procedures” where you can have it done on your lunch hour and resume normal activity “go right back to work” immediately following.  For the most part, this is very true but there are some restrictions that should be considered if you would like to have the best possible result with the least amount of complications which include but are not limited to; swelling and bruising.

 

Things to avoid after Wrinkle Relaxing Injections

 

  • Avoid lying down for 4 hours after injection.
  • Avoid working out, Yoga and strenuous activity for 24 hours after injection.
  • Avoid massaging or rubbing the area of the injections for 6 hours.  
  • Avoid headbands, baseball caps or hats for 6 hours if you were injected on the forehead.  
  • Avoid excessive amounts of alcohol for one day after injections. 
  • Avoid blood thinners, NSAIDS, and supplements that thin blood for one day after injections. (Consult your Doctor before stopping prescription blood thinners).
  • Avoid excessive heat exposure (sauna, hot tub, tanning) for one day after injections.

 

Things to avoid after Dermal Filler Injections

 

  • Avoid intense physical activity for 24-48 hours after injections.
  • Avoid extensive sun or heat for 24-48 hours after injections.
  • Avoid excessive alcohol or salt for 24-48 hours after injections.
  • Try to keep head elevated for sleep for the first night.  
  • Icing and massage can help recovery for the first 24-48 hours after injections.

 

We want to ensure you always receive the best possible outcome and ensure that you understand the products.  We offer complimentary consultations on all aesthetic injections. Call today to schedule your appointment 248-524-0620. 

 

Kristen Lotz, PA-C

 

Will aesthetic filler permanently stretch the skin on my face?

 

Dermal fillers are used to correct fine lines, wrinkles and add volume that has been lost due to the aging process.  Aesthetic injections replace lost volume, hence filling an empty space.

 

When injecting for wrinkle correction the product is filling the area under the skin to lift it up to be the same level of the surrounding skin. This type of injection is not going to noticeably stretch the skin. We also will add product to increase volume. The most common area for this is the cheeks where we naturally lose collagen over the years.  This type of injection is essentially stretching the skin as the volume is added but it is in a minuscule manner. To keep this in perspective most patients are not injecting extensive amounts of product. A 1 ml syringe is about 1/5 of a teaspoon. Dermal fillers are temporary, typically lasting anywhere from 6 to 18 months, depending on the product.  As the filler slowly dissipates most skin is able to contract to its original presentation.

 

Many of the questions I receive like this are due to not fully understanding the product/procedure. Before I start any treatment I take the time to ensure my patient’s questions have been answered and they understand.    Patient education is one of our top priorities. We offer complimentary consultations on all of our aesthetic injections. Call today to schedule your appointment 248-524-0620. 

 

Raquel Merlini, RN

Aesthetician and Registered Nurse