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Fat Banking Takes Deposits to a New High

February 28th, 2014 Miguel A. Delgado Jr, MD

San Francisco, California-Liposuction patients are choosing to freeze their fat that has been removed during liposuction surgery. Saving the harvested fat allows the patient to use their own fat for future use for cosmetic enhancement.

Fat removal by liposuction

Fat cells contain a substantial amount of stem cells. Clinical trials using stem cells are showing promise for degenerative disease such as rheumatoid arthritis and multiple sclerosis. Tests to date are very preliminary but in the next few decades who knows what might be discovered, having stored stem cell loaded fat cells could prove to be very beneficial as fat can be stored for decades and be thawed as needed. By storing the cells now, the youngest possible cells are being preserved which have more proliferation than older cells.

The cells are cryopreserved in liquid nitrogen and should remain useful indefinitely. When the fat cells are frozen, the metabolism is greatly slowed down preventing deterioration and preserving the cells for future use.

Today, women are having breast augmentation and butt enhancement with their own fat. Many patients choose to have the cheek area filled out during a facelift, or aging hands smoothed out. Imagine taking more youthful fat cells that have been stored for years, thawing them out and using them to regenerate areas that have lost their fullness due to aging.  Having youthful stem cells for applications that haven’t been discovered yet is like having an insurance policy with your own autologous fat. Fat transplants don’t always take, but if they fail, the body will reabsorb the cells without any incident.

Before and After liposuction

This is a 35-year-old, female resident of Napa, California who presented to the Novato office in Marin County, California for evaluation for liposuction. She is 5 feet 6 inches and weighs 140 pounds. She underwent liposuction of the abdomen, flanks, inner and outer thighs at Marin Cosmetic Surgery Center in Marin County, California. She had a total of 5500 cc of fat extracted from these areas. Her photographs were taken one year after surgery. Note the much slimmer body appearance.

 

Fat injections and fat grafting have been around for a long time and have been used for cosmetic and reconstructive procedures. In addition to augmenting the body where fat loss has happened due to aging, it has been invaluable for reconstructive procedures such as correcting a “crater deformity” caused by too aggressive fat and/or tissue removal during a male breast reduction (gynecomastia) surgery. It can be the optimal choice as a dermal filler as the body will not reject it.

Realizing the incredible benefit to his patients, Dr. Delgado has arranged to have the option available for those having liposuction to have their fat banked through a company called AdiCyte. The costs for storage are dependent on the amount stored.

AdiCyte’s state of the art laboratory is at the University of Arizona Health Sciences Center in Tucson, Arizona. AdiCyte is registered with the FDA and is in full compliance as a tissue processing bank. The collection kits, transportation, processing and storage procedures insure optimal viability of the tissue.

Dr. Delgado is a Board Certified Plastic Surgeon, treating patients in the San Francisco Bay Area, San Jose and Sacramento, since 1988. Call today (415) 898-4161 for a consultation to discuss your fat banking options along with your liposuction surgery.

“Non-Surgical Center of Excellence” for Concierge Care

November 30th, 2013 Miguel A. Delgado Jr, MD

Reception at Dr. Miguel Delgado

Reception for Dr. Miguel Delgado
Marin County, Novato CA

San Francisco, California-Always forward thinking, Dr. Delgado makes available to his patients the latest and most innovative procedures that he has determined are safe and give the best results. Not all patients desire cosmetic plastic surgery for various reasons such as: corrections are only minor, taking the time out of a busy schedule, fear of surgery and/or anesthesia, or financial limitations.

There are many non-surgical options for patients that can reduce signs of facial aging, sculpt the body, and refresh the skin. Subtle changes can increase self-confidence and one’s perspective on life. With this in mind, Dr. Delgado continues to expand procedures offered to his patients at his “Non-Surgical Center of Excellence”.

Many patients are confused as to what procedures may benefit them when they see so many treatments available that are showcased on television talk shows, the internet, and all forms of media. It is recommend that patients schedule a consultation with Dr. Delgado to discuss problem areas that patients find disturbing and with Dr. Delgado’s expertise, he can recommend the optimal treatment for the best result.

The latest procedure that Dr. Delgado has added to his practice is “CoolSculpting”. CoolSculpting is the exciting non-surgical solution to removal of those stubborn areas of fat that dieting and exercise will not eradicate. For details on this procedure see the previous blog or the section on this website.

CoolSculpting is in good company with other procedures that Dr. Delgado offers, also added this year is “ Ultherapy”   a FDA approved procedure.  Ultherapy is a non-surgical facelift that tightens the skin by ultrasound which stimulates new collagen growth. One 60 to 90 minute treatment will continue to show improvements for up to 6 months. This is the perfect treatment for patients who are not ready for a facelift but would like a little tightening, or for facelift patients that need a little touch-up.

Ultherapy Featured in New You

Ultherapy Now Offered in Marin County is
Featured in” New You”

Fat injections continue to gain popularity as an excellent filler for the face where some fat loss has occurred. Using one’s own fat loaded with stem cells has proved to be the longest lasting correction. In addition to the face, fat injections or fat grafting can correct such defects as “crater deformity” in the male chest from over resection during a gynecomastia or male breast reduction procedure. Many cosmetic surgery patients are choosing to take advantage of a service that Dr. Delgado provides through “AdiCyte”, which is a company that stores a patient’s fat for future use, known as fat banking.

According to the American Society for Aesthetic Plastic Surgery (ASAPS), non-surgical procedures have increased 356% over the last 15 years, with Botox the number one injectable every year. In 2012, Botox increased another 24%! Botox works by blocking the nerve muscles. The wrinkles will then soften and relax when the muscles can’t contract. The most popular areas treated are the glabella, (the area between the eyebrows), crow’s feet (the corners of the eyes), and the forehead.

As an expert injector, in addition to Botox, Dr. Delgado offers Dysport (similar to Botox), Restylane, Juvederm, Radiesse, Sculptra and Artefill. Each has different advantages, so it is recommended that you discuss your options in consultation with Dr. Delgado.

To complete the offerings of the “Non-Surgical Center of Excellence”, are Diolite, Photo-facial, and laser hair removal.

Diolite is a laser that treats age spots, skin tags and red vessels of the face. Photo-facial will treat brown spots, shrink pores and even out skin tone. One of the top cosmetic procedures in the United States is laser hair removal, requested by both men and women.

You can be assured that as new procedures become available, Dr. Delgado will be offering them once he is convinced that they are safe and may be of benefit to his patients and not just another marketing hype.

Consultations are offered at both the Union Square San Francisco office, and Marin County’s Novato office. Call (415) 898-4161 for a complimentary consultation for your non-surgical desires or email.

CoolSculpting Freezes the Fat Away!

October 26th, 2013 Miguel A. Delgado Jr, MD

coolsculpting_procedure

CoolSculpting Procedure
Dr. Miguel Delgado
San Francisco, CA

San Francisco, CA-According to the statistics of the American Society for Aesthetic Plastic Surgery, the two most popular cosmetic surgical procedures, are breast augmentation and liposuction. Liposuction is very popular with men looking to get rid of love handles and reduce the abdomen. Women love it for reduction of their: “saddle bags”, abdomen, thighs and more. Liposuction has been available in the United States since the early 1980’s and the popularity continues to grow.

Fat reduction is big business, which is very evident by the multiple choices of the many types of fat reducing devices available. Competition is intense for market share between manufacturers, but competition is always good in a free market society encouraging manufacturers to continue to produce more effective and higher quality devices. There have been many liposuction machines introduced, but most are just variations with small differences.

Liposuction is surgery requiring: pre-operative lab tests, surgical and operating room fees, prescription medications, compression garments and downtime for recovery. To find a way of fat reduction that does not involve surgery, has been a dream of many, for years. That dream is now a reality! Doctors from Massachusetts General Hospital in Boston noted that children who consumed many popsicles were developing dimples in their cheeks due to fat loss. Through testing, the doctors discovered that intense coldness killed fat cells, and the fat cells were then eliminated naturally by the body. Even though it is a somewhat slow process, it is permanent. This discovery led to the development of CoolSculpting. With CoolSculpting, there are not any needles, scalpels, scars or downtime.

CoolSculpting has hit the market with great reviews; the demand for the procedure shows how many patients embrace the idea of a non-surgical fat reduction option. CoolSculpting will not replace liposuction as it is not as aggressive. CoolSculpting is not meant for large areas of reduction; it is more for those difficult localized pockets of fat that diet and exercise will not remove such as: the abdomen, love handles and for some men with pseudo-gynecomastia it will reduce the fat on their chest.coolsculpting-logo

You are born with a certain amount of fat cells, if you consume more calories than your body can use, the extra calories will be stored as fat, and the cells will grow larger.  If you lose weight the cells will shrink, but they will not go away unless they are removed by liposuction or CoolSculpting. CoolSculpting only removes subcutaneous fat, fat that is attached to the skin. It does not affect visceral fat, which is deeper and surrounds the organs.

The ideal patient is within 20 to 30 pounds of ideal body weight, if you can pinch more than 2” you may want to lose weight first or consider liposuction.

For treatment, the patient arrives in comfortable clothing and lies or sits on the treatment table. Most patients read, use their laptop or take a nap. The targeted area is placed between 2 cooling plates that are held into position by a vacuum. The fat is then subjected to intense coldness, which will kill the fat cells but does not affect the blood vessels, nerves or skin. The treatment lasts for about an hour per area. Most patients claim the procedure is not painful, but they feel the initial coldness and some pressure. The side effects are minimal, and if any would include: some redness, numbness, swelling and minor bruising.

Results will not be evident right away, the destroyed fat cells can take up to 2 to 4 months to be shed by the body. Many patients state that they first start seeing results after 2 to 3 weeks when they noticed the difference in how their clothes fit. In general, one treatment will reduce an area by 20%, if a patient desires to have more removed additional treatments can be done.

Success for permanent results will be based on lifestyle changes of a healthy diet and exercise program.

To find out if CoolSculpting is for you, schedule a consultation with Dr. Delgado in either his Marin County office in Novato or his Union Square office in San Francisco. Ask about other procedures available through the “Non-Surgical Center of Excellence”such as: Ultherapy for skin tightening, Botox, fat injections, and facial fillers.

Stem Cell Facelift Controversy Continues…

May 31st, 2013 Miguel A. Delgado Jr, MD

 

Centrifuged fat

San Francisco, California-If you Google “stem cell facelift”, you will see an abundance of advertising for this catchphrase which is considered to be a pure marketing gimmick that is not medicine. The “stem cell facelift” is actually a misnomer; it is a nonsurgical procedure involving fat injections to plump up the face, not a surgical procedure like a conventional facelift that requires cutting, lifting and sewing.

Most physicians who advertise are taking advantage of the latest marketing ploy, by using fat which already contains stem cells for their “stem cell facelift procedure”. There are a few doctors who are adding stem cells to the fat claiming the “enriched fat” is what gives superior results. It is not proven that fat grafting with added stem cells gets any better results than fat grafting without the added stem cells, and fat injections or fat grafting, is a well-established procedure that has been around for two decades and is an excellent procedure for facial volume replacement.

A recent abstract published in The Aesthetic Journal states that; “Despite encouraging data suggesting that adult stem cells hold promise for future applications, the data from clinical evidence available today do not substantiate the marketing and promotional claims being made to patients. To claim that the “stem cell facelift” is a complete facial rejuvenation procedure surgery is unethical.”

Stem cell technology for aesthetic purposes is exciting and perhaps very promising. However, the jury is still out, scientific evidence does not support the safety and efficacy at this time. The American Society of Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) request their Board Certified Plastic Surgeon members only use this procedure in clinical studies under institutional review board approval and report their findings.

There will always be practitioners that are quick to take advantage of new trendy procedures, see the blog on the “Vampire Facelift” dated June 22, 2012. Do your homework, and “let the buyer beware!”

Ultherapy – The New Non-surgical Facelift Now Available To San Francisco Patients

May 15th, 2013 Miguel A. Delgado Jr, MD

Ultherapy Ultrasonic Machine

San Francisco, California-Ultherapy is the new FDA approved ultrasound treatment that stimulates the deep structural support layers of the skin. The subcutaneous layer and the fibrous SMAS layer are heated up by ultrasound energy, which stimulates growth of new collagen over time to tone and tighten loose and sagging skin of the face and neck. This is achieved in most cases with one 60 to 90 minute office treatment. The patient has no downtime, no skin scabbing and the skin lifting results are seen over the course of 2 to 3 months, with some patients seeing continued improvement of lax skin for up to 6 months.

Ultherapy does not replace facelift surgery, but is a perfect skin tightening treatment for those Marin County patients that are not yet ready for surgery or for those who have had surgery and may need a little skin rejuvenation.

Featured on many TV shows such as 20/20, The View, Good Morning America and multiple magazine articles, Ultherapy is not a Facelift but an Uplift! To see if you are a candidate for this exciting new procedure call (415) 898-4161 for a complimentary consultation.

 

Many Benefits of Cosmetic Plastic Surgery

May 14th, 2012 Miguel A. Delgado Jr, MD

There have been wonderful advances in cosmetic plastic surgery through the years, and for most people the benefits are very rewarding. Sonoma patients notice the boost in self confidence and self esteem saying it can be life changing.

Consider the young patient who has ears that stick out or a large nose, or the young boy who has developed male breasts (gynecomastia) at puberty. Teasing is cruel and can have long term harmful effects. For the wise parent who seeks an evaluation from a Board Certified Plastic Surgeon, their child may be able to have corrective surgery ending the torment.

Then consider the woman who has had children and is left with droopy skin in the stomach and breasts. Even with all the rewards of motherhood, most women are frustrated with the changes their body has gone through. For her the “mommy makeover” can make a dramatic difference as to how she feels about herself, which is not only a benefit to her but her family as well.

For the aging patient who is trying to compete in the workforce, a facelift can make a dramatic difference. Not only does the patient look better, the boost in self esteem may give the patient the extra confidence needed to land that new job.

San Francisco Bay Area women claim breast reduction surgery is one of the most rewarding procedures, not really considered cosmetic surgery but an elective procedure. Sometimes insurance will cover most of the cost if certain criteria are met.

Benefits of Computer Imaging at the Consultation

February 14th, 2012 Miguel A. Delgado Jr, MD

Computer Imaging by Dr. Delgado

There are many things San Francisco Bay Area patients need to consider when deciding to have cosmetic surgery. One is to be very selective in choosing a surgeon. Most patients understand the importance of picking a Board Certified Plastic Surgeon, but then what? If possible try to see at least three surgeons in consultation and determine who you feel most comfortable with. Look closely at before and after pictures you may be presented with of the surgeon’s own patients and determine if you like the results. Many surgeons now offer computer imaging; this is a great opportunity to see if you and the surgeon are on the same page!

If you are not familiar with computer imaging, it is a wide field that includes digital photography, scanning and manipulation of bit-mapped graphics. In plastic surgery this is an excellent tool to aid the surgeon in communicating with the patient the desired goals and realistic outcomes.

Many patients have a hard time visualizing the outcome of possible cosmetic surgery, computer imaging enhances the consultation by allowing the surgeon to show a patient a unique three dimensional view of changes the plastic surgeon recommends, which otherwise would be hard to express by non-visual means.

The process is fairly simple; the surgeon takes photographs of the patient and can then project the photos onto a computer screen. Dr. Delgado uses a specialized computer program called “Canfield Mirror Imaging Systems” which allows him to manipulate the image to give the patient an idea of what the surgical goals are. Imaging works best for facial procedures such as: eyelids, facelift, nose reshaping and chin enhancement. Conservative results can be demonstrated for liposuction. Computer imaging does not work well for breast surgery, gynecomastia surgery or tummy tucks.

The computer cannot provide a guarantee of a specific result but is used more as a tool to demonstrate anticipated surgical changes. Imaging is just an approximation. But Dr. Delgado’s patients have found it to be very valuable in helping them to consider their options during the decision making process.

 

The Trend for Bridalplasty is Increasing

September 7th, 2011 Miguel A. Delgado Jr, MD

Bridalplasty was the controversial American reality TV show that had 12 engaged women competing to win their “dream” wedding and multiple cosmetic surgery procedures. The idea is not as farfetched as it may seem. Most women dream of their wedding from the time they were small girls, and wanting to look their absolute best is not unreasonable.
“Bridalplasty” has been around for a long time, but just recently became a popular topic of conversation since the “new buzz word” was coined by the reality show. For years women have done whatever they could to make their “special” day perfect. Many go on diets or change the color and length of their hair, or have a makeup artist do their makeup. And many have a surgical procedure. The most popular cosmetic procedures for brides, have been; Botox and fillers, breast augmentation, liposuction and rhinoplasty.
It is important to plan ahead so healing can be complete. And it is highly recommended that the “husband to be” is in agreement. A new look is not the kind of surprise most men appreciate.
If the surgical procedure is something the bride has been wanting a long time, such as  breast enhancement or a nose job, then why not proceed before the biggest day of her life? The photographs of the wedding are something that will be shared for years to come, and if an aesthetic change is to be made, most women would want it to show up in the photos.
But if the surgery is a decision made on a whim, then further consideration should be given. This is something the bride should be sure she is doing for “herself” and not outside influences.

What is Cellulite? Do Cellulite Creams Work?

August 14th, 2011 Miguel A. Delgado Jr, MD

Cosmetic surgeons recognize cellulite as a condition that many San Francisco patients seek to find a cure, however the medical community does not see cellulite as a disorder but a normal condition for many women and some men.
Cellulite is a term first used in the 1920’s and became a “buzz word” when used in a Vogue magazine article in the 1960’s.  According to the Mayo Clinic 8 out of 10 women have some degree of cellulite; it does not seem to affect men very much, probably because estrogen makes fat and testosterone breaks down fat. Men with elevated estrogen have the propensity to develop gynecomastia (male breasts).
The physical cause of Cellulite is caused by fibrous cords that connect the skin to underlying muscle with fat in between. When fat cells increase they push up toward the skin and the cords are pulling down causing a dimpling effect.      
Some causes of Cellulite are:
• Hereditary
• Inactive lifestyle
• Stress
• Use of hormonal contraceptives
• Weight gain and an unhealthy diet
• Aging and the loss of skin elasticity

Many San Francisco patients come in to see Dr. Delgado with the hopes that liposuction will remove cellulite; it won’t, and in some cases can make the condition worse. Liposuction is for body sculpting not for removing fat under the surface of the skin.
What about all the creams and lotions that are advertised to remove the unwanted dimpling? Save your money, there has not been any conclusive evidence that this can cure or improve cellulite.
Endermologie uses vacuum rolling and radio waves to break up fat and help increase circulation. There have been many patients that claim they get results with this method but they have to have frequent treatments and if they stop the cellulite may return.
But due to demand, research continues and perhaps there will be a permanent cure for cellulite one day.

The Reality of Medical Tourism

July 17th, 2011 Miguel A. Delgado Jr, MD

Medical tourism dates back thousands of years.  Greek pilgrims traveled to the Sacronic Gulf to a territory called Epidauria, considered the first medical tourist destination, for medical treatments and mineral waters for healing not unlike our spas today. Medical tourism seems to be gaining resurgence with elective surgeries. The lure of a tropical vacation package in a far off land which combines the cosmetic procedure of your choice with sunshine, beaches, rest and relaxation away from family, friends and home at a reasonable cost is a tempting proposition to some San Francisco Bay Area patients. There are many countries that are marketing themselves as medical tourist destinations, including; Thailand, India, Brazil, Costa Rica, Mexico, South Korea and more.
There are some very important things to consider that may not seem apparent at first look. Language and cultural barriers make communicating with doctors and nurses frustrating. Doctors in some countries are regarded as authority figures who often are not questioned. Many countries have infectious diseases that Americans and Europeans would not have built up a natural immunity to such as mosquito transmitted diseases, influenza and tuberculosis. Standards of post operative care can vary dramatically depending on the hospital and the country. Accreditation and other measures of quality vary widely across the globe.  Traveling a long distance after surgery can be dangerous for possible blood clots in the legs.
Many countries and doctors have lower fees because they do not have protection for patients such as liability insurance. Or they may be using inferior products for such popular surgeries as breast augmentation or breast augmentation with a lift. French made silicone P.I.P. breast implants have a high rupture rate and were eventually recalled. Consultant plastic surgeon Douglas McGeorge of the British Association of Aesthetic Plastic Surgeons (BAAPS) said PIP implants were not used by members of the Association. He said “These are cheap products that tend to be used by commercial companies and could well be used in women who have gone abroad for surgery. They are attracted by cut-price deals but as ever, you get what you pay for”. The recalled implants resurfaced and were rebranded as M-implants putting even more women at risk. This would not be the case in the United States where implants are closely monitored by the FDA for safety.

If you should be awarded a mal practice suit by a court, the doctor or hospital may not have insurance and collecting may be impossible. If a medical complication should arise, your personal medical insurance will probably not cover you while you are out of the country so additional costs could result. If you have a complication once you return home you then either have to return to the foreign country or find a local doctor willing to take on a case with complications which can be very expensive.

Relaxing on the beach to recover is not a good option, it is important to stay out of the sun and the water to avoid scarring and infection. Being close to home where you may have a friend or family member to watch out for you is optimal. And most importantly having your surgeon nearby is the safest situation. After healing is a good time to plan and enjoy a trip to a far off destination.