Plastic surgeons are constantly on the hunt for fresh ways to improve a patient’s results as well as his or her overall experience. To this end, new modalities, techniques and products are constantly being developed. The goal is for plastic surgeons to have better tools for addressing a patient’s needs. This drive has given birth to non-surgical fat reduction, drainless tummy tucks and a long lasting pain medication that helps to greatly reduce a patient’s recovery time.
Dr. Bruce Van Natta prides himself on having always been an early adopter. He firmly believes in embracing the new, but only practices those techniques on his patients that actually work. But to figure out what works, he has to try everything. Here are some of the current and future innovations that have him really excited.
FaceTite, BodyTite & Microneedling
There are some really fantastic non-surgical modalities out there that, when combined, can deliver almost surgical level results in the right patient. FaceTite and BodyTite are the latest generation non-invasive skin tightening devices to use radio frequency. What makes them so cutting edge is that they work both above and below the skin. A probe is inserted beneath the skin through a tiny insertion point. One arm of the probe travels under the skin in the treatment area while the other arm travels above. The thermal energy is then passed through these two points. This allows the FaceTite and BodyTite to work three dimensionally: reducing fat, tightening surface skin and tightening the underlying connective tissue. What’s being developed now is a companion device, called Fractora, that will allow for bipolar microneedling. This could be a total game changer for hard to treat areas such as loose skin in the neck and jowls, inner thighs and knees, and upper arms.
In Office High Resolution Ultrasound
As a leader in the field of breast surgery, Dr. Van Natta is super jazzed about the new in office high resolution ultrasound. It is being developed specifically for plastic surgeons to assess the integrity of breast implants. Until now, the gold standard for monitoring your breast implant has been an MRI. But they are not fun for the patient. There’s also a 10% misdiagnosis rate of false positives. This new ultrasound will allow surgeons to evaluate the state of your implants in the office with a statistically higher diagnosis rate for ruptured implants. Not only will this save patients time, reduce stress and prevent unnecessary surgery, but it could have other far reaching applications. This ultrasound could potentially be used to ascertain fluid collection in abdominoplasty patients as well as fluid around an implant. The options are infinite.
Dr. Van Natta has been at the forefront in the use of GALAFlex. It’s a polymer mesh that acts just like an internal bra. Many women do not have the breast tissue and/or skin to support their desired outcome. Before GALAFlex, they either had to settle for a smaller sized implant or live with the fact that the skin on their chest would eventually stretch and they would need revision surgery.
Dr. Van Natta uses GALAFlex to deliver superior results in a:
- breast lift
- breast lift with a breast implant
- breast reduction
- breast augmentation in small-breasted women who want a bigger implant than their anatomy can support
- breast revision surgery where the skin & tissues have been stretched with time and/or a too large implant
But surgeons are beginning to use GALAFlex in new and exciting ways. In massive weight loss patients with deflated buttocks, Dr. Van Natta typically performs fat grafting. But he’s playing around with the idea of eventually using GALAFlex to provide internal structure and lift. Although he has not personally used it in the face, surgeons are inserting a small strip of GALAFlex into the neck and brow. It acts almost like a sling. The problem, so far, has been maintaining the results since the skin on these areas is so thin.
Drainless Tummy Tuck
A tummy tuck or abdominoplasty has historically had a notoriously difficult recovery period. In fact, a number of patients who really need a tummy tuck to improve their body contour shy away because they don’t want to deal with the downtime and pain. One of the main contributors to an abdominoplasty’s less than joyful recovery is the fact that the surgery typically requires a drain to remove fluid from the abdominal cavity. Drains are cumbersome, embarrassing and sometimes even painful. Dr. Van Natta is offering his patients what’s called the drainless tummy tuck. Instead of inserting a tube with a drain attached, surgeons are sealing the gap between the surface skin and underlying tissue of the abdomen with progressive tension sutures. Being able to get rid of the drain has been a huge improvement in abdominoplasty.
The other contributor to an improved recovery with a tummy tuck is Exparel. This is a long lasting analgesic that is injected during surgery. It basically gives the patient up to 4 days of complete, pain free comfort. This means that patients are up and walking around immediately after surgery. This improves circulation, reducing the risk of a blood clot. Moving is also great for speeding up your recovery. Although Exparel can be used with any surgical procedure, it is an additional cost and in Dr. Van Natta’s opinion, usually unnecessary outside of the tummy tuck.
Plastic surgeons are always looking for new ways to make patients more comfortable. This is what gave birth to Exparel and also to PRO-NOX. Great for taking the edge off when treating sensitive areas such as the lips with filler or the underarms with MiraDry, PRO-NOX delivers a 50/50 oxygen and nitrous oxide combination. It’s basically a milder form of the laughing gas used in many dental offices. A few hits effectively eliminates pain, but the gas is out of your system in 10 minutes. So, patients are able to drive themselves home. It’s allowed Dr. Van Natta to do some procedures under local anesthesia, such as FaceTite, that he couldn’t before. It’s also been a great addition for his procedures for men who typically have a much lower pain tolerance than women.
Fat Grafting to the Labia
Thanks to a new bare down there aesthetic in waxing as well as women’s everyday embrace of yoga pants, the labia have hit the mainstream. Not only are women more aware of how their outer lips look, but so are plastic surgeons. Dr. Van Natta treats a lot of Mommy Makeover patients. While the labia weren’t necessarily on his radar before, now that they are, he has realized how many women can benefit from plumping up the labia with fat grafting.
There’s more to labiaplasty than fat grafting. In fact, the surgery initially referred to removal of excess tissue of the labia minora, or inner labia. Many women, especially following childbirth, end up with sagging, extra tissue that hangs worse with exercise and can rub painfully. It can also be uncomfortable during sex. In many cases, Dr. Van Natta finds that the external labia are deflated, or under filled. He may suggest fat grafting to correct this problem and provide a much prettier picture of the anatomy. He will often combine breast surgery with a labiaplasty that includes fat grafting and it’s actually the latter procedure that patients seem to find more life altering.
Tummy Tuck with Fat Grafting to the Buttocks
When it comes to body contouring, Dr. Van Natta always takes a 360° approach. The tummy really works in conjunction with the outer edge of the buttock. Many women could stand a bit more fat in this lateral section of the derrière. The beauty of combining a tummy tuck with fat grafting is that the fat has already been harvested as part of the abdominoplasty. Dr. Van Natta then takes some of this fat and injects into the buttock to improve shape. This ability to add and subtract fat from a patient’s body contour is the closest thing that surgeons have to sculpting. It gives them the kind of precise control that delivers truly amazing results. Dr. Van Natta’s mommy makeover patients who’ve had a tummy tuck with fat grafting to the buttocks are loving their results. Especially when wearing the now ubiquitous yoga pants.
Breast Implant Studies
As a leader in the field of breast surgery, Dr. Van Natta often participates in breast implant studies. Currently, he is involved with one that uses the new in office ultrasound machine to examine patients who have breast implants with the GALAFlex mesh. The goal is to prove that when the breast implant is right up against the mesh, the GALAFlex in no way harms or damages the implant. This will be an important study clinically for the FDA. He’s also currently an investigator in the United States on the Motiva breast implants. He feels strongly that it is part of his job to participate in studies on new products and techniques that have the potential to deliver better outcomes, quicker recoveries, and less painful surgeries for his patients.