The annual meeting of the American Society of Aesthetic Plastic Surgery was held in New York this year and ended today. This is a showcase meeting in which new procedures are introduced, the latest technologies are examined, and controversies are addressed.
One theme I saw at the meeting was a very aggressive approach to body contouring, particularly of the abdomen, flanks, and back during a single surgery. Many of us were trained, for example, never to liposuction the upper abdomen during a tummy tuck, because it may lead to poor healing and scarring. There are a growing number of surgeons, however, challenging this concept and very aggressively doing liposuction circumferentially around the trunk at the same time as a tummy tuck. Although not a new trend, surgeons continue to combine multiple procedures during body contouring after massive weight loss (brachioplasty, abdominoplasty, breast lift) with good success. The lipoabdominopasty developed in South America continues to be an intriguing way to create major improvements in the abdomen and waist. This procedure involves more liposuction of the tummy and sides and less undermining of the skin during a tummy tuck. It is interesting when one considers the differences in aesthetic "ideals" in South America and the United States.
There is great interest in stem cells and their role in fat transfer, breast enhancement, and reconstructive surgery. New ways to isolate these stem cells and allow their use in cosmetic surgery are being developed. Fat transfer as a means of breast augmentation and reconstruction is being successfully performed to create modest improvements in breast size and shape. As an adjunct to breast reconstruction, fat transfer can help to smooth out surface irregularities and treat very thin tissues overlying implants. Fat as a filler in facial procedures (facelift, eyelids) seems to also get more and more popular.
Laser and other energy-based treatments for facial skin problems continue to be advanced and developed. A laser attached to a wire that is placed under the skin is being investigated to see if significant skin tightening can be achieved and how long the results last. Cool sculpting is a novel technique in which fat is cooled and gradually over weeks dissolves under the skin without down-time or surgery.
Allergan recently introduced a shaped, highly cohesive gel breast implant that is receiving much attention in the press. Appropriate patient selection is a key to success with this breast implant.
Safety is always a major part of the Aesthetic meeting and is incorporated into many of the lectures.