Q & A with Michael Giuffrida Plastic Surgeon

Why is Body Sculpting your chosen niche? 

The words Plastic Surgery stems from the Greek word plastikos meaning “to mold” or “to form”. I knew I wanted to be a plastic surgeon when I was 13. I was inspired by the story of an European plastic surgeon who came from an entire family of artists, painters, sculptures.  She described her passion to mold and shape the body. Years later I learned during training and in practice most plastic surgeons dislike liposuction. For various reasons:  “too much work”, it’s not a “sexy procedure” like a facelift or breast enhancement. I found the reason is because it is easy to remove fat, very challenging to create pleasing shape and form with liposuction.   Unlike other aesthetic procedures which I mastered rapidly, it took me years to do so with liposuction. There are so many variables:  the male and female form are quite different and often patients are seeking different shapes.  Skin elasticity, redundancy, age, physiologic health and well-being all play a part in the result. The architecture of the skin, meaning the thicknesses and resiliency of the skin in various body regions and extremities behaves differently and not always predictable. I learn something new from each liposuction I perform but strive for perfect form and shape given the starting point, the “canvas” and patient desires. It’s a wonderful process.

Who is your favorite Candidate/body type for Body Sculpting?

I love performing liposuction on all body types, weights,, shapes.  What’s really fun is when someone feels they have “no buttock” and I share with the patient it is because of maldistribution of fat in the torso or thighs “hiding” their great buttock. I can create a round and shapely buttock by removing unwanted fat in surrounding areas. Having said that I get more predictable results with patients who have great skin tone, that is a treat for me as a surgeon as the skin will tend to contract and lay down smoothly during the healing process. Yet most patients I see and perform liposuction on have inelastic skin and often with stretch marks.  As long as the patient is not a smoker, has no significant health problems to disallow a surgical procedure, most patients can have liposuction and have improvement of size and shape.  The smoothness of the skin remains the greatest challenge due to the pre-surgical condition of the skin when they get to my office.  Liposuction can sometimes improve the appearance and tightness of the skin with careful planning and surgical technique.  Not guaranteed though.

Who should stay away from Liposuction?

Patients who are gaining weight consistently, smokers, stress from life and work, patients with major life events like death and divorce or job loss. Those are the biggies.

Why is the Brazilian Butt-lift with fat transfer not just a trend but rather here to stay? 

Fat transfer to the face and body has been a procedure around for decades in plastic surgery.  It is only getting more popular and common.  The challenge is in the safety which may limit its use.  Only board certified plastic surgeons trained in a residency certified by the American Board of Medical Specialists should  be doing liposuction.  

How much actual fat do you need for Brazilian Butt-lift?

Example? I tell all my consults who come in for a BBL that at least “half” of the operation is removing the surrounding fat from unwanted torso and hip/thigh areas. That in and of itself creates shape and form and a round perky buttock.  The amount of fat not much so as much of the fat transferred either is resorbed or turns into scar tissue which is important.  Studies have shown only very thin strands/pearls of fat surrounded by well vascularized tissue survive fat transfer.  So transferring liters of fat does not increase fat survival or results. It’s all in the shaping beforehand.

Is there a body type the Brazilian Butt-lift is perfect for?

Ideally it’s for a person who has 25 plus pounds of well distributed fat in the torso and hip/thigh region with good elasticity.

What types of cases of liposuction can be done awake?

All liposuction procedures can be done awake.  The limiting factor is the amount of areas due to the amount of lidocaine required to numb any given area.  It a patients has too many areas to perform all safely, the liposuction can simply be broken up into multiple surgeries performed at least 2-3 weeks apart at a minimum.  Longer preferred. 

What types of cases do you insist on patients being completely asleep?  Procedures that are long:  it is very difficult for anyone even the calmest person to sit still for hours and hours.  More commonly, it is a patient having multiple areas of liposuction all done at the same time or combining liposuction with other face and body procedures.  Not possible to do awake.

Does the recovery time from liposuction vary in procedure location, age or whether or not the patient was put under?

I’d say in my experience the greatest factor that affects recovery time is patient motivation and physiologic health.  Patients who are motivated to get back to work and patients that are motivated to exercise, eat well and reduce stress exceed all expectations usually.

What do patients say about their results?

Patients love the results of liposuction. Disconnects happen when expectations are not set and received. In my experience patients are shocked how quickly they can returns back to work and normal activities.

Is it really true that if you can grab and pinch it, it can be removed with liposuction?

In a word “yes”. Even loose lax skin has some fat.  The challenge with lax skin is causing more irregularities so those consults take extra- long and often I do not recommend liposuction on these patients as they often want to lose weight or are expecting dramatic changes. Patient selection makes all the difference.

Will patients need more than one treatment? 

Usually not if expectations set correctly.  Having said that, sometimes patients do need to be debunked in any given area of unwanted fat and need to come back in 12-18 months to get shape.

Fact or Fiction?

Does fat then get transferred to another area once its removed from an area?

As long as a patient’s body weight remains stable within 5-10 pounds it does not.  If patients gain a great deal of weight they will notice fat showing up asymmetrically in the surgical area and in overall gross amount in un-suctioned areas.

 

Author
Michael Giuffrida MD Michael Giuffrida is a Plastic Surgeon and is part of the Turner Medical Arts team.

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