"I'm very happy with the results," says Smith, who is 5-foot-3, weighs 135 pounds and went from size 7 to 9after her operation. "I feel a lot better, a lot more confident when I go out and get dressed up. I get a lot of compliments on my shape and how small my waist is."

The third generation of liposuction -- called liposelection, fat-grafting or fat transfer -- has arrived, garnering buzz in the cosmetic medical community and drawing media attention, including being featured on CBS' "The Early Show" this week.

Dr. Bruce Chau, a plastic surgeon who practices in Southfield, travels the nation training other surgeons. He says it's a safer and more precise procedure that requires less healing time than older forms of liposuction. And the results, he says, can be remarkable -- not just in sizing people up, but in trimming them down as well.

"I've taken people down from a 14 to an 8 or a 12 to 6, even a 4," Chau says.

In addition to transferring the fat that makes love handles, thunder thighs, and belly and back rolls to fill out wrinkled faces and enhance breasts and bottoms, the surgery also can help repair bad breast augmentations, skin damage from radiation therapy and improve the appearance of scars.

Doctors also have discovered another surprising benefit of the surgery. Youn says when fat is injected into the skin, it renews the area, which gives away to suppler, baby-like skin.

The results are so remarkable, Chau believes stem cells from fat could eventually help with advances in stem cell research.

"This is brand new and is really the cutting edge of research right now," he says. "Hopefully, in the end we may not have to worry about stem cell research because we can use the stem cells in fat."

Less painful surgery

Dr. Renato Saltz, president of the American Society for Aesthetic Plastic Surgery, says older forms of fat-grafting were popular in the 1980s, but eventually faded away because the procedure required multiple sessions for injections. The newer form of fat-grafting was introduced about seven years ago, and has been quietly gaining recognition.

"Now, it's really popular again," says Saltz, who attended an international meeting of cosmetic surgeons in Spain this past week where attendees spent an entire day discussing the latest fat-grafting technique. "There is a new push for fat transfer and fat injections."

Compared to the older forms of liposuction that required violent jabs to the body and weeks of recovery time, the newer liposelection procedure uses an ultrasound instrument that is more gentle. Fat is removed from arms, backs, hips, outer and inner thighs and abdomens and is placed in a container. A syringe is filled with it and injected elsewhere with a needle. Some of the excess fat is stored in case additional injections are required.

Ranging from $3,500 to $12,000, similar in cost to older procedures, the surgery doesn't disturb nerves, is less painful and requires only a short healing time. While earlier liposuction required about six weeks of healing time, the newer procedure requires only about a two-week healing period, and patients are up and about in about four days. The body will naturally absorb some of the fat and eliminate it, so the surgeon has to add more fat than wanted during surgery and keep some on hand in case more injections are needed in a particular area. The downside is the surgery can have unpredictable results such as lumpy skin.

Saltz, who practices in Salt Lake City, says patients can expect about 30 to 70 percent of the injected fat to remain in place. Experienced surgeons tend to get the better results, he says.

After studying the safety issue for two years, an American Society of Plastic Surgery task force reported that fat-grafting may be considered safe for breast augmentation and correction of defects from medical conditions and previous breast surgeries.

Because longevity of the surgery is still unknown, the group warns that additional treatments may be needed, and fluctuations in body weight may affect the graft over time. Additionally, the task force recommended that physicians should use precautions when considering performing surgery on patients with a high risk for breast cancer such as family history of breast cancer or mutated BRCA-1 or BRCA-2 genes.

Youn says the most surprising result might be the stem cells leading to an age reversal in the skin that has had fat-grafting.

"It rejuvenates the skin, improving aging changes and radiation damage," he says.

Body mass plays a role

Native Detroiter Carol Mitchelson says she was spending $700 every few months to get collagen injections to help thicken her extremely thin lips.Then, she turned to Youn for liposelection, removing fat from her abdomen to fill out her lips."I love what he did," says Mitchelson, 64, now of Crosstown, Tenn. "My lips look really, really good, and they look natural; they don't look like a trout."

Youn of Youn Plastic Surgery in Troy says most of his patients want facial work."It's definitely one of the most popular surgeries that I do," says Youn, also an attending physician at Beaumont Hospital in Troy. "When we age, in addition to the skin drooping, the face deflates, so when we add volume we can fill out the face again, in addition to tightening."

Chau, who says most of his patients want fat-grafting to the buttocks, explains that not everyone is a good candidate for fat grafting.

"People who are a little overweight with a 28 to 33 BMI, we can help reshape them, but they are not going to look like a skinny person," explains Chau, who is program director for residency for Plastic Surgery at Henry Ford Macomb. People who have a BMI between 22 and 27 get best results, he says.

Smith is really pleased about her newly contoured body and shapelier buttocks."You can really see a big difference," she says. "It's bigger, but it's a perfect size for my body."

Fat-grafting

Cost: $3,500 to $12,000 depending on procedures

Results: 30-70 percent of fat will remain in place

Who's not eligible

• People with little to no body fat

• People who have too much body fat or a body mass index higher than 35-40

Pluses

• Less pain than previous procedures

• Faster healing time

• No foreign objects introduced to the body, as would be with implants or collagen injections

Minuses

• Unpredictable results

• Possible

lumpiness

• May need to repeat procedure

Source: Dr. Bruce Chau, Dr. Renato Saltz, Dr. Anthony Youn

Safety concerns

After studying the safety issue for two years, an American Society of Plastic Surgery task force reported that fat-grafting may be considered safe for breast augmentation and correction of defects from medical conditions and previous breast surgeries as long as hygienic equipment is used.

But Dr. Renato Saltz, president of the American Society for Aesthetic Plastic Surgery, says the verdict is still out overall on whether the technique could interfere with mammograms and other forms of cancer screening.

"There are several colleagues using it, although the data is not completely there yet," Saltz says. "We don't have anyone confirming this is 100 percent safe. We are being conservative and are trying to be sure before we issue something to the public."

Source: Dr, Bruce Chau, Dr. Renato Saltz, Dr, Anthony Youn

http://www.detnews.com