Breast reconstruction in overweight patients can be a difficult challenge for plastic surgeons. A higher body mass index can be associated with greater post-operative complications and poor cosmetic results. This study found that obese women were as likely to be generally satisfied with their breast reconstruction as normal weight patients. For those who had reconstruction using their own skin (TRAM flap), as opposed to a breast implant, body mass index had no effect on satisfaction. The study concluded that for overweight patients, the quality-of-life benefits from breast reconstruction outweighed the surgical risks. More than 57,000 breast reconstructions were performed in 2007, according to the ASPS.

After major weight loss, many patients want to further hone their body by having body contouring plastic surgery. This study looked at demographic factors that influence patients’ desires for plastic surgery following massive weight loss. According to the study, the majority of post-bariatric surgery patients want body contouring. In addition, younger, divorced women who had minimally-invasive gastric bypass surgery had the strongest interest. Almost 67,000 body contouring procedures after massive weight loss were performed in 2007, according to the ASPS.

Not only are cheeks central to your face – they are central to the American concept of beauty. A study in June’s Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), found that a deep fat compartment located within the cheek is vital to a youthful-looking face. Not only does rejuvenating or returning volume to this fat compartment make the cheek more youthful, it also improves volume loss under the eyes, helps eliminate “parentheses” lines around the nose and mouth and gives more curve to the upper lip – essentially restoring a youthful appearance to the overall face.“From the irresistible urge to pinch the cheeks of adorable infants to our admiration of Hollywood stars like Audrey Hepburn and Angelina Jolie, we’ve known for a long time that cheeks are vital to what we consider beautiful,” said Joel Pessa, MD, ASPS Member Surgeon and study co-author. “Adding volume rather than lifting is not a revolutionary concept in plastic surgery. But the idea that restoring volume to deep cheek fat will affect so many areas of the face is a breakthrough in our understanding of how to better treat facial aging.”

In the study, 14 cadavers were injected with dye to identify the deep cheek fat compartment, which is located underneath the fat beneath the skin. After latex was injected into the compartment, which then set overnight, the study authors located the boundaries of the fat compartment, as well as the compartment’s relationship with adjacent muscles. Three additional fat compartments in the face were also identified in this study.

According to the study, volume loss to the deep cheek fat compartment leads to “hollowing” of the face. It further noted that volume loss of the deep cheek fat compartment could be the determining factor in much of what a person observes as aging in the midface. When volume was restored deep within the cheek, either by using fat, tissue fillers or an implant, improvement in the hollowing of the face became apparent immediately. Finally, when the injection was done correctly into the fat compartment, a smaller volume of fat or filler was needed, the study noted.

The study authors concluded that many other compartments of fat remain to be identified in the face and human body. But the finding that adding volume to particular facial compartments results in highly specific, predictable and immediate results, brings plastic surgeons closer to fighting facial aging in an algorithmic or step-by-step way.

According to ASPS statistics, nearly 8,000 cheek implants were performed in 2007. In addition, nearly 47,000 fat injections and 1.1 million injections with hyaluronic acid fillers were performed last year.