Interview TV of Dr. Bergeret-Galley, Aesthetic surgeon woman from Paris.
Fat transplant with the water jet system
The forehead lift is performed with an endoscope and very fine incisions behind the hairline, the skin and the muscles are removed in depth. The periosteum is open just above the eyebrows, and when traction is applied to the forehead, the eyebrows are raised. It is also possible to change their orientation, by excising part of the facial expression muscles below the eyebrows. This will make the patient look less angry, less tired and worried. A light brow lift opens the eyes and gives a more alert look. Finally, the new positioning of the eyebrows is fixed with small screws. There is a short recovery period, and the patient can resume normal activities within about a week.
Ten years ago we used to throw away the fat that we collect during liposuction. From now on, we keep it preciously in order to inject it into the breasts or buttocks. We have a few requests from our patients to get huge buttocks, as we can see in the United States or South America. In general, women but also men want shapely buttocks, plump but not necessarily very large. However the increase in buttock volume that we can get is limited by the amount of fat available. In some cases we do not have enough fat, so we must take gluteal implants as an alternative.
Brachioplasty or arm lift is done to reduce excess skin in the upper arm. If the excess is moderate, brachioplasty is performed with a horizontal incision in the armpit. In this case, the recovery only lasts a week. If the excess skin is larger, a longitudinal incision is made inside the upper arm. In this case, the recovery lasts between 2 and 4 weeks. The procedure begins with liposuction of the affected area, then incision of the skin. The appearance of the scar can be improved with injections after the operation, as you can see in this video.
Also called a tummy tuck, it is often combined with liposuction of the abdomen. The design of the skin to be removed is done while the patient is standing. Once the incision that separates the fat from the muscles is made, the muscles are brought together towards the center like a corset. The excess skin is removed so that the belly is perfectly flat. This is the treatment of an abdominal diastasis. It is one of the most common operations when women want to repair their bodies after giving birth. Another reason why as many men as women have a tummy tuck is the significant loss of weight or cosmetic consequences of obesity. If the excess skin also includes the thighs and buttocks, this surgery can turn into a body lift.
The upper blepharoplasty is one of the most frequent operations in our office with facelifts. It is often combined with a lower blepharoplasty or lower eyelid surgery. The skin of the upper eyelid is very thin, and shows the first signs of aging. The opening is made with a fine radiofrequency scalpel in order to obtain a smaller scar. The underlying muscle is incised if there is an excess of fat, it can be removed (fatty pockets, fatty hernias). The recovery period lasts one week, and full resumption of activities is possible after 10 days. This operation is often combined with a cervico-facial lift or a frontal lift.
It may be combined with a superior blepharoplasty. The skin is separated from the muscle, if it is only a cutaneous excess, the skin is excised and the operation is finalized by stitches. However if the patient also suffers from pockets of fat or fatty hernia, this fat will be removed or re-smoothed in order to give the eyes a younger and fresher appearance. We are always careful not to remove too much skin, as this would change the shape of the lower eyelid and give it a rounded appearance.
Facial lipofilling can be performed alone or combined with a frontal lift or cervico-facial lift. The procedure begins with the infiltration and removal of the fat where it is in excess. It is injected for two purposes: the first being to give volume to an area that is lacking, then to spread the injection under the entire skin of the face, so that the stem cells after a year are renewed and give an appearance younger looking. It is sometimes also combined with a facial peel.
This procedure has the advantage of leaving very small scars in the armpit as opposed to leaving a visible mark on the chest. The endoscopic procedure gives total control of the dissection and this process is reserved in the case of complications for breast augmentation. The dissection plane is located below the muscle, above the ribs. As you can see in the video, there is very little bleeding. The extent of the pocket dissection is determined by the surgeon depending on the anatomical conditions. The implant is introduced through the axillary incision and the positioning of the prostheses / implants is controlled with the patient in the sitting position.
The procedure begins with liposuction of the areas where there is an excess of fat for example the belly or the breeches of horse. The removed fat is collected / collected in a sterile container, it is cleaned and concentrated. Thus the patient benefits from an improvement in her figure thanks to liposuction and breast augmentation without implants. The fat is transferred into small syringes and then reinjected into the breasts, in order to obtain a prettier shape and an increase.
It is a liposuction technique, which is less traumatic, less painful postoperatively and which causes fewer bruises. This means that the patient will have a shorter recovery time, just a few days, before they can return to work. The technique is based on the simultaneous injection of water to relax / relax the fat cells and at the same time suck them up. The fat is collected in a sterile container, it is purified and concentrated, ready for reinjection.
In this video we use the BODYJET for liposuction followed by the reinjection of fat into the chest. Like all liposuction, we focus on the areas that have excess fat. This allows the patient to notice an improvement in the silhouette and also to obtain an increase in the breasts. The limit of breast volume increase depends on the size we can get, this is limited by the amount of fat available. Breast lipofilling can be associated with breast augmentation by prosthesis if the available fat is insufficient. The final shape of the breast of course depends on the skills of the surgeon.
The classic facelift is the most common procedure associated with plastic surgery. Whether it is performed on a woman or a man, the procedure is the same. The classic facelift was designed a hundred years ago, but today it is of course improved in terms of techniques, scars and associated procedures. The procedures associated today are most often a facial lipofilling, an upper and / or lower blepharoplasty, a forehead lift or a peel. We start the procedure with a marking of the skin while sitting. We start the intervention by infiltrating the local anesthesia, the patient is sedated (very slightly asleep), this in order to avoid bleeding during the surgery. The skin is lifted in all the areas concerned, then the superficial aponeurotic plane above the muscles is put back in tension which avoids a frozen appearance of the face and obtaining a natural and relaxed face. The excess skin is removed, the scars are hidden by the ears, with the threads which are absorbable. Bruises and swelling usually goes away after 2 weeks and normal activities can resume after 3 to 4 weeks.
Liposuction of the legs most often treats the thighs but in some cases it is sometimes necessary to sculpt the calf and the ankle as well. In case the leg needs to be fully refined, circular liposuction is done on both legs. This intervention includes liposuction and combined lipofilling. It is a difficult surgery that involves turning the patient over to the operating table several times. The recovery time is longer than conventional liposuction, i.e. 6 weeks. We need compression stockings for 6 weeks. Part of the fat from liposuction is kept so that it can be reinjected into the desired area to get a better leg shape. It can also be injected into the buttocks. (Lipofilling of the buttocks and lipofilling of the breasts). It is also an opportunity to treat cellulite with very fine fat injections or micro lipofilling after removing small skin adhesions.
The armpit opening is 5 cm and has the advantage of leaving no scars on the chest. The muscle below the breast is identified and the compartment is made under this muscle. The box is made behind the muscle with a special instrument and of course depends on the size of the prosthesis which will be used according to the anatomical possibilities and the patient's desire. The prosthesis is introduced into the compartment through the opening in the armpit. The position of the prosthesis is evaluated when the patient is seated on the operating table, if the result is satisfactory, the opening is closed and the stitches are removed after a week.
This is an alternative that allows an increase in the buttocks without prosthetic buttocks. In order to increase the areas concerned, the fat is recovered in the regions of the body, it is in excess and not necessarily aesthetic. It is washed and concentrated before being reinjected into the buttocks. It is important to avoid sitting for the first two weeks after the procedure. The recovery period lasts two weeks, there is practically no pain.
It is possible without surgery to treat the lower eyelid, with injections, hyaluronic acid and botulinum toxin, a peel (chemical dermabrasion) or the laser (laser dermabrasion). Most often, these are the injections that are used to camouflage the falling skin, wrinkles and pockets of fat. Peeling and laser can improve the appearance of the skin as well as pigmentation. The upper eyelid is more difficult to treat without surgery, but the option of peeling and laser is still possible can cause a skin reaction and smooth the eyelid. Conservative / classic eye treatment may be an alternative for those who are not yet ready for eyelid surgery.
Presentation "BIA-ALCL, french regulation experience" à VDAEPC 2020, Dusseldorf, IMCAS Session
Dr. Bergeret Galley also told us about cosmetic surgery of the eyelids and forehead.
Dr. Bergeret Galley told us about cosmetic surgery concerning the total restructuring of the legs, combining liposuction and lipofilling.
Dr Bergeret Galley was invited to talk during the congress in IMCAS 2014 Paris. She was appriciated speaker with three presentations wichi you can follow here. She presented among other things the total reconstruction of the legs combining liposuction and lipofilling.