All about Fat Transfer – with Dr Justin Perron

Trish

Hello, listeners. It’s Trish Hammmond here from the Transforming Bodies Podcast. And today I am joined by the delightful Dr. Justin Perron. Dr. Justin Perrin runs the Herstellen clinic, which is in Brisbane and he is an amazing Plastic Surgeon. And today we’re going to talk about the thing that’s on everybody’s lips at the moment, and that is fat transfer. So it’s I think it’s a relatively new procedure, but everybody’s wanting to do a bit more fat transfer here and there’s all these exciting things happening in the future so we’re gonna have a chat about it today. So welcome, Dr. Perron.

 

Dr Perron

Thanks very much Trish. Thanks for the thanks, introduction. I think maybe a bit overstated. I don’t know what you’ve said, but that’s all good.

 

Trish

That’s how I feel.

 

Dr Perron

I really appreciate the invite. It’s always nice to have a chat.

 

Trish

Oh, look, thank you so much for taking the time because you know, I really appreciate it.

 

Dr Perron

No, no, me too.

 

Trish

Lovely. So tell me about fat transfer. Now. That’s just like that’s really growing in popularity these days. And of course, it’s way better now than it was, say 10 years ago. So, so first of all, like, had that kind of start about, like, how long has it been going for?

 

Dr Perron

Yeah, that’s a good question. So fat transfer comes in various different names. So sometimes it’s referred to as fat transfer, sometimes fat grafting. Sometimes, it’s incorporated in other ways so people will describe operations as a hybrid operation, or sometimes add little descriptors for a procedure and that can sometimes implicate the use of fat. So basically taking it from one part of the body, processing it and re-injecting it into another part of the body. It’s been around for quite a long time and I think most of the mainstream acceptance was due to the worry of fat grafting, potentially causing problems based on the type of cells that were being injected. So what I mean by that is adipocytes or fat cells, some of them can act as what we call stem cells. So they potentially can start in one type of cell and be transformed into another. Now the way that the adipose stem cells are, there was a real worry, several years ago, that by injecting fat in certain parts of the body, those stem cells could convert and, you know, turn quite nasty, and potentially into cancers. There have been a few studies, especially around injection of fat into the breasts that potentially can cause breast cancer or can encourage cells that might not be normal to convert into something else. So there were a few studies that showed that that wasn’t, in fact true and why fat grafting or fat transfer became a little bit more mainstream or a lot more mainstream was because of the insurance situation. So fat transfer, I think it was about four or five years ago, maybe a little bit longer, was not allowed. So if we, as Plastic Surgeons, did fat transfer, we wouldn’t be covered under our medical indemnity and it wasn’t until they had good evidence to say that the fat transfer stem cells weren’t going to cause cancer that the medical indemnity said fine, it’s actually allowed. And since then, everybody has, you know, adopted different techniques to do it. There’s lots of different fat processing devices and they all are essentially doing the same thing, which is concentrating good fat cells so that when you process it and reinject it, there’s a better chance of all those fat cells working.

 

Trish

Okay, so, so basically, when you take the fat out, you’re really doing liposuction, aren’t you? So you’re liposuction the fat out? Just like normal liposuction,

 

Dr Perron

Correct, just like normal liposuction, sometimes we’ll do it on parts of the body that patients want a little bit of a better contour, say thighs or abdomen and then we take that fat processing and then reinjected back in.

 

Trish

And which different parts of the body can you have that injected into?

 

Dr Perron

You name it. So the most common cause, the most common areas would be face so for various aesthetic reasons, lips face, sometimes into the back of hands. So certainly for people who as we age, the skin on the back of our hand thing wins and we also lose a little bit of fat volume. So re-injecting a bit of fat to the back of the hand is a pretty well described procedure. Re injecting fat, particularly for breasts. Buttocks is obviously a really common one, everyone calls it a Brazilian butt lift, but it’s essentially just fat grafting to the buttock area and there are little spots here and there that will inject fat to help with areas that may have been injured as a result of radiotherapy. So people who have had cancer treatments and they get the radiation. Fat grafting can be used in a medical way to help improve the quality of skin and then in unusual circumstances, some people will inject it into other intimate parts for aesthetic and non aesthetic reasons as well.

 

Trish

My girlfriend was actually saying that today, I thought, nah, that’s not true. She said, no, no, no, it’s true. There are girls that do it because they just naturally might not be noticed that might need to be fuller, I guess.

 

Dr Perron

Absolutely. And it’s uh without getting into excruciating detail, a lot of it has to do with whatever you’re born with those cells that are there, they will, the only thing they can do is to grow or shrink based on your body weight. And so if for whatever reason, you’ve got a little bit less cellularity, so adipocyte count or fat cell count in those areas. In some cases, that can actually be a real problem and that happens in some patients, for example, when they sit down, they’ve got not as much fat over their sacrum or their tailbone. And some people have a real problem with a sore tailbone because there’s not enough padding. And so I’ve had a few patients, certainly body lift patients where I’ve actually had to put fat into their tailbone like not actually into the bone on the outside, just to pad the area, because it gets so irritated from those areas.

 

Trish

Wow, I never even thought of that and it is there because I remember, years ago, hearing that there was like watching a liposuction procedure in the US where they took out something like 11 kilos of fat or something like that and that was just liposuction a bit. Is there a rule in Australia as to how much you can take out? I mean, there has to be a rule. So of course, what is that rule in Australia? Or is there no rule anymore?

 

Dr Perron

Yeah, I mean, there’s sort of some pretty strong guidelines. And I think, from some of the recent controversy with some of the other doctors in the country who do these mega liposuction procedures, or sorry. The reason why that’s dangerous is that whenever you do liposuction, you always have to remove by default, a little bit of blood and a little bit of body fluid, bodily fluid that’s already there. And so if you’re doing very large volumes, there is a risk, you know, and that’s not insignificant that you potentially start, you know, really causing problems with that patient’s hemodynamic stability, which is the stability of your blood pressure and everything else as a result of doing those procedures. And there are tricks to that as in when we do liposuction, there’s a technique called tumescent liposuction, which is pretty much this the standard for a lot of these sorts of procedures, where you actually inject a bit of fluid, a bit of adrenaline, which helps to constrict blood vessels, and a little bit of analgesia, so a little bit of local anaesthetic. So in the process of doing that, you actually help to decrease the amount of blood that is and volume that is removed from your body. So if you start taking out more than a boat, four litres, four litres is considered the upper most limit of safe liposuction. Then, once you get past four litres, you’re really into it, you kind of start thinking like, what are we doing? It’s actually getting dangerous so those techniques where they were taking out, you know, 7-8-9 litres of liposuction from somebody’s body, the questionable act there is, are you actually putting your patients in danger more by doing that procedure than assisting them by removing the fat. And I’d also argue that maybe that patient, if they’re having nine litres of fat removed, maybe they should have had a better BMI going into it. And it’s not to criticise someone else’s judgement, because you know, they’re at the time but nine litres of liposuction aspirin is too much and that is very unsafe. Oh, anything. So once I hit three litres, I stopped. So three litres is my absolute maximum and if someone comes back and says I want to do it again, great. We can book another surgery. We can do it when you’re recovered and well and everything else. But the last thing I want to do is put patients into a point where it becomes dangerous or unsafe.

 

Trish

Yep. Yep, I totally agree. And so to me, because the question came up, because we’ve had this, we’ve been talking about fat transfer all afternoon made with my girlfriend’s while we’re drinking a little bit of champagne, we’ll talk about fat transfer. And one of the things we were talking about is, like, does it depend? Like, is the fat the same in all different parts of the body? Like, can you take the fat out of my body and put it in my boobs, or can you take the fat off my thighs and put it in my face, like, it’s fat, different parts of the body, and that was like, I have no idea.

 

Dr Perron

So we have, interestingly enough, lots of different types of fat in our body. And I think a lot of it has to do with how we’ve evolved over the millennia and millions of years. But, for example, when we’re born, we’ve got one particular type of fat called brown fat. Brown fat is, it has evolved to produce a lot of heat and that’s what keeps babies warm. It was to a certain extent, and that’s what that’s what kind of helps them through is they’ve got this particular type of specialised fat as we get older, we don’t need that fat, and that fat goes away and is replaced by normal yellow fat. In other areas of our body, we’ve got very specialised types of fat as well. So around our heart, we’ve got specific types of adipocytes that do a specific job, they’re different types of fat cells in our abdominal cavity and then we’ve got lots of different things that sort of sit in different areas that are slightly different. And sometimes you can tell the difference based on the colour. But for the most part, the fact that we use for fat grafting for aesthetic purposes, is usually just simple storage fat, I mean, that’s the metabolically active areas that you can harvest without causing a major defect to where you bought it from. And you can get as long as you do it in a safe way, with those with those fat cells in a very gentle way, you can re-graft them to another part of your body that will receive them and provide a bit of blood supply and they still live. So the fact that we generally use is just a bog standard, it shouldn’t be a bog standard kind of storage fat that your body just uses as a metabolic bank for energy, where we get that from other abdomen, thighs, lower back, wherever it might be. The goal there is not to and the reason why we use the areas we do is because we can, we’ve always got a little bit of extra fat that we can borrow, without creating a big problem or a hole in that area. So if you created a bad deficit from the fat donor site, it’s not. It’s not a nice outcome and it’s one of the I guess the principles of plastic surgery is we always have to consider your donor site. So you want to consider where you’re getting your fat from, and not to create too much of a problem in that area. So we do that as a reconstructive thing as well. So whenever we do reconstructive surgery, we always consider where we are getting our donor site from? And can we put it in an area that’s strategic or doesn’t look too awful?

 

Trish

So is some fat better than others? Like, like, say, for example, if I would say, oh, yeah, I want to get some fat put in my lips? Is the fat from your butt? Better fat than say fat from your thighs? Or you know, like, yeah, so from the outside of your thighs?

 

Dr Perron

So it’s a good question. And I think what we learned from some of the earlier fat grafting techniques from places locally and overseas, is that you want to use a similar fat. So some of that stuff if you try and be a little bit strategic as to where you borrow it from. So sometimes facial fat, if you’re going to be doing injections there, you can certainly borrow a little bit from your tummy, but you’re not going to inject a huge amount because of course, if you gain weight, that fat will then be metabolically active from your abdomen. So you can potentially end up with very bizarre appearances. Once people gain weight and we all gain weight, lose weight. And so that’s a normal thing that we do but if you take fat from an area that for one person might be very metabolically active, but from another person, it isn’t based on body types and the rest of it, you can end up with unwanted results. So a lot of it is just sort of considering where you’re getting that fat from, absolutely. And so you have to be strategic about it. Certainly for something like breasts where you’re just going for volume, and for most patients who want slightly larger breasts, but they don’t want implants, you can kind of get the fat from almost anywhere. And because all we’re going there is for volume, as long as you’re not creating a big defect, then that’s fine. For facial stuff, as in facial injections and other cheeks or lips, or, or wherever it might be, you’ve got to be a little careful. And I think looking at some of the senior colleagues around the world who used to do a lot of fat grafting to the face, you can see that over the years, they’ve decreased significantly the amount of fat that they now inject because it is metabolically active tissue. And if that person goes off and gains a few kilograms, it might look good for a short period of time. But if they can’t keep gaining weight, it can actually look really, really bizarre.

 

Trish

So is what you’re telling me. So say, for example, if I had fat transfer, and I got put in my lips, and and then I put on, say, 20 kilos, I would put weight on where the fat is and if it’s in my lips, I would put on weight there as well.

 

Dr Perron

Correct. So if you, if you gain weight, that fat will, if it’s metabolically active, will act like the fat that it’s for the area that it’s come from. Absolutely. So there was a presentation that I saw about six years ago, seven years ago in Melbourne and it was by a facial aesthetic surgeon from the US. And he came down to talk about some of this fat grafting, and then said, just a heads up for everybody, I’m starting to see these problems and he started putting up some slides of patients who he had fat grafted. And then he saw them back when they came back with those problems. And I had these very large cheeks, very large lips, here, there and everywhere. And the question he posed everybody, he said, “So what do we do now? Like we do, we like to suck those areas, like that’s going to be really difficult.“ And it really did create a lot of discussion about how we do this? What do we do now? Can you use fat dissolving injections? Can you know that? Is that going to create more problems? Can we do liposuction in some of these areas? So it has to be you have to be really careful. And you have to, again, going to someone reputable, who knows what they can and can’t do is by far the most important, that’s why filler is nice in a lot of those areas, because that volume doesn’t change. So we’ve got to be really careful with injection of fat in certain parts of the body, particularly in the face.

 

Trish

Yeah, right. I had no idea that that was the case that you could actually cause, like, guess your body’s only got a certain amount of fat cells. And if you put on, am I right? Tell me if the body’s got a set amount of fat cells, if you put on weight, those fat cells just get bigger, as opposed to or do you get more fat cells?

 

 

Dr Perron

No, they’ll just grow in size. So they don’t necessarily grow in number, but they will grow in size.

 

Trish

So I don’t know if because I heard once that you can only actually grow fat cells at the age of five, at the age of 14. Is that true? Or is that just some random thing that I heard with no evidence behind it?

 

Dr Perron

It’s a good question. I don’t actually know where or even if fat cells multiply with age, it’s an interesting question, I’m actually gonna go have a look at that. Because I don’t know when that happens, I do know that once we get past a certain age in certain parts of our body that just don’t multiply. So for example, if you go to the gym, and you work out and you get big muscles, those muscles aren’t actually increasing in the number of cells, they’re just increasing in size. So the number of muscle cells stays the exact same, it’s just that they get bigger. And for fat cells, it’s pretty much the same. But some fat cells are programmed to get bigger, more so you know, your fat cells, for example, around your eyeballs, they won’t get as big as fat. So if you go and gain 50 kilograms, for example, sure, you’re gonna put a lot of weight on your abdomen and your thighs, but your eyes don’t bulge out and close over. You get a little bit scared. Yeah, exactly. That there’s so that’s why some fat cells are programmed to be metabolically more active than others. So if you’re taking these really metabolically active cells, when you are minus 50 kilograms from your abdomen, putting your face and you put on 50 kilograms, the fat cells from your abdomen and are gonna, they don’t care where they are, they’re just going to grow like as if they’re in the abdomen.

 

Trish

That makes so much sense. Okay, I get it now, now that you’ve explained like that, I kind of understand, right? Okay. And you find in that because let’s say for example, if someone wanted bigger breasts, but they don’t want implants, like, is it really feasible that you could add to end up with a decent size of boobs, you know, a decent pair of breasts, with the fat transfer with like three kilos of fat,

 

Dr Perron

Definitely, I think there’s a safe amount of fat injection and there’s a safe amount of what you can do within certain tissues. So part of injecting fat is you need good recipient tissue, so you need to be able to put the fat into a tissue that will actually work. So tissue needs to be fairly lacking. And that’s why breasts work really well, because there’s a little bit of laxity in that tissue, and you can inject fat and it works out really well. The problem with injecting fat versus putting in implants for the breast is that the results, the physical results will be quite different. So fat will just, if you inject fat into the breast, that it’ll just make the breasts bigger, but they get a much more natural shape, which if you put an implant in the implant is a very stable and distinct volume, that doesn’t change. And so that’s why with implants, you get a little bit more of that upper pole fullness, and you get a little bit more of an obvious effect. To achieve that with just fat. You just need a really good push up bra. So you can certainly inject fat into the breasts when you take your bra off from a different appearance when you put your bra on probably a very similar appearance.

 

Trish

Okay, yeah, I’m thinking like, maybe I want to get that done so that I don’t ever have to wear a bra again. Yeah, well, that’s so having said that. So what about because I heard from years ago, I remember someone saying, Oh, that the fact that you get when you do a fat transfer, it dies and not all that holds like not the whole 100% the fat holds? Can you kind of explain if that’s true, like explain that a little bit?

 

Dr Perron

Yeah, so. So what we sort of call off, so in quotations, is how much fat will actually take or work. There’s a lot of factors that come into play that to simplify it, there’s essentially two things we need. So we need good fat, and we need to inject it into an area that’s a good recipient. So certain people just naturally based on genetics, and soft tissue and all the rest of it. And it gets a bit nebulous, like it’s one of these qualitative things, sometimes you can’t put your finger on until you do a little bit of liposuction. And then you see this really good fat come out and you think, yeah, this is excellent, it’s going to work and then in some cases, you know, in a similar patient, you do liposuction, you pull it out, and most of the fat comes out as quite oily fat or it’s quite broken up. In those patients, fat grafting isn’t going to work very well. Do we know who those patients are beforehand, not always and that’s the frustrating thing. Generally, as a general rule, the better fat grafting patients with better fat grafting candidates are going to be young patients that are going to have areas with a little bit of excess adiposity, or a little bit of excess fat in a couple of different places. They’re going to be fit and healthy non-smokers with no major medical comorbidities, they make by far the you know, the best patients. The patients that aren’t as good are, I would say patients who are smoking, smoking is always bad. Patients who are on certain medications. So certain medications are usually things like breast cancer medications, some blood thinning tablets. And I’m trying to think of a couple of others who have diabetes tablets that don’t work with fat grafting very well. And then I do find with some of my, the bariatric patients, so patients who’ve had gastric sleeve or bypass, what happens there is with a sleeve or a bypass your body metabolism changes. And the fat that is active sometimes just doesn’t want to work or take and I still can’t put my finger on why that is. I think it has to do with the body’s metabolic system has changed a bit and that fat sometimes just won’t, it doesn’t. Your body would rather use it for energy than it would for trying to keep it in an area. So I would say that those patients generally fat grafting isn’t necessarily the best option. Sometimes we can sledgehammer those through a little bit. So for example, if I do a body lift on those patients and they’ve got a little bit of extra fat from the abdominal part that we’ve removed, what I’ll do is, rather than taking that bit that we’ve removed and just throw it in the bin, I’ll keep it and then lipo suck that piece that we were removed, take all the fat off of that, process it and then use that as a reinjection. And if you sort of overdrafted a bit, you do get much, you still get a good in a reasonable amount of take, but it would be way lower than somebody who is a non bariatric surgeon in the same position.

 

 

 

Trish

And do you reckon that, like, because I reckon more people are talking about it more people are wanting, you know, lipo here and put it in there or whatever. But is it? Have you noticed that it’s actually becoming more and more like something that you’re doing more of?

 

Dr Perron

It definitely is, I think, certainly from a surgical offering. I think the people who do offer it, I think patients, they do talk and they do know who’s who does certain procedures. I would say that, some people don’t like doing it, so they don’t like liposuction, and that’s fine. Like I don’t like doing rhinoplasty but no shade on those who do. It’s just not my forte. And liposuction, same thing, you know it, but it’s also not only the type of liposuction. So these are liposuction, for example, there have been a few papers that have shown when you do Vaser, the fat is still just as good to graft as non Vaser liposuction, but at the same time. I’ve watched and heard stories of people who do Vaser and they go to put it into a fat purifying machine, and it just absolutely melts away. And there’s almost nothing left afterwards. And that’s just, I guess, one of those things that I guess is a traditional thing in terms of doing liposuction. All do just bog standard, normal, boring, arm assisted, as in, I just use my arm to move the cannula back and forth. I don’t particularly like some of the other types of liposuction again, no shade on those people who use it, I just find it. You know, the fact that I get from a normal life assumption is better and it just graphs better.

 

Trish

Yep, yep. And so you know, you talk about different types of fat, like the brown fat, the yellow fat, the storage, so the best fat is the yellow fat for fat transfer?

 

Dr Perron

This is just the storage fat, usually from thighs, outer inner thighs, lower back and abdomen seems to work very, very well. You know, hunting for some of the other types of fat. Probably not something that needs to happen. It’s just the fat that sits one layer below the one layer below the skin and that stuff works really well.

 

Trish

Yeah. And is anyone ever too skinny to get fat from?

 

Dr Perron

Definitely. Yeah, absolutely. I do get some patients that come in and they don’t want implants. They’re very, very thin, very fit, lots of time, the gym, etc. And they come in and say yeah, see, I can pinch this one centimetre of skin, you can get fat from there and not really. Yeah, right? Yes. If there’s no fat, there’s no fat. And you know, those patients if you can’t get fat off, and again, they might be a better candidate for a small implant.

 

Trish

Yep. You know, this is a really stupid question. But someone did actually ask me this question and I didn’t know why it’s not possible. But why can’t you use someone else’s fat? Like, I mean, if I could sell my fat, I could make a fortune. Like, why can’t you even use like even willows or something like relatives or something? Why can’t we transfer my fat into someone else?

 

Dr Perron

Technically, the only person who could do that would be twins, because they have the exact same types of cells. So the issue with grafting fat is that your body, your body’s immune system will recognize the cells from somebody else as foreign and it’ll just destroy them.

 

Trish

Yeah, right. It seems I’m a little bit embarrassed but it is a question.

 

Dr Perron

Only reasonable. And I think it would be like doing a fat transfer from one person to another that is unrelated, would be like doing a kidney transplant or liver or a heart transplant. It’s the same kind of principle, you’re actually transplanting other people’s tissue and so the body will reject it entirely. And it just won’t work, unfortunately.

 

Trish

Yeah, fair enough. And so tell me after you’ve done the centrifuge effect, which kind of cleans it, and kind of gets it ready to use somewhere else.

 

Dr Perron

You can centrifuge it. Not all techniques do and you don’t necessarily have to. So centrifuging is one technique to sort of separate the different layers. So when we get fat off as when we like to suck fat and use and if you were to let fat just sit in the corner of the room for however many hours it’ll generally separate it four layers. So the bottom layer is the aqueous layer, the liquid layer, the middle layer, where the second layer is the platelet rich plasma layer or the PRP laser layer, or the plate and platelet rich layer, sorry. And then there’s the fat cells that sit in that third layer, and at the very top is just lipid, meaning just free fat so stuff that isn’t in cells. And so when you the whole purpose of centrifuges is to basically hurry that settling process along. So when you spin it down, you just get those layers very quickly. I find the issue with centrifuging and from what some of the evidence in papers show is that centrifuging doesn’t sort of decrease the likelihood of fat working. So it’s sort of a little bit traumatic to the fat cells if it’s a little bit more time consuming. So you can put the fat in, but you need a centrifuge, you have to load them up, it has to all be sterile, which is a real pain. And if the centrifuge isn’t balanced, that’s another thing that’s really important because you got to spin them around. And if the centrifuge isn’t balanced, they get unbalanced into real pain. So the centrifuge method, there is a filter method. And there’s quite a few different types of filters on the market. And most of them do the same thing, they basically take all that lipo aspirin and put it through a couple of very specialised filters and try to retain as many large fat cells on one side. Now, they’re not perfect either, they can let you know viable fat cells through the other side. And they certainly don’t retain any platelet rich layer, but they’re very good at getting fat that is oil free, the oil is probably the biggest problem and getting rid of the aqueous layer. So they’re very good at doing that. But they don’t necessarily keep all the fat cells behind the mesh.

 

Trish

And so say, so you have your lipo, have your fat transfer and then tell me about the recovery? Because like I someone mentioned to me, wouldn’t it make sense to like, as soon as you’ve had surgery, if you eat a lot of food that’s going to kind of put on a bit of weight, straight after surgery is that kind of going to make the fat, grab a bit more like and I don’t mean sugars and stuff like that. I mean, like carbs, and, you know, like proteins? And just like if you eat a lot more food for a bit with that kind of fat better? I don’t know.

 

Dr Perron

Yeah. And look, a lot of what is in any surgery is having good nutrition, good diet. And that’s I mean, that’s another podcast entirely. But I think the crux of it is that you need to support your body during that healing phase. And certainly, if you were to say, look, I’ve had an operation and I’ve been on antibiotics, it’s day five, I want to go on a gut cleanse and do all these kinds of diets worst possible thing, because not you just basically putting more strain and stress on your body when it needs support. So after after surgery, generally, the things that are going to help a lot are as exactly as you say, a little bit of carbs, a little bit of good fats and good protein to help kind of get things going, I’d always tell my patients to have a little bit of vitamin C and Zinc that helps with collagen production and avoid salt, salt makes things swell a lot. And so if you avoid salt, you get less swelling. And the thing that typically happens with with fat grafting, or fat transfer is that you do get a bit bruised, and so bruising, you want to stay out of the sun, bruises that what happens with the sun is that it actually changes the shape and the and the configuration of the red cell pigment, which is what makes red cells red. And so what that does is it turns it into an insoluble pigment that actually collects in the skin and again, can stain your skin brown and it’s really, really hard to get rid of so I’m a little bit off track.

 

Trish

That’s so interesting. No,

 

Dr Perron

Yeah, but diet is very, very important and so making sure you have a good steady diet for at least two weeks afterwards is probably the most important.

 

Trish

Yep. You know, I know you’re really big on nutrition for patients. So we do need to do another podcast on that because that is so interesting itself as well.

 

Dr Perron

Yeah, it’s a huge thing, diet is probably the most important thing. I think postoperatively being pre op and post op, but you know, that can be the make or break between a good scar, scar that is not very strong, and making sure that patients kind of, you know, dance at a hospital versus you know, having a wheelchair note. It’s very important.

 

Trish

Of course, so I won’t keep you too much on let’s have one more question. So say for example if I’m like and I’m just using me in an example. Yeah, I wouldn’t do this but just well you never know. I could do anything but I have to have liposuction, and then I get the fat transfer to my body, which I never would, because my butt’s away big enough as it is, to get a transfer but that was the procedure that I wanted. Tell me about the recovery. So when I wake up from surgery, I’m going to have a compression garment because I’ve cut because if you’ve fat transfer, do you still get compression coming on?

 

Dr Perron

So it’s so the areas that we want to provide a compression to the areas we’ve taken the fat from. So having a nice sort of gentle compression, that just helps to counteract a bit of the excess of swelling and whatnot, just just it’s a bit more of a comfort thing. And so when you take the fat, correct, and then where we put the fat, you need to support it, but not not in a really strong way. So not really super, for example, putting on the breast if you put on a sports bra, it’s probably not the best idea. But a nice gentle support is good, just so it’s not moving around, and the breasts are kind of going everywhere. If it’s in the if it’s in the bum, then I would say, again, same thing, gentle support, just to make sure it’s not it’s not unsupported. Because it is just uncomfortable and doesn’t help with that post op recovery.

 

Trish

Could I sit on my bat? Or do I have to? Or do I have to? Like, how do I sleep at night? In my bum?

 

Dr Perron

Yeah, so usually. So for buttocks, it’s usually side to side. So you want to sleep from one side to the other side and then or on your front so sleeping on your abdomen. And you really kind of want to do that for about a week, after about a week or so. If it’s not too sore, you can maybe put a little bit of pressure on it in terms of sitting on your buttocks. I mean, it’s just a natural thing that you have to do and we do have to sit and that’s one of those things that is fine. Really, when you look at where you put pressure on your buttocks, it’s actually on the lower part rather than the upper part that goes in your buttocks is actually not too bad. As long as you know, as long as you’re not sitting directly where the fat is gone. It’s okay.

 

Trish

Yep. Do you know what they got those we sell in, in our shop The Popp Co. We sell those BBL pillows, and they’re really popular and I actually sit on them every day because I just find it really comfy because your butt is kind of in the air a bit but I like it because it’s up high. So it makes me sit higher at my desk and so and then there’s no pressure on the butt. But you kind of I don’t know why I just like sitting on him. But that would be good because then your butt’s not being touched at all. It’s just, yeah.

 

Dr Perron

Yeah. And a lot of that is specialised types of foams. And some of them actually are the same ones that are used in patients with spinal injuries who are in wheelchairs. So some of those very specialised foams, they do a very similar process, which is basically distributing that pressure over a wider area rather than just being in those two bony parts on the buttocks.

 

Trish

Yep. Yep. And one last question. So recovery time, like if like, when could I go back to work?

 

Dr Perron

Oh, I’d say two weeks without a problem.

 

Trish

Nice, nice. And isn’t as painful as like, like breasts, to me a breast reduction was really painful. So do you still need to have those strong painkillers or it’s not so bad?

 

Dr Perron

Not too bad. I mean, certainly the first couple of days, you get a bit of bruising, it might be a bit sore and having a little bit of extra pain, pain relief is reasonable. I would say if you’re still really sore at the end of a week, maybe we’ll probably have to have a look at that. That doesn’t sound very good. If it’s at the end of two weeks, you should be off pretty much everything it shouldn’t.

 

Trish

Yep. Why would you? Like when you say you’d have a look at that, what could it possibly be?

 

Dr Perron

If you’ve got a hematoma or, or a big bruise inside. So in some patients that I’ve done liposuction on because you’re doing it in a blind fashion, meaning you can’t see where they’ll necessarily exactly where that liposuction is going. And certainly if you hit a few of the big perforating blood vessels that come from down behind the muscles and then up through the skin, since some people those perforating blood vessels are quite large, and into those with the liposuction cannula that can cause a bit of bleeding and you’ve got to be very mindful of that. Again, that’s one of those big risks with large volume liposuction, if you knock a few of those few of those off in certain parts of the body. You can again, that’s potentially life threatening for some people.

 

Trish

Yep, yep. Oh, that’s been so interesting. Like I’ve really enjoyed it like I probably actually have had liposuction once I had it. Just to define my waist a little bit more after a revision tummy tuck. And because I thought, oh my god, I look really square so I got that done. And they did my thighs as well, I’m on sleep, it’s the best surgery ever. And my, like, I got out of my surgery. And I was like, I didn’t have any pain and, and I’ve had a breast reduction that was so painful. But after my liposuction, I was just like, really has anything actually been done? So for me, lipo was great.

 

Dr Perron

Yeah. And I think I think you’ve kind of hit the nail on the head with good with an operation that’s done well, you get good results. It’s very good. And unfortunately, the stuff that we’ve seen in the news over the past year with oh my god, like, I’ve seen a lot of those patients come through my doors with lots and lots of problems that are very difficult to fix. Very difficult to fix and it’s that, an overzealous attempt to correct that is, it is sort of the incorrect way of doing things. And that can be for anything that can be for noses, it can be for breasts, tummies, whatever it might be. And if someone’s not familiar with those areas, again, you know, I think one of the important things is to recognize your limits. So, you know, as I say, for noses, I’m not going to touch your nose, because I know I don’t have the skill set for that area. So I just leave it to my colleagues who do it regularly.

 

Trish

Yeah, yeah, totally. And you know what you said, like mine was tumescent liposuction. And I do believe that that’s a bit more gentle, because I’ve seen, I’ve seen stuff on TV just recently, and they’re just going hell for and then they’ve got, you know, 12 jars of frickin fat sitting there. And you just, like, you don’t know what’s happened underneath that as well, because they’ve just gone for it. Like, I’m all into the gentle. For sure. Yeah.

 

Dr Perron

I mean, it’s so dangerous. It is so totally and I mean, it’s good that it’s become a very important topic because it’s so debt. It’s presented in such a way as to do it and it’s all very showy, and music and all the rest of it. It’s easy to get sucked into that. But the reality of it is that that’s definitely not the safe way. And it’s, I mean, five minutes safe. It’s actually very dangerous. Yeah. And so having it done in an appropriate way with someone who’s familiar with it is good.

 

Trish

Yep. No, I agree. Look, thank you so much. I won’t keep you any more. I could actually talk to you all night. This is one of my favourite things to do. But you could have gone to have some dinner. I guess I do as well. But look, thanks for joining us tonight. Really, really appreciate it. Lovely, lovely. Pleasure. And listeners. Look, if you do want to find Dr. Justin Perron he’s in Brisbane at Herstellen Clinic is that amazing clinic. They have non surgical treatments there as well. So yeah, definitely go and check him out. Thank you so much for joining us tonight. Dr. Perron.

 

Dr Perron

Thanks very much.

 

Trish

Thanks. Hey, no worries. Bye.

 

You can check out more about Dr Justin Perron here.

Or click on the link here to find out more about Herstellen Clinic.

His Instagram handles are @drjperron and @herstellenclinic

 

 

 

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