Fat transfer and breast lifts: Are multiple procedures more or less costly when done in the same surgical setting?

Question

What is the differenc between plastic surgery and cosmetic surgery? Is it possible to loose to much weight where there is. It enough fat to harvest for other procedures? What are the pros/cons of fat transfers? Since it is fat can the transfer sight get lumpy or hard? Is there sensory loss on a breast lift &bbl? Does a bbl require upkeep? What is the difference between abdomnioplasty and a full circumferencial tuck?

Dallas Buchanan, MD · Answer

This is a long list of questions that do not seem to be related to one another, so I am not sure what your goal is. I would suggest you offer more information about yourself and your goals and try to limit the information you are trying to obtain. This can help us to give you answers that will help you rather than generic answers.

Ron Soltero, MD, FACS · Answer

dear patient: a Plastic Surgeon is Board Certified by the American Society for Plastic Surgeons (ASPS) which is the most prestigious board for a Surgeon to have which performs multiple or more challenging plastic surgery procedures.
A Cosmetic surgeon has no federally recognized board.  Any doctor without any aesthetic training could claim to be a Cosmetic Surgeon.
Hope this is a clear explanation for choosing your surgeon.
Regarding Fat Transfer, if you dont have enough fat in one area of your body (usually we harvest from the abdomen or flanks) your Board Certified Plastic Surgeon should be able to graft Fat from other parts like upper arms, Bra-Strap, thighs, back, inner thighs etc. That should be enough to Transfer to your Buttocks area.  
Usually there is no sensory loss after Fat Transfer to your breasts or Buttocks, you might experience some numbness, soreness and discomfort post op during the first weeks but that should most probably dissapear within the following months.  An experienced Board Certified Plastic Surgeon should Graft, process and inject the desired Fat in the Buttocks or Breast areas and should over inject since anywhere from 20 to 50 percent of the Fat will be reabsorbed by your own body.
Difference between a Tummy Tuck and a Circumferencial Tummy Tuck is the scar you will end up and the type of procedure and results you will be getting.  Usually a Tummy Tuck would include the tightening of your abdominal muscles, excission of your excess abdominal skin, and this resulting in a scar that is normally placed lower and from side to side Of your bikini line area, which should be covered by your underwear.
The Circumferential Tummy tuck involves a longer more invasive procedure, where the Tummy Tuck is performed (tightening of your abdominal muscles+ excission of skin ) and the Board Certified Plastic Surgeon will continue the excission of skin on the back, in this way giving you a scar that mimmks a belt, all around your lower front area and then going around your lower back area.  Usually the Circumferential Tummy Tuck would be performed on patients that have gone through heavy weight loss and have excess hanging skin that is detrimental to their lifestyle.
Hope all of this information helps!!!!

Jason Emer, MD · Answer

These can all be done together and are typically better to do in a single setting to save money.  Best, Dr. Emer.

Kenneth Sumida, MD · Answer

You have a lot of good questions.    You should interview a few of your local experts for your answers.

Mats Hagstrom, MD (license on probation) · Answer

Plastic surgery is a very diverse surgical specialty.
It is one of the most link the training programs of any medical specialty with a minimum of 10 years of medical training.
Within the scope of plastic surgery is cosmetic surgery.
Cosmetic surgery is generally procedures not medically necessary for the aesthetic enhancement of the patient.
All plastic surgeons have extensive experience with cosmetic surgery during their training.
With very few exceptions only plastic surgeons are formally trained in cosmetic surgical procedures.
Ear nose and throat doctors are trained in certain facial aesthetic procedures. And can undergo separate facial cosmetic surgery fellowships.
Some dermatologist or exposed to limited liposuction but only done as office based procedures.
Ophthalmologist can also undergo oculoplastic fellowships giving formal recognize the training in aesthetic procedures around the eyes.
Legally no Dr. has ownership or is legally limited to doing any or all medical or surgical procedures.
This means that legally the pediatrician could do liver transplant surgeries.
Most people are not aware that there are no legal limitations to the practice of medicine.
There are however major limitations in obtaining hospital privileges for performing these procedures.
No hospital would allow someone to perform major surgical procedures without having proper training and usually being board-certified.
S is such any doctor can call themselves a cosmetic surgeon.
There is no residency in cosmetic surgery.
There are fellowships and cosmetic surgery generally limited to plastic surgeons after they've completed their plastic surgery residencies.
All medical specialties that have formal resident training have associated board certifications.
All of these board certifications or medical boards are under the umbrella of the American Board of medical specialties.
The majority of these medical training programs or affiliated with university's with medical schools.
Just like no single doctor can claim ownership to any single procedure legally anyone can form an organization and call it a board.
There are a few boards made up by physicians that are not recognized by the American Board of medical specialties.
One of these boards is the American Board of cosmetic surgery.
This board is not recognized by the American Board of medical specialties since there is no residency training in cosmetic surgery alone.
You would think the majority of members of the American Board of cosmetic surgery would be plastic surgeons but this is not true.
Very few plastic surgeons belong to this organization many of the ones that do we're not able to pass their boards in plastic surgery.
The great majority of members of the American Board of cosmetic surgery are doctors various backgrounds like emergency medicine and family practice OB/GYN who want to do cosmetic surgery primarily because cosmetic surgery is by far more lucrative than performing medical procedures with insurance reimbursement.
This can be very deceptive to people unless they understand the inherent structure a medical training in the United States.
How are people supposed to know that someone who belongs to the American Board of cosmetic surgery may have no formal presidency training in any cosmetic surgical procedure.
While board certification in plastic surgery is no guarantee that someone is highly competent it does show that the doctor has gone through some of the most rigorous training in all plastic surgery procedures including cosmetic surgery. 
One of the major differences between a board certified plastic surgeon versus doctors of different specialties would choose to perform cosmetic procedures is that a plastic surgeon can offer all alternative procedures, can diagnose and manage The complications associated with these procedures.
Board-certified plastic surgeon's or eligible to have admitting privileges and operating room privileges in formal hospitals and surgery centers.
When complications happen they often need to be treated in the hospital by setting with an operating room requiring an anesthesiologist.
Doctors who cannot prove they have formal residency training in cosmetic procedures are generally never given privileges to perform these procedures in operating rooms or surgery centers unless they own their own operating room.
The majority of doctors performing cosmetic surgery whi not or certified in plastic surgery or a medical specialty with cosmetic surgery training perform these procedures in an office space setting often a non-accredited facility.
Should a complication occur from a Doctor Who cannot obtain hospital privileges then patients are often told to go to an emergency room and now has to rely on another doctor to take care of their complication.
The patient in a sense it's now abandoned by the Doctor Who performed the procedure.
While there are exceptions to my statements these represent typical scenario is often seen when doctors perform cosmetic procedures that were not taught during their residency training.
My suggestion is always see an experienced board-certified plastic surgeon when it comes to having any cosmetic surgical procedures.
The exceptions are a custom medic fellowship trained your nose and throat doctor for facial cosmetic surgery or a fellowship trained oculoplastic surgeon for cosmetic eyelid surgery.
Patients who are very thin may not have sufficient amounts of fat to undergo certain fat transfer procedures.
The topic of pros and cons of fat transfer is perhaps too complex to review on this forum.
Both liposuction and fat transfer can leave uneven contours and lumps.
The chance of this happening varies greatly upon the confidence of the doctor performing the procedure.
There can be some sensory changes from both breast lift and BBL's.
Breast lift generally do not change the presentation but they can be slight numbness of the skin of the lower part of the breast.
Most of the sensation returns but this can take several months after the procedure.
Both liposuction and a BBL can leave some loss of sensation though this generally always returns within a few months.
A BBL should not require upkeep if done correctly.
A standard abdominal plasty removes skin from the front of the abdomen.
Often muscle tightening is involved from muscle separation secondary to pregnancies.
For patients who have loose skin on not only the front of the abdomen but on the sides and back it is often better to remove skin not only from the front but the sides and back as well.
Some people refer to this procedure as a body lift.
I find a term wraparound abdominoplasty more appropriate and more descriptive.
It is generally just an extended abdominoplasty that tightens the skin on the sides and back as well.
When patients who have loose skin on their sides and back undergo a standard abdominoplasty they're off the left with loose skin on the sides referred to as "dog ears".
A good board-certified plastic surgeon can help determine how much skin should be removed to get the best results.
I hope this helps answer your questions.
Best,
Mats Hagstrom M.D.

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