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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.

Facelift Surgery, Achieving a Nice Jawline

February 14th, 2014 Miguel A. Delgado Jr, MD

San Francisco, California-As evidenced by the many different results of facelifts, also known as rhytidectomy, the skill of the surgeon is critical. Beyond ascertaining that the surgeon of choice is Board Certified in Plastic Surgery, you want to know the surgeon’s experience and techniques for facelift surgery.

As a layperson, it can be difficult to know what you are looking for. Observing the surgeons before and after pictures, in many cases, will reveal the quality of work. Arming yourself with good questions can help you determine the level of skill. In addition to asking if the surgeon tightens the underlying muscle (SMAS), uses fat injections in areas that may need volume, ask the surgeon if the effect of the buccal fat pad is taken into consideration in surgical planning. The herniated buccal fat pad is one of the most common missed causes of the jowl. The jowl or jawline is one of the most bothersome areas of the aging face.

Before and After Facelift

This is a 54-year-old, male resident of San Francisco who presented to the San Francisco office at Union Square, California for evaluation of his aging face. He underwent an eyebrow lift and lower lid eyelid lift with a lower facelift. He had buccal fat excision, or cheek fat excision, of his cheeks and he also had 7 cc of fat injected into his right and left upper cheek. He underwent a prejowl chin implant.The lower facelift included a SMASectomy excision, which is excision of the deep tissue to thin his face as opposed to a SMAS plication, which would give more volume to his face. He had liposuction in the jowl region and a complete platysma transection in his neck. He had the eyebrow lift with 11-millimeter elevation bilaterally. His procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the herniated cheek fat that has caused a significant fullness in the jowl location.

The buccal fat pad is an area of fat located just below the cheekbone area, in the mid face. It can be as large as a golf ball or as small as a grape. Fluctuations in weight will cause a change in volume. The effects of aging may also cause the size to reduce. If the buccal fat pad descends or herniates inferiorly, it will add to the size of the jowl. If it is not removed during a facelift, the jowl will only be partially corrected.

It takes an experienced cosmetic plastic surgeon to diagnose and recognize the herniated fat pad in order to get the best result for the jawline.

Removal of the fat pad is most often done from the inside of the mouth. Sometimes during the facelift procedure it may be removed from the outside when the SMAS layer is exposed, however, this can be a little riskier due to the facial nerves in the area.

Right Buccal Fat Pad being removed

Right Buccal Fat Pad being removed

 

Today more  men are seeking cosmetic procedures than ever before, along with facelifts, popular procedures for men are: liposuction, gynecomastia (male breast reduction) and rhinoplasty (nose reshaping).

Dr. Delgado is a highly experienced top cosmetic plastic surgeon who has been in practice since 1988, performing the most up to date facelift procedures. Serving the greater San Francisco Bay area, including Sacramento, San Jose, and Los Angeles. Call or email today for a phone or virtual consultation at (415) 898-4161.

“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.

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!”

How Long Will a Facelift Last?

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

This is a 60-year-old female who presented for evaluation for a facelift. She had undergone a lower facelift, including the neck, upper and lower eyelid lift and an endoscopic brow lift.

 

A popular question with Marin County patients is, “How long will a facelift last?”  A facelift, technically called a rhytidectomy, won’t last forever but it will have lasting results. You will always look younger than if you did not have one, but the aging process is ongoing.

There are several factors that contribute to how long a face lift lasts, some in your control others that are not. Genetics and skin quality are important factors, but the experience of the surgeon and the technique used plays the biggest factor.

The lifestyle lift, thread lift or mini facelift last the least amount of time with the most disappointing long term results. A modern facelift including a neck lift using a SMAS advancement and plication will last the longest, usually 8 to 10 years.

Patients who take care of their skin by; using good skin care products, avoid the sun as much as possible, and use good sun screen protection, do not smoke, and keep a stable weight, are able to prolong the great results of their facelift surgery.  Many San Francisco Bay Area patients opt to have a chemical peel and/or fat injections at the time of their facelift surgery at Marin Cosmetic Surgery Center, which helps  extend their results.

At the time of a consultation with Dr. Delgado at 450 Sutter Street San Francisco, or 165 Rowland Way, Novato in Marin County, you will learn what results you can expect from your facelift surgery.

Alternative to Botox…Corrugator Muscle Excision With Brow Lift

February 28th, 2013 Miguel A. Delgado Jr, MD

 

Before and After Brow lift, eye lift and corrugator release

 

 

Botox has been used for treatment of the glabellar frown lines since 1992. The glabellar frown lines are the moderate to severe frown lines between the eyebrows. Marin County patients have asked if there is a more permanent treatment available other than repeated Botox treatments every 3 to 4 months or for some 6 to 8 months. The answer is yes, the corrugator muscle excision. The corrugator muscle excision can be done in conjunction with a brow lift or upper eyelid lift.

The corrugator muscles are used frequently when we laugh, frown, squint, concentrate, and show surprise or anger, causing the skin and tissue to wrinkle and stretch. Botox temporally weakens or relaxes the muscle allowing the frown lines to disappear. If the corrugator muscle is surgically removed, Botox injections will no longer be needed.

San Francisco Bay Area patients may be interested in discussing the corrugator muscle excision with Dr. Delgado at the time of their consultation for any cosmetic facial procedures.

Facelift Scar in Front of the Ear Versus Inside the Tragus

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

 

External Ear

The best placement for rhytidectomy or facelift incisions is unique to each San Francisco Bay Area patient depending on facial anatomy, hairline and gender.

This is an important topic for the surgeon to discuss with the face lift patient as the goal is to have the resulting scars as invisible as possible. Sonoma, Napa and Marin women say they want to be able to wear their hair in any style.

Careful placement of the incisions by the cosmetic plastic surgeon are generally around the back of the ear in the natural folds, and inside the tragus which allows the scars to be hidden.  The little cartilage in front of the ear that covers the ear canal is called the tragus. Tension on the sutures needs to be avoided so that the result is not a “pulled” look and so that the scar can heal properly without becoming wide.

Men usually have their incision in front of the ear so as not to bring the beard in the ear but laser hair removal can take care of this.In addition to having well hidden scars, the surgeon’s goal in having a natural result is also to keep from distorting the hairline and the ears.

Lifestyle Lift Controversy

December 29th, 2012 Miguel A. Delgado Jr, MD

Due to the massive advertising on television for the Lifestyle Lift (LSL), many San Francisco Bay Area women ask what it is and how is it different than the traditional facelift.

Even though, it is advertised as something new and unique, it is not. It is basically a mini-facelift that has been around since the 1960’s. The mini facelift is for the patient with simple facial laxity. It is not for the patient with large amounts of loose skin and fat.

The aggressive marketing practices target women that are looking for a less expensive solution for their aging face than the traditional face lift procedure. Lifestyle lift claims that the procedure can be done in an hour, pain free, under local anesthesia, and it is possible to go back to work the next day. Some patients have been pleased with their results, but many are not.

Do your homework, Google “lifestyle lift controversy” and see for yourself.  CBS 46, an Atlanta TV station, did a 3 month investigation; the results can be viewed in a 9 part video on You Tube, which shows interviews with former employees and patients. Some former employees stated they had quotas to meet and were pressured to “close the deal” no matter what. They also were to wear white lab coats even though they had no medical training.  CBS 46 points out that many companies that have reported unhappy patients have been sued, including CBS 46. Evidently LSL is quick to sue to try to silence their critics including WebMD. Cases have either been settled or dismissed by the judge. LSL reached a settlement with New York State over claims that LSL had posted false customer endorsements on third party websites including realself.com.

Most of the surgeons performing the surgery are not board certified plastic surgeons; in fact many are not even plastic surgeons but osteopath doctors.

Is Weight Loss Before or After a Face lift Bad?

November 25th, 2012 Miguel A. Delgado Jr, MD

Before and After Facelift

Some patients have asked Dr. Miguel Delgado during  consultation at 450 Sutter Street, Suite 2433, San Francisco if it is a good idea in preparing for facelift surgery to lose weight. When you gain or lose weight, your face can change dramatically. It is good to be close to your ideal weight prior to surgery, a weight you are comfortable with and that you can maintain.
If prior to a rhytidectomy (face lift) you were to lose a substantial amount of weight, you may end up with a loss of volume in the face that can make you look sick or gaunt. During a face lift procedure, loose skin is tightened, but in some cases it may be recommended to have facial fillers or fat transfers to restore volume giving a more youthful appearance.
After a facelift if one loses 10 to 15 pounds, it probably won’t make much difference to the face, but if you were to lose 20 pounds or more you may end up with loose skin as the volume decreases. Patients are encouraged to speak directly to Dr. Delgado at (415) 898-4161 for any concerns they may have regarding facial rejuvenation.

Which Face Lift Technique is Better, SMAS Plication or SMASectomy?

August 27th, 2012 Miguel A. Delgado Jr, MD

 

SMASectomy

SMAS is an acronym for superficial muscular aponeurotic system. SMAS is the muscular system of the face that is manipulated during a facelift or rhytidectomy.

There are two popular SMAS procedures, the SMAS plication and the SMASectomy. Plication means to fold and ectomy means to cut. San Francisco Bay Area facelift patients ask, “Which procedure is best for me?”

The SMAS plication is where the SMAS is folded over onto itself and sutured in place giving extra strength, fullness and definition to the face which many patients lose with aging. For the patient that extra fullness is not warranted, the SMASectomy would be performed where the SMAS is cut, a strip removed, lifted and sutured back to itself to prevent additional volume and may thin the face somewhat.

Each patient is unique; it takes a well trained Board Certified Plastic Surgeon with a critical, aesthetic eye to determine the best procedure for optimal results.