There are two methods to augment the buttocks : inserting an implant or transplanting your own fat.
“Brazilian butt lift” is the most common term for fat transfer buttock augmentation.

Brazilian buttlift does not really come from Brazil, as many people think, but rather from the United States, so the term “Brazilian butt lift” is somewhat misleading.
The Brazilian butt lift creates a curvy and attractive shape of the buttock as popular in Brazil, hence the name, at least I presume so.

The Brazilian butt lift works with fat transfer for buttock reshaping.
There is no foreign body involved, we use the patient’s own fat.

This is especially important on the buttocks, since foreign bodies such as implants tend to create a lot of problems here.

In the vast majority of Brazilian butt lift surgeries, we take this fat from the flanks, thighs and abdomen, which indirectly also makes the but curvier an more attractive.
In Braziliian butt lift surgery, this effect is called „accentuation“ .
I believe that this accentuation is a very important contribution to the overall result in Brazilian butt lift surgery.

Brazilian butt lift surgery has been made much more attractive both for surgeons and patients with the Jet assited fat harvest technique.
This technique enables harvest of high quality fat grafts within reasonable time and with excellent take rates.
This makes the operation not only less invasive and faster, but also more cost effective for patients.

If needed, a large volume fat graft can be harvested and simultaneously filtered in the Lipocollector system.
The fat harvested in this way contains the highest percentage of viable fat cells, which are the best ones for transfer.
The quantity of good quality viable cells harvested in this manner is much higher than with other fat grafting technqiues (Based on centrifugation and/or stem cell enrichment.

The results are excellent, and we have downgraded an operation which used to take around 5 hours to 1,5 hours under local anesthetic.

We have observed a marked increase in requests for this kind of surgery in the last years, and it seems that the Brazilian butt lift is becoming a strong trend in cosmetic surgery in Europe.

For me as a surgeon, the new fat transfer technique with jet assisted liposuction has made this a much more enjoyable procedure, since the fat harvest is much more straightforward.

Should you require some more extensive information on this procedure, either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.

In many cases, the best way forward is to combine the two.

The main advantage of jet stream assisted liposuction is as follows: no extensive infiltration of fluids is required and therefore it is much more precise, it is virtually bloodless and enables removal of large quantities of fat in a relatively short time.

The third, and crucial advantage of the water jetstream assisted liposuction technique is that it enables to simultaneously harvest excellent quality fat grafts, which in our practice is mainly used for breast and buttock augmentation as well as a natural filler in facial rejuvenation.

Body Jet uses a very precise waterstream to remove fat preserving viability of the cells. The fat harvested in this way can be used to inject it elsewhere.
The basis for Body Jet is that the fat harvested in this way contains all its inherent growth factors and stem cells, resulting in optimum conditions for graft survival.

The main advantage of laser liposuction is that it provides very even and reliable retraction of the skin. I like to use the laser technique especially for arms and neck (double chin deformity).

In cases of larger deposits, it is ideal to first remove the deeper bulk of fat with Body Jet liposuction, and then treat the more superficial layer with the laser for best skin retraction.

Both of the abovementioned body contouring techniques have significant advantages over “conventional” liposuction.

I have in fact completely abandoned tumescent lipsouctuion in my department.
Tumescent liposuction, to my opinion is an outdated technqiue which has no other advantage than it does not reuqire any major investments in gear other than a suction tube and a cannula.

Both techniques, laser liposuction and water jet stream assisted liposuction are day case procedures under local anesthetic.

For more information visit our Homepage:
www.beautymedicine.es/liposuction-smartlipo

We practice in a very body conscious environment, with very body conscious patients, who mostly embark on a very outdoor orientated lifestyle.

Use of fat for cosmetic procedures has been limited historically because transplanted fat has shown a tendency to re-absorb back into the body, making the increase in volume temporary.
If one reviews contemporary scientific literature, it seems that most publishers report results which are rather a lottery, rather than being in any form predictable.

However, cell-enriched cosmetic surgery harnesses and focuses your body’s own innate healing abilities.

Studies have shown that this helps the specially prepared graft tissue to fully incorporate into the transplant location, thereby increasing the chance of the graft taking.

According to current scientific literature, the most effective modality here is the Body Jet fat harvest procedure, which has originally been developed for effective large volume liposuction.
The technique does largely leave the harvested fatty tissue viable and maintains the viability of the stem cells naturally inherent to human adipose (fat )tissue.
The effectiveness and safety of the procedure is proven in very robust scientific literature and has been breakthrough in modern Plastic surgery technique.
We successfully apply Body Jet fat grafts for natural breast augmentation and buttock augmentation (brazilian butt lift). Take rates are documented to be consistenly around 80% making the procedure very predictable.

Should you require some more extensive information on this procedure, either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.

Prior attempts at autologous fat transfer to the breast have not proven to be constantly successful .
They were successful in some cases , but no so in others, in summary the results were very unpredictable.

New techniques in Natural Breast Augmentation employ the latest technologic advances in fat harvesting.
The principle of these techniques is that they “wash and filter” fat instead of “centrifugation”.

“Wash and filter “techniques are much better to handle and our current scientific data suggests that they also give superior results in fat transfer breast augmentation.
We believe that the less the fat is manipulated the higher the survival, provided of course that the harvesting process is gently enough to keep fat cells alive.

The Body Jet technology (also known as “Aqua-Lipo”) in the U.S. is currently the best option for “wash and filter techniques.
It has been extensively “road tested” and scientific data gained is impressive.

Since Body Jet natural fat transfer breast augmentation does also eliminate unwanted deposits of fat, mostly from thighs, flanks and abdomen, at the same time, patients suitable for this breast augmentation modality do also seem to be much happier with the final results.

The procedure will not interfere with future mammograms because the fat is never injected into the breast gland directly, but in different planes around the breast.
After fat transfer breast augmentation the breasts are more like natural breasts.

Other advantages of natural fat transfer breast augmentation are massive:There is no need for implant exchange ever nor any risk of implant related complications.

From my surgical perspective, the handling characteristics are also a crucial advantage of the Body Jet.
The simultaneous irrigation , suction and filtering process has made natural fat transfer breast augmentation much more user friendly.
Previous centrifugation techniques were extremely time consuming and a lot of fat was lost during the preparation process.

With Body Jet, we do normally need about 1-1,5 hours to complete the breast augmentation procedure, which is done under local anesthetic.
That makes natural fat transfer breast augmentation a much more realistic alternative for many patients.
In our Marbella practice, natural fat transfer breast augmentation does already make up for about 60% of breast augmentation cases, with numbers further rising.

The operation of rhinoplasty has traditionally been between the disciplines of ENT and Plastic surgery, with continous diputes regarding who does it better, the ENT’s or Plastics ?

In my Plastic surgery department in Hospital Quiron Malaga I have tried to find the ideal soultion for this.

We have managed to contract one of Spain’s leading ENT, Dr.Ortiz, as a permanent staff member of our Plastic surgery department, enables us to operate all noses in a team of minimum two specialists, an ENT and a Plastic surgeon, which is really to the benefit of the outcome.

To my knowledge, there are only very few centres in Europe doing it this way (I am not aware of any other practice in Spain or the UK who does this as a standard protocol), but I think that it is a concept that is in th best interest of patients.

Our audit data confirms that this seems to be to the real benefit of patients. I have always enjoyed operating rhinoplasty very much, although rhinoplasty is a very delicate operation.

However, for the functional part of the operation I find it of real benefit to do this together with a very experienced ENT surgeon.

I do increasingly see patients who after purely aesthetic rhinoplasty report taht there breathing is better although they had not been aware of any impairment before.

We have also included pre-and intraoperative rhinoscopy into our protocol, which revelas for instance the need for turbinectomy (which we currently do in about 40-50% of our rhinoplasty patients).

Overall, the experience in my department does strongly encourage me to think that our protocol to operate noses in such an interspeciality team is a very good one.

Should you require some more extensive information on this procedure, either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.

These predictions are based on patient questionnaires as well as interviews with surgeons who are chairing the countries leading academic Plastic surgery departments.

They are also influenced by publications in relevant scientific literature.
This expose is a very valuable predictor both for patients and surgeons working in the field of aesthetic surgery.

These forecasts have shown to be very reliable in recent years.

For me the most interesting trends for cosmetic surgery in Spain trends are the following:

1. The society foresees that demand for facelifts and other facial rejuvenation surgery will increase.
This is a relativeley easy prediction since growing age in the overall population will always fuel facelift surgery numbers.
Recent techniques with less invasive procedures have made the procedure regain popularity.
Non-surgical facial rejuvenation procedures will also see some growth, and I believe they will continue to do so in the coming years.
I see a steeply rising interest both amongst surgeons as well as, naturally, patients in less invasive and scar free facelifts.
I believe that especially new advances in fat grafting and possibly improvement of the PRP (plateteled richened plasma) technique promise ome exciting advances in 2011.

2. Our population is more and more aware of the dangers and health consequences of obesity, and the number of patients seeking plastic surgery procedures for body contouring after dramatic weight loss (abdominoplasty, lower body lift, upper arm lift, etc.) will rise in 2011.

We have seen a steady increase in such surgeries in the last years, with specific demand for combined body contouring procedures (so called „mummy makeover“).

In this kind of surgery, an abdminoplasty(tummy tuck) is usually combined with a breast surgery procedure, usually breast augmentation with or without breast uplift.
Other combinations are possible and frequent.

Recent publications have clearly shown this to be a safe procedure for a skilled surgcial team and patient satisfaction rates tend to be signifcantly higher as compared to single stage procedures.

In our own publication of 132 cases treated in Cirumed Clinic Marbella we have reported the second largest series published worldwide so far.
In summary we have seen the difference in patient satisfaction to be nearly 15 % in favour of the combined group.
With weight loss procedures on the rise, especially the gastric ballon procedure, this trend will likely continue both in Europe as well as in the U.S.

3.Breast implants, the second most popular cosmetic surgery in Spain (and worldwide), will continue to grow.
This year many baby boomer women who have aging implants and/or breast ptosis will replace their implants and have breast lifts.
In my department, we have also seen a marked increase in demand for non-implant breast augmentation, mainly Macrolane and fat transfer.
Again, very promising advances in fat transfer techniques, such as for example jet assisted liposuction, promise exciting advances in 2011.

4. To my assessment buttock augmentation with fat transfer (“Brazilian butt lift”) will be one of the most popular procedures in coming years.
In our department , we currently see a dramatic increase in demand for this kind of surgery, which relies on transplanting fat , usually from flanks and thighs, to augment the buttocks.
The procedure has seen great advances enhancing the survival of fat grafts in recent years, and will continue to do so in the future.
Again, I think that the jet assisted fat tarnsfer procedure is the one that is so far the most promising advance.
Recent advances in fat transplant technique have made the procedure more predictable and reliable.
It requires a lot of experience in tissue transfer to do the procedure correctly, but I think that the rates of patient satisfaction are really worth it.
I think that the secret of success in this procedure that patients somehow have the feeling to “kill two birds with one stone, since harvesting of the fat, which is done by liposuction with special cannulas, results in some good toning of abdominal and hip areas.

5. As the popularity of non surgical and minimally invasive procedures continues to grow, surgeons and manufacturers will develop new techniques and products that advance the science, produce even better results and lessen recovery time.
This will of course continue in 2011.
In our department laser liposuction is currently an innovative technique which we develop with great enthusiasm.

The quality for Plastic surgery research has steadily increased in recent years and will continue to do so in 2011.

Reproducible data and quality documentation will increase consumer safety and satisfaction.
Patients will be able to rely on reproducible data and less on self declared „artists“.

Following the trend in increased consumer sophistication patients will increasingly want to know if the latest procedure and device being touted on the internet and TV talk show really works and if it is safe.
By incorporating evidence-based medicine into the core specialties of plastic surgery, we will make it easier for both doctors and patients to determine fact from fiction.
This will raise quality in cosmetic surgery in this and coming years.

Should you require some more extensive information either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.

The advantage is that patients , to my experience, are much happpier with the more dramatic change of a combined operation.

We have recently published our experience of 138 cases of such “mommy makeovers”, which is the second largest series published so far. Like other surgeons publishing on the same topic, we have alos found such combinations to ver very safe and pleasing for patients.

The only objection we had after review of our data was that large volume tumescent liposuction with large fluid load seemed to increase problems, therefore we do not include large volume tumescent liposuction into the mommy maleover surgery any more.

If liposuction is necessary, we do now use laser liposuction which has significantly less blood loss and faster recovery, and does also require less fluid load.

A factor attracting patients is also the issue of cost-effectiveness, and whilst combined procedures do doubtlessly offer an imopressive saving potential, I recoemmend to never base any decisions for or against surgery on that.

In the South of Spain, I work in an environment where patients will spend half of the year on the beach, and good implant size correction is of utmost importance.
Most of our patients are eager to have scar free minimally invasive breast augmentation surgery, and natural fat transfer breast augmentation has become one of our most frequently performed operations.

Fat transfer breast augmentation is our procedure of choice for all patients who are suitable, this means who have at least one problem zone fat to spare.
Removing this problem zone together with the breats augmentation does significantly increase patient satisfaction.

However, not all patients wanting breast augmentation have such extra fat.

When using implants, I generally use cohesive silicone gel implants. Cohesive means that the gel is stable, and no evacuation of fluid can occur.

I do not regard saline implants as indicated for any breast , at least not in my practice.

There is no substitute for accurate measurements. The size of an implant is just one aspect, but form and projection are equally important for a perfect result.

Another important factor is skin laxity or looseness. To achieve successful augmentation, you must have enough tissue to cover the breast implant. It is also important to make sure your breasts are even.

My experience, and other surgeons seem to share this, is that patients tend to rather err on the conservative side, meaning that it is very common that patients go for bigger implants later rather than for smaller ones.

Should you require some more extensive information on this procedure, either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.

Every surgeon may have different preferences, but more importantly not every facelift is the same.

The vast majority of facelifts in my department are done with the so called scar sparing (MACS) technique (although not every facelift candidate is suitable for this).

I think the ideas of the majority of Plastic surgeons including myself have changed in recent years , and the trend is going to less invasive procedures and most importantly, have changed from mere stretching to an understanding of volume loss.

When patients come to my Marbella practice for a facelift consultation, I normally ask them to bring me a photo showing themselves at closer range 10-20 years ago.

One nearly always sees that over the years they have lost volume in the midface (a normal effect of aging).

There are some exceptions of this rule, but not many.

Every aging face does also show frequent areas of skin sagginess (mostly skin and jowls).

We do therefore work a lot with volume restoration in the face together or instead of a facelift.
All patients seeking facelift surgery benefit from that, sometimes together with a facelift, but sometimes even instead of facelift.

In cases of marked nasolabial folds I prefer to restore facial volume with fat grafts (the Bod Jet hydrosurgery technique has made this a very quick and reliable procedure) instead of surgical facelift.

Patient satisfaction with that is very high, and togheter with endolaser (Smartlipo) treatment this combination can make surgical facelift indeed unnecessary.

If an additional surgical facelift is required, volume restoration with fat grafts makes the result significantly better, and helps to keep scars shorter.

Should you require some more extensive information on this procedure, either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.

The concept is to retore a more youthfuul facial anatomy naturally.
It is far less traumatc than conventional facelifts and, the results are more natural and is if far less traumatic than a „conventional“ facelift.

Usually I take a fat graft , usually from the abdomen. Fat grafts have historically been a very troublesome and lengthy procedure, requiring extensive centrifugation of grafts.

The Body Jet technique, which uses a waterbeam irrigation suction system to harvest such fat grafts, has changed this dramatically, and has converted fat grafting into a very swift and straightforward procedure. With the Body jet technique graft take rates are excellent.

In areas of saggy skin, mostly the nasolabial folds and the neck, we add the Smartlipo technique, which is able to add some significant skin retraction of about 25%.

The whole voluma facelift procedure takes about one hour and is done under local anesthetic.
Pateints can go home immediately afterwards. There are no scars.

In my current practice, about 50-60 % of patients wanting a facelift are suitable for this technique, and , in fact, I find that satisfaction rates of these patients are somewhat higher than with „conventional“ facelift techniques with scars.

Should you require some more extensive information on this procedure, either in the Department of Plastic Aesthetic and Reconstructive Surgery at Hospital Quiron Malaga or in Cirumed Clinic Marbella please contact us.