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Cosmetic Plastic Surgery: How Microsurgery Can Make a Big Difference

Cosmetic Plastic Surgery: How Microsurgery Can Make a Big Difference

November 13, 2013

  • Martin Newman, MD

Moderator: Welcome to our "Cosmetic Plastic Surgery: How Microsurgery Can Make a Big Difference" online health chat with Dr. Newman. The chat will begin at noon.

Moderator: Unfortunately, Dr. Newman is currently delayed with a patient. Today's web chat will start shortly. We apologize for the inconvenience and appreciate your patience. 

Moderator: Welcome to our Online Health Chat "Cosmetic Plastic Surgery: How Microsurgery Can Make a Big Difference" with Martin Newman, MD. We are thrilled to have him here today for this chat. Let’s begin with the questions.

grammarhodes: Is it possible to transfer fat from the lower abdomen to either the cheeks or the breasts?  Would the transferred fat help rejuvenate a sagging face or enlarge the bustling?

Martin_Newman,_MD: Yes. This is commonly done. However this does not involve microsurgery.

Ribby53: Can the surgery be done with the breast reduction?

Ribby53: Not sure what you mean? Reduce the breast with breast reduction but enhance it with fat injection? Seems counterintuitive?

Danalynn: Can cosmetic plastic surgery be done safely on someone who is taking warfarin? Does laser surgery cauterize as it goes making bleeding less of an issue?

Martin_Newman,_MD: Blood thinners are usually adjusted prior to elective surgical intervention  - most often by the prescribing physician.

LindaB12:
Where does the soft tissue come from when covering the open bones? Does this damage that part of my body?

Martin_Newman,_MD: Skin, fat, and muscle, alone or in combination, can be moved from one part of the body to another. The site we take it from is known as the 'donor site'. If you 'give up' a muscle to cover a bone elsewhere on your body, it does not grow back.

Heatfan3:
Does surgery need to be done as soon as a burn happens or later in life can this procedure be done?

Martin_Newman,_MD: Reconstruction for burn injury can be done later in life, yes.

Moderator: For those now joining us, we are currently chatting with Martin Newman, MD, who is taking your questions about cosmetic plastic surgery and how microsurgery can make a big difference. To ask a question, type in the box below and then click 'Ask'

CathySab: If I am having surgery will I have to undergo radiation as well?

Martin_Newman,_MD: The need for radiation therapy does not depend on, or is not obviated by, the need for surgery. Assuming you are talking about some sort of cancer - your need for either or both would be a decision you would make with your oncologist. 

BermanM:
Following surgery will I have feeling in both parts of my body, the treated area and the area that the tissue was taken from?

Martin_Newman,_MD: It depends on several factors. However, sometimes tissue can be moved from one place to another on the body with 'nerve grafts'.

PHO1997:
How much swelling is expected following the procedure? If it is really bad, how soon does it go down?

Martin_Newman,_MD: The amount of edema (swelling) depends on the procedure and patient factors.
It is impossible to predict not knowing the procedure or patient.

Jenny0665: Is there any other option besides microsurgery for a large open wound?

Martin_Newman,_MD: We approach wounds in a stepwise fashion. We call this the 'reconstructive ladder'. At the bottom of the ladder there are simple things - like dressing changes. At the top of the ladder there are more sophisticated treatments - like microsurgical tissue transfer. In between, there are many options. But ultimately, it depends on the wound and the location on the body.

YondaReeves: Does Cleveland Clinic treat burn patients? How often is microsurgery used for these patients?

Martin_Newman,_MD: We are not an American Burn Association certified 'Burn Center'. Microsurgery is a reconstructive technique that can be employed by the reconstructive surgeon. When and where they choose to employ this technique is a decision made between the patient and the surgeon.

Izzybusy:
In the healing process, should I expect to be on bed rest following breast reconstruction? If so, how many days?

Martin_Newman,_MD: Depending on the TYPE of reconstruction, this may vary.

SweetandSassy102: Will my body adapt to the new area that was affected? What will change?

Martin_Newman,_MD: Assuming you are referring to the donor site, know that often tissue can be considered excess or redundant -  the removal of which can be well tolerated. For example, in a breast reduction or in a tummy tuck.

LaurenAshley: If I am overweight can I have fat taken out during the process since they are taking tissue from my belly?

Martin_Newman,_MD: Fat can be transferred from one area of the body to another. However, we routinely do no simply remove fat at reconstructive surgery.

Moderator: We have approximately 15 minutes left in the chat. We received a large amount of questions and we will continue to answer as many as possible. We apologize if we did not get to your question. If you have additional questions after the chat, please use our contact link clevelandclinic.org/webcontact to submit your questions or please go to clevelandclinic.org/health/livepersonchat to chat online with a health educator.

Rj2kids: Will my blood flow be normal post operation? I've had circulation issues in the past and am concerned this would be an issue when tissue is transplanted to another part of my body.

Martin_Newman,_MD: This is a hard question to answer without knowing your individual situation.

SeahawksFan17: Is a micro-surgeon a special surgeon or do they do other types of surgeries as well?

Martin_Newman,_MD: Microsurgery is a technique - it is taught in different residency programs of which plastic surgery is one.

Moderator: We are getting ready to close for today. A large number of questions were received and we apologize if we did not get to your question. We will try to answer as many questions as possible in these last few minutes. If you have additional questions, please go to clevelandclinic.org/health/livepersonchat to chat online with a health educator.

Moderator: Thank you for joining us today. We appreciate all of your questions. Please join us for our next web chat, "Keeping Those Extra Holiday Pounds Off" on December 3, at 12:00 pm, with Lillian Craggs-Dino, RD.

EJones: How long has microsurgery been available as a treatment option? Is it fairly new?

Martin_Newman,_MD: Compared to many operations we do today, microsurgery is fairly new. It has been evolving along with other techniques. The introduction of the operating room microscope as well as the ability to make very small needles with suture has helped to advance this science.

Jerry_Roberts: What types of sutures are used in microsurgery? Is there less scarring than traditional surgery for reconstruction procedures?

Martin_Newman,_MD: A variety of sutures are used - smaller ones for structures that can be measured in millimeters (eg: small blood vessels) and larger one for larger structures (eg: skin, muscle, fat). There should be no difference in scar formation.

Moderator: If you would like to view the entire transcript of this chat it will be available in about two weeks on the Cleveland Clinic Florida website at http://my.clevelandclinic.org/florida/about/web-chats.aspx.

Moderator: If you have additional questions, please go to clevelandclinic.org/health/livepersonchat to chat online with a health educator.

Moderator: I'm sorry to say that our time with Martin Newman, MD is now over. Thank you again, Dr. Newman for taking the time to answer our questions today about cosmetic plastic surgery and how microsurgery can make a big difference. To make an appointment with Dr. Newman, or any other specialist at Cleveland Clinic Florida, please call 877.463.2010. You can also visit us online at vanity clevelandclinicflorida.org.