When Cronin attended a plastic surgery meeting, one of his colleagues told him about a new company which had a new product that can be made into solid and liquid form, with a variety of viscosity.  Another great thing about the device was the extreme compatibility with the human tissue.

The medical-grade silicone can be turned into a solid form which will serve as the shell, while the cohesive silicone gel will act as the filling.  This material then paved way for the invention of silicone-filled breast implant, one of the most commonly used devices in cosmetic plastic surgery to date.

After creating the first prototype of silicone breast implant, the device was implanted into a dog.  The trial worked okay and so Cronin and his colleagues started to look for a woman who would be interested to have the first breast augmentation surgery through the new device.

The plastic surgeons found a willing test subject: Timmy Lindsey.  Now she is 80 years old and working in a care home in Texas.

At the time, no one would have ever imagined that breast augmentation surgery would become one of the most popular cosmetic surgeries worldwide.  In fact, a 2010 survey conducted by the American Society of Plastic Surgeons showed that 296,000 procedures were performed in the US.

It has been estimated that 5 to 10 million women worldwide had breast augmentation surgery for cosmetic reasons, although a significant number also had it to reconstruct their breasts after mastectomy (or cancer surgery), and for transsexual people to transition from male to female.

While breast augmentation is popular in the US and UK, this is not the case in some countries which have their own standard of beauty.  For example, the procedure is not as popular in Brazil because most people there prefer large buttocks rather than big breasts.

Today, most women who seek for cosmetic breast augmentation are categorized into two groups: those with small breasts who want to increase their bust size, and those mothers who have deflated-looking bosoms which are caused by childbirth.

In the US and most European countries, breast augmentation for cosmetic reasons can only be conducted for patients aged 18 years and older.

However, a recent study has proven what plastic surgeons have always been telling their patients: nose jobs, if correctly performed on the right candidates, can result to a more youthful appearance.

In a study conducted by the researchers from the University of Toronto, young and middle-aged patients on average looked 1.5 years younger after rhinoplasty surgery.

The study, which is published in the January-February issue of Archives of Facial and Plastic Surgery, suggests that patients will achieve a more youthful appearance—whatever their age—after their nose jobs.

“The age of the patients at the time of surgery had only a small effect on the age reduction,” according to the report, which involved 53 individuals who had nose surgery; their pictures were taken prior to the procedure and one year afterward.

The pre- and post-surgical photos—which were taken at the same angle, lighting, and camera—were examined by 50 “untrained” lay observers in two sessions.  Half of the respondents were asked to first look at the pre-operative pictures before the “after” photos; the remaining half examined the images in the reverse order.

Each respondent was asked to guess the patients’ age from the paired frontal and lateral images.

Meanwhile, the age of patients at the time of their surgery was between 15 and 61, with a mean of 35.  Most of them were from the 20-30 age bracket, with about three-quarters were women.

As people reach the age of late 30s or early 40s, it is not uncommon to experience visible changes in the nose especially with its tip drooping.  Also, the skin thickens around the nostrils as the nasal tip becomes elongated because of the aging and pull of gravity, resulting to an unpleasant appearance.

Aside from making the face look older, age-related changes in the nose may also lead to breathing difficulties particularly if the drooping tip is severe.  To correct this problem, most plastic surgeons will manipulate the flexible nasal tissue, or graft cartilage behind the ear and then transfer it to the nose.

Grafting cartilage behind the ears, which is to be transferred to the nose, does not affect the organ’s appearance or hearing of a patient.

Perhaps one of the growing trends in plastic surgery is the minimally invasive facelift, which is ideal for patients aged between 35 and 45 who have “isolated” sagging and wrinkles.  The procedure—which is usually conducted under local anesthesia and is combined with laser treatment to tighten skin and other minor surgeries—allows older people to postpone a more invasive facial rejuvenation surgery.

The good thing about mini facelift is the shorter recovery period; in fact, patients can resume most of their normal activities just four to five days after the surgery.

Another new breakthrough and growing trend is the use of a very fine tube that allows plastic surgeons to conduct lip augmentation and soft tissue filler for the aging face with little to no downtime and less bruising.  And because of the device’s precision, it would be easier to achieve the best results possible.

During the previous years, breast augmentation, more often than not, was performed as a way to achieve the “larger than life look.”  But nowadays, plastic surgeons have noticed that a growing number of women choose smaller breast implants and previous patients who are asking to downsize their implants.

Experts believe that most women nowadays seek the natural appearance rather than the “heavy” top look.  In fact, this growing trend can be seen in the way Hollywood celebrities make their decision; for instance, Kate Hudson has chosen small breast implants in 2010 that no one would even know she had surgery if not for her previous pictures.

As with the previous years, breast augmentation will still remain one of the most sought-after procedures in 2012 especially with the introduction of a new 3D technology called Vectra, which allows the patients to visualize the final result of the procedure.

The good thing about Vectra is that it can also be applied to a wide range of cosmetic plastic surgery including rhinoplasty (“nose job”), liposuction, and body contouring surgeries.

But still, stem cell is seen as the most promising development in cosmetic and reconstructive plastic surgery.  While the potential of this type of cell has not been fully harnessed, scientists and plastic surgeons are expected to further focus their attention on how to make the technology work more effectively and safer to their patients.

Fleur-de-lis tummy tuck is ideal for massive weight loss patients whose pannus may even reach their pubic area, resulting to foul odor, poor hygiene, back pain, limited physical movement, and skin irritation because the flap of tissue is trapping moisture and sweat.

While the traditional tummy tuck’s horizontal incision can narrow the waist, this is not enough for MWL patients who also need a vertical incision in the middle to further contour the midsection.  For this reason, the incision pattern with fleur-de-lis abdominoplasty looks like an inverted T.

The procedure is designed to remove more amounts of excess skin and fats and narrow the midsection.  It can also reduce and lift the outer thighs and to some extent the inner area, abdomen, and buttocks.

Because the technique involves the extensive use of incision, the ideal candidates are patients who already have a vertical scar from a bypass or weight loss surgery.  Meanwhile, women are more likely to be interested with the inverted T-shaped incision pattern more than men because they often need more contouring.

The fleur-de-lis abdominoplasty is only reserved for people who need substantial amounts of hanging skin removed and a lot of lifting and tightening around the waist area.

Plastic surgeons use tummy tuck technique that requires the smallest incision possible so the scars are less noticeable and the healing time is shorter.  However, MWL patients will likely need longer excisions because of the severe body disfigurement.

In many cases, patients with moderate to severe redundant skin will need to have their navels repositioned or their plastic surgeons may even create a new one.

As with any body contouring surgery, all types of tummy tuck can provide a long-lasting result as long as the patients will maintain a stable weight for the rest of their lives.  For this reason, the surgeons also consider a person’s willingness and determination to live a healthy life and engage in regular exercises and moderate diet.

While fleur-de-lis can significantly improve the body shape and help patients fit better into their clothes, it may be difficult to achieve a “near perfect figure” because obesity has already stretched and weaken their skin.  But still, the procedure is worth it especially if the hanging skin and fats cause irritation, back pain, foul odor, and other problems.

The findings support a previous study showing that younger patients are more ideal candidates than people aged older than 50 as the latter achieve more unpredictable results, resulting to lower satisfaction rate.

The new study involved patients categorized into three groups: individuals younger than 50, between 50 and 60, and over 60 years old at the time of facelift surgery.

The findings show that patients younger than 50 with minimal signs of facial aging scored higher in terms of satisfaction after short- and long-term follow-ups.  According to the experts’ analysis, these people have “remarkable maintenance of their youthful appearance” years after their facelift.

By contrast, patients aged 60 and above have reported “significant changes caused by facial aging.”  While the report has shown that they looked younger than the “untreated” people of the same age, they manifested more signs of “regression” in the five facial areas that were graded by plastic surgeons.

In general, the patients’ satisfaction ratings were consistent with the analysis of experts when they reviewed the before-and-after photographs.

The experts graded the satisfaction rate of the patients using a 5-point scale (with 5 being the most satisfied).  Most individuals from the 50 and below age group rated all their facial areas with 4 and 5, while the 50-60 rated themselves with scores between 2 and 5.

The patients over 60 rated their facial areas with lower scores of 2 and 3.

While the number of patients in the new survey was relatively small, the researchers believe their findings were consistent with previous studies showing that individuals 50 years and younger are more likely to achieve longer-lasting results with “less noticeable postoperative changes.”

The researchers have discovered that after an “equal number of years elapsed, the facial aging of patients from 40 to 50 age group was less dramatic than the individuals aged 50 to 60 years old.”

According to the findings, younger patients are also ideal to have less invasive facelift techniques in order “to buy time” or postpone an extensive facial rejuvenation surgery.

Less invasive facelift techniques are ideal for younger patients and individuals who need “maintenance procedures” to correct the facial aging.  All forms of facial rejuvenation surgery, while able to remove five to 15 years off from one’s face, do not stop the natural aging process.

FAQs About the Keller Funnel Breast Augmentation Technique:

1. Question:  What is the device used during the Keller Funnel technique?

Answer:  It uses a cone-shaped, disposable device that allows the surgeons to introduce the breast implants into the breast pocket without having to touch them, thus significantly reducing the risk of contamination.

The Keller Funnel is made of nylon with its interior covered with hydrophilic coating, which becomes more slippery when submerged in saline or anti-bacterial solutions.

2.  Q:  Can it lower the risk of capsular contracture?

A:  The risk of capsular contracture—which happens when the scar tissue around the breast implant contracts and squeezes the device, leading to pain and visible distortion—can be minimized because the Keller Funnel prevents contamination.

3.  Q:  How is the Keller Funnel performed?

A:  The cone-shaped nylon pouch and breast implants are both submerged in saline or sterile solution immediately before the implantation of the devices.

During implantation, the nurse will place the breast implants inside the Keller Funnel pouch, which is held by the surgeon who will then squeeze it so the implants can be inserted into the breast pocket.

4.  Q:  Why is it the Keller Funnel pouch only used once?

A:  The device is designed to be disposable.  Also, there is no data showing that it can function effectively after the sterilization and whether the process could compromise the integrity of the pouch.

5.  Q:  What are the other benefits of Keller Funnel aside from reducing the risk of contamination?

A:  The breast augmentation technique can reduce the force applied on the implants by approximately 95 percent; for this reason, the shell’s durability will not be compromised and the risk of premature implant rupture can be significantly minimized.

And because it uses shorter incisions, the scars will be less noticeable compared with the finger-push technique’s.

6.  Q:  What are the types of implants applicable to the Keller Funnel technique?

A:  Smooth and textured silicone implants up to 800cc can be inserted into the breast pocket using this technique.  However, textured implants require a slightly more force than the smooth versions.

Meanwhile, the Keller Funnel pouch has been successfully used in pectoral and butt implant surgery.

7.  Q:  Will the technique results to shorter operating time?

A:  Yes, a recent survey shows that approximately half of plastic surgeons who use Keller Funnel said the technique reduces the operating time by 10 to 20 minutes.

8.  Q:  What is the other name for Keller Funnel?

A:  Some doctors also call this as no-touch technique.

As people age, they lose a significant amount of fats in their face that leads to a tired, old appearance.  During the previous years, the loss of facial volume was only treated with soft-tissue fillers which are relatively safe, although some patients may develop allergic reaction.

Meanwhile, this is not a concern in using fat transfer since no synthetic material is introduced in the body.  For this reason, many patients are choosing this treatment over alternative fat injections such as Radiesse, Juvederm, Restylane, and Sculptra.

However, fat transfer is not just about collecting fatty tissues and then transferring these to another body part.  To increase the survival rate of the fats, plastic surgeons perform purification method in which they separate and remove the blood, tissues, and other impurities.

By employing the proper purification treatment, doctors can increase the survival rate of the fats to 65 to 85 percent which means the result can be long lasting (or even permanent) and also noticeable.

After removing the impurities, the fats are injected to a new area at a varying level in order to encourage better absorption and achieve a more symmetrical and natural appearance.

The good thing about this procedure is that patients enjoy two benefits: they can remove the excess fats from their abdomen and areas where these accumulate, and they can augment the parts which need to be more prominent such as the buttocks, cheeks, and breasts.

For treating larger areas such as buttocks and breasts, patients should have enough fats especially in their abdomen to achieve a drastic change in size.  With this consideration, thin or petite individuals may not have the same noticeable result compared to those with a good amount of fatty tissues in their body.

In case that fat transfer is not ideal or even impossible to perform, patients may choose biocompatible implants to augment and/or improve their breasts, buttocks, chest, cheeks, calves, and other deflated-looking areas which are supposed to be prominent.

Perhaps the most notable development is the tumescent liposuction which has allowed plastic surgeons to perform fat removal completely under local anesthesia.  This is not the case during the previous years when the procedure was conducted under general anesthesia or heavy intravenous sedation which may expose patients to higher risk of complications.

The tumescent liposuction uses a mixture of drug which is injected to the fatty areas to make these more dense, thus easier to be dislodged and suctioned out from the body with very little trauma on the surrounding tissue.  For this reason, patients nowadays can expect faster recovery, minimal or almost no bleeding, and less post-operative pain and discomfort.

Aside from minimizing the surgical trauma, the tumescent fluid has also made it possible to use a smaller cannula or stainless steel tube for suctioning the fats out.  With an outside diameter of less than 2mm, this instrument can easily fit into tiny, round incisions which can completely heal for as short as two weeks without forming any visible scar.

To further improve the fat suctioning process, plastic surgeons complement the tumescent liposuction with power-assisted technique in which they use a motorized cannula that can effectively dislodge the fats by producing, tiny accurate vibrations.  With this new design, doctors can eliminate 25 to 30 percent more fatty deposits than manually pushing the tube back and forth which may injure the surrounding tissue.

In addition, power-assisted liposuction can make the procedure safer since it shortens the surgical time, reduces bleeding and trauma, gives doctors more precision, and paves way for a faster recovery.

Because this liposuction technique allows more precision, this is highly ideal in treating fibrous fats that are notoriously difficult to remove.  These are usually found in the male breasts, back area particularly the bra line, inner thighs, and around the navel.

As with any fat removal technique, power-assisted liposuction involves risks such as irregularities in the skin due to disproportionate collection of fats, unsightly pigmentation in the incisions (although this usually fades over time), and seroma or the accumulation of excess fluids under the skin.

However, patients can significantly reduce such risks by only consulting with board-certified plastic surgeons who have been practicing liposuction surgery for at least five years.

In 2006, the US Food and Drug Administration has approved SmartLipo as an effective and relatively safe fat removal treatment for healthy patients who are near their ideal weight.  It is important to note that while this procedure removes the excess fats, this should not be seen as a substitute to regular exercise, healthy diet, or weight loss surgery.

In many cases, this procedure starts by injecting tumescent solution combined with local anesthesia directly to the fatty area in order to make this firmer and swollen, thus making the suctioning process less traumatic to the surrounding tissue.  In this way, plastic surgeons can also significantly minimize bleeding and shorten the operating time.

Once the tumescent solution reaches the fatty areas, doctors will create several small incisions where they can insert a cannula or fat-suctioning probe attached with a laser fiber.  This instrument then liquefies and drains the fat cells with minimal effect on the tissue.  With this, patients can expect less pain, bleeding, and bruising.

Another advantage of this treatment is that it uses smaller instruments to further reduce the risk of visible scarring.  For instance, the SmartLipo cannula only has a diameter of 1mm unlike the one used in a typical fat removal treatment which has a thickness of 3 to 6mm.

Aside from eliminating the excess fats, SmartLipo is also noted for its tightening effect on the skin by promoting the growth of collagen which is the main protein found in the tissue.  But despite this advantage, this plastic surgery procedure does not guarantee to remove or improve the appearance of cellulites.

In treating small pockets of fats in the chin, neck, male breasts, upper arms, and abdomen, many plastic surgeons recommend this procedure.

As with any cosmetic plastic surgery, SmartLipo involves certain risks such as skin discoloration and burns.  To avoid these complications, some doctors are using an infrared thermometer to make sure that the temperature in the skin will not get too high during the procedure.

Because of psychological and emotional health consideration, not everyone is a good candidate for this procedure especially if performed for cosmetic reasons.  According to experts in cosmetic plastic surgery, experienced doctors can identity “troubled” patients during the consultation period and will most likely decline to operate on these people.

Meanwhile, these are the types of patients who are considered as a bad candidate for cosmetic plastic surgery:

• Patients with unattainable, unrealistic expectations and goals with the surgery.  There are some people who seek the procedure in order to look like a certain celebrity or achieve perfection; these goals are usually impossible to achieve.

Because the goals and expectations of patients can have a significant impact on their chance of being satisfied, it has become a standard in plastic surgery to conduct extensive interview and consultation before proceeding with any cosmetic procedure.

• People experiencing an emotional crisis.  Unemployment, separation or divorce, or death of a loved one can make anyone feel sad and alone.  However, qualified plastic surgeons believe that any cosmetic procedure should not be treated as a solution or a way to fill the emotional void, instead, patients should first work through the crisis before considering this procedure.

• Individuals suffering from mental illness.  Those who have clinical depression, schizophrenia, paranoia, and other related disorders are generally considered as poor candidates.

But in some cases, plastic surgeons allow these patients to have a cosmetic procedure as long as their goals are not related to their neurosis.  Just to be on the safe side, they usually work closely with the psychiatrists or recommend these people to undergo counseling before the surgery.

• Patients with body dysmorphic disorder.  BDD is a condition in which a person is excessively concerned and preoccupied by a perceived aesthetic defect (real or imaginary) that he or she suffers from psychological distress and fail to function well in a society.

According to aesthetic plastic surgery specialists, these people have the tendency to be addicted with cosmetic procedures because they are usually not satisfied with the result.

People with BDD are also impossible to please because their main problem is not really about the physical flaws but rather emotional and psychological issue.