Hartford Doctors

What Procedure Do You Recommend to Repair the Bicep Area After an Accident? (photo)

I was riding my bike to work when a girl opened her passenger door and it slammed into my bicep. I now have a scar, 3 puckered spots around my bicep and a bulge on my upper left arm. My plastic surgeon says that my scar healed nicely. What do you recommend to repairt the puckered spots and bulge - fat or collagen? Thanks very much, Sue

Sue,

It is difficult to answer you questions without addition information, better photos, and an examination to determine the nature of the problem.  Best advice is to return to your plastic surgeion.  Things to consider are rupture of the biceps, damage to the fat (althought you look very lean), displacement of the fat due to loss of the normal connections of the fat to the underlying tissues,  and normal post injury swelling.  As long as the tendon is not ruptured or the muscle not significantly severed or crushed, then you will probably need to wait at least 3 months to allow the swelling to subside before being able to determine the degree of soft tissue injury.  If a soft tissue depression still exists and is due to fat damage or displacement of the soft tissue, then fat grafting may be of benefit.  There are many good plastic surgeons in the BC area.   

John Borkowski, MD

Hartford Plastic Surgeon

How Long to Wait Between Brazilian Butt Lift and Breast Lift?

I want to get a brazilian butt lift and a breast lift w/ augmentation. I want to perform both surgeries together but I know that will be painful. How long is the waiting period to perform both surgeries. Which surgery do I perform 1st? How long is the recovery period for each surgery. I have a flat booty and wish for a butt, not a nicki minaj butt but a nice butt for my body. No less than 800 cc,s due to the fact that I.m 5'9. My bra size is currently A bt want a C.

Stage the procedures. 

First the augmentation/lift.  The amount of work involved and the length of the breast incisions are related to the degree of droop and the volume of the augmentaion.  This procedure can put stress on the incisions.  Therefore, the last thing you want to do is sleep on them for 14 days while the buttocks heal. 

Regarding the BBL, as mentioned above, if you are going to now sleep on your back to protect the breast surgery, you risk damageing the fat grafts.  Regarding the volume, you mention that your buttocks are flat and that you would like 800cc.  Fat has to be injected in relatively thin columns separated by healthy tissue in order for the fat cells to survive.  Blobs of fat become lumpy and don't survive.  If you are flat you may require more than one fat grafting session to achieve the desired result, assuming you have enough fat elsewhere for grafting. 

Timing between procedure, minimum 2 weeks, 6 weeks or more is better.

John Borkowski, MD

Hartford Plastic Surgeon

What is the Best Method/technique of Fat Harvesting and Injecting?

1)What is the best method/technique of fat harvesting in which the cells survival is the most? 2)Is the injecting technique/method as important as the fat harvesting part? If yes, tell me about the best injecting technique/method also. Thanks, Best Regards

• The technical aspects of harvesting and transferring are equally important
• The best harvesting techniques involve low vacuum so as not to disrupt the fat cellsand  2mm - 3mm cannulas
• There is no consistent data to prove that adding substances such as platelet rich plasma or growth factors improves the results.  The same can be said for centrifugation, separating fatty layers, stem cells, washing the fat, etc.  To date, the less you do to the fat from aspiration to injection, the better the survival
• Injection techniques utilize14g to 18g cannulas, injecting thin columns of fat separated by tissue with a good blood supply.  Large blobs of fat don't survive. Therefore, if an area requires significant augmentation and the tissues are thin, several sessions of grafting may be required.

I hope this answers some of your concerns. 

John Borkowski, MD

Hartford Plastic Surgeon