GalaFLEX Surgical Scaffold for Plastic or Reconstructive Surgery

 
 
 
 
 
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A post shared by Effie Politis, MD, FACS (@dreffiepolitis)

Another important technique to point out from the case that we’ve recently posted about(please see our grid @dreffiepolitis ), is the use of Galaflex Ravioli construct⁣⁣⁣⁣⁣.⁣⁣

The GalaFLEX Scaffold (Galatea Surgical, Inc., Lexington, MA) for plastic and reconstructive surgery belongs to a new generation of products for soft tissue reinforcement made from poly-4-hydroxybutyrate (P4HB)⁣. ⁣

It is comprised of high-strength, resorbable P4HB monofilament fibers. It is a knitted macroporous scaffold intended to elevate, reinforce, and repair soft tissue. The scaffold acts as a lattice for new tissue growth, which is rapidly vascularized and becomes fully integrated with adjacent tissue as the fibers resorb.⁣

The “ravioli” technique involves using 2 pieces of extra thick ADM to completely wrap the TE/implant. The 2 pieces of ADM are cut to the size of the TE/implant with 1 piece covering the anterior and the other covering the posterior surface of the TE/implant.⁣⁣

Acellular dermal matrix (ADM) is a soft connective tissue graft generated by a decellularization process that preserves the intact extracellular skin matrix. Upon implantation, this structure serves as a scaffold for donor-side cells to facilitate subsequent incorporation and revascularization. In breast reconstruction, ADM is used mainly for lower pole coverage and the shaping of a new breast. It helps control the positioning of the implant in the inframammary fold, and prevents the formation of contractile pseudocapsule around the breast implant.⁣⁣

The “ravioli” construct is something Dr. Stephen Sigalov came up with which involves performing a 360 degree wrap of the implant with Galaflex to stabilize the implant in the breast pocket given the normal landmarks are obliterated with the mastectomy. The Galaflex or P4HB totally resorbs (turns in CO2 and H20) in 18-24 months and is replaced by the patients own Type 1 collagen to provide long lasting implant support. Type 1 collagen is the strongest collagen in the body. This prevents issues such as stretch, bottoming out, malposition, implant flipping etc. ⁣⁣

Tummy Tuck: All You Should Know

Do you have loose skin, stubborn fat deposits and stretch marks in your abdomen? Are you feeling embarrassed and self-conscious because of your protruding belly? Have you tried to achieve a flat tummy through diet and exercise without success?

If so, a tummy tuck is ideal for you.

Abdominoplasty, better known as a “tummy tuck,” is a surgical procedure to reshape and flatten the abdominal area. The surgeon removes excess sagging skin, gets rid of stubborn fat, tightens abdominal muscles, and corrects a protruding belly. The surgeon also removes some, if not all, stretch marks.

More detailed information about Tummy Tuck here.

What is SPY Elite Imaging?

SPY Elite imaging uses an injectable fluorescing agent to intraoperatively assess the perfusion and viability of tissue, including skin flaps, during post-mastectomy reconstruction for breast cancer patients.⁣⁣
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We evaluated the patient preoperatively and also used intraoperative SPY imaging (intraoperative laser angiography) to ensure adequate perfusion of the mastectomy flaps prior to engaging in single stage reconstruction. ⁣⁣
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Intraoperative laser angiography using indocyanine green (ICG) is a vascular imaging methodology that can be used in the intraoperative or postoperative setting to visually assess superficial blood flow. ⁣⁣
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Characteristics of ICG angiography make it a desirable option for tissue evaluation. The technique provides real-time assessment of tissue perfusion that has been correlated with clinical outcomes and guides surgical decision making, such as flap design or intraoperative tissue resection. ICG has an excellent safety profile and short plasma half-life, allowing for repeat evaluations during the same operative procedure. ⁣⁣
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Please note: These are my individual patients who have provided written photo consent. These photos and posts do not constitute medical advice. Results may vary. See a board certified plastic surgeon for evaluation.⁣⁣⁣⁣⁣⁣

“Breast in a day” direct-to-implant breast reconstruction

 
 
 
 
 
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Surgical Technique

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Type of Recon: Single Stage Direct to Implant Breast Reconstruction after Mastectomy⁣⁣⁣, Galaflex Ravioli construct⁣⁣⁣⁣⁣
Type of Mastectomy: Nipple Sparing or Nipple Preserving⁣⁣⁣ through inframammary approach⁣⁣⁣⁣⁣
Implants: Natrelle Inspiration Cohesive SCF 295⁣⁣⁣⁣⁣
SPY Elite Imaging⁣⁣⁣⁣
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Breast in a day” direct-to-implant breast reconstruction represents an emerging technique in the field of postmastectomy reconstruction and holds appeal, as it shortens the reconstructive process, eliminates the expansion period, and avoids a second operation.
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This case was performed with bilateral nipple sparing mastectomy and single stage reconstruction with cohesive implant and Galaflex ravioli construct placed in prepectoral position.⁣⁣⁣⁣⁣
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The advantage of this technique is that it is performed at time of mastectomy whereas traditionally, we place tissue expanders partially under the muscle and expand the patient and then perform a second procedure in 3-6 months where we exchange the expanders for permanent implants. ⁣⁣⁣⁣⁣
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Therefore, instead of a staged process, we can achieve stable and long term results with a single stage or direct to implant reconstruction. This requires collaboration with the surgical oncologist, meticulous dissection, scaffold material (Galaflex to stabilize and secure implant in mastectomy pocket ), and cohesive implants, we are able to perform implant based reconstruction in a single stage. ⁣⁣⁣⁣⁣
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Also, the implants are typically placed over the muscle, which decreases pain, animation deformity, preserves shoulder/arm strength, and creates a more natural result. ⁣⁣⁣⁣⁣
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Please note: These are my individual patients who have provided written photo consent. These photos and posts do not constitute medical advice. Results may vary. See a board certified plastic surgeon for evaluation.⁣⁣⁣⁣
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What to Know If You’re Considering Liposuction

Bothered by stubborn fat deposits that won’t go away even with regular exercise and healthy eating? At Politis Plastic Surgery, we recommend you consider liposuction to achieve a more comfortable and confident look.

What is liposuction?

Liposuction is a minimally invasive procedure that removes unwanted fat deposits from specific areas of the body. A plastic surgeon makes incisions to reach the fat deposits and uses a cannula to draw them out. The areas commonly treated include the abdomen, arms, thighs, hips, ankles, calves, neck, love handles, tummy, face, chest and buttocks.

read more here

Buttock Augmentation – Procedure Overview

A healthy body with delightful curves can improve your self-confidence and make a positive impact on your emotions and behavior. This confidence might even lead to better relationships, work satisfaction and feeling connected to your environment.

A healthy body with delightful curves can improve your self-confidence and make a positive impact on your emotions and behavior. This confidence might even lead to better relationships, work satisfaction and feeling connected to your environment.
Buttock augmentation is a procedure that reshapes the buttocks, making them round, firm and nicely curved. And along with full, proportionate buttocks, you will enjoy a more balanced look, enhanced self-image and greater self-confidence.

Read more about Buttock Augmentation here

Breast Implant Removal with Lift

Breast implants don’t last forever, eventually they need to be removed and replaced. When replacing implants, many patients opt to get mastopexy, or breast lift, in conjunction with placing new implants. During consultation, Dr. Effie Politis can evaluate the condition of your implants and advise if they should be removed and replaced, or removed altogether if you wish to return to a more natural look, with your natural breast size restored. When your breast implants are completely removed, this can make your breasts look saggy and deflated. But, fret not! This can be fully resolved with a custom breast lift. This procedure involves the removal of excess skin and reshaping your breast to make them plump, shapely, and round, while restoring the natural breast tissue to youthful position on your chest. If your nipples have drooped or sagged, their position and size can be altered in the same surgical procedure. If you have more questions regarding this procedure, don’t hesitate to reach out to us and schedule a consultation. You can call us at: (813) 542-2587. Looking forward to hear from you!

Breast Augmentation With 24-hour Rapid Recovery Method

Here’s a before and after of a primary breast augmentation with 24-hour rapid recovery method. When I was training in my residency at USF, Dr. Tebbetts and Dr. Adams, who pioneered the method, lectured and performed hands-on training demonstrating this method. The 24-hour rapid recovery breast augmentation is a procedure that relies on process oriented steps that maximizes planning, minimizes tissue damage and allows patients to get back on their feet in as little as a few hours after waking up from anesthesia. The recovery time is minimal because the procedure involves no bleeding, minimal tissue damage, and is very gentle and precise. It allows the patient to continue with regular life by that very same evening or the next day. Heavy exercise and intense work should be avoided initially; however, patients are encouraged to get moving right away. Patients who have undergone the 24-hour breast augmentation procedure can manage any lingering pain with over-the-counter painkillers. Will be talking more about this on another Instagram live talk soon. Stay tuned for the annoucement! Have a great week ahead!.

What you need to know about your liposuction recovery

Have you tried getting rid of stubborn pockets of fat in your belly? Are you frustrated by barely noticeable results after months of exercise and dieting? If so, then liposuction—an outpatient cosmetic procedure—can offer a fast and effective solution to your dilemma.

What is liposuction?

Liposuction is a minimally invasive procedure that removes excess fat from a localized area of the body. A thin, hollow tube called a “cannula” is inserted through incisions made in the surgical site and used to loosen the excess fat and suction it via a vacuum or cannula-attached syringe.

Who can undergo the procedure?

You can be a candidate for the procedure if you have overall good health, have one or more areas of excess fat that do not respond to diet or exercise, and are within 30% of your ideal weight. Liposuction is not a substitute for losing weight or exercising. The goal is to remove stubborn pockets of fat to make your body appear slimmer and contoured.

What are the prerequisites of a successful liposuction?

While highly safe and effective, liposuction involves surgical incisions and comes with a downtime and recovery period. Hence, it requires preparation in order to recover properly and achieve the desired results.

The most critical aspect of this procedure is consulting a board-certified plastic surgeon experienced in liposuction. A skilled surgeon will offer an individualized consultation, align your aesthetic goals to what the surgery can do, help you understand the potential results, and guide you in making an informed decision. She will also help you understand what you should expect during and after surgery, which will make your recovery process easier and faster.

You should have realistic expectations of what liposuction will help you achieve before you undergo the procedure. Liposuction can be superbly transformative when used to achieve specific aesthetic objectives, but much less so for those with unclear goals. This is why it is important to share your objectives and expectations with your surgeon and have them evaluated to ascertain the feasibility of the procedure in helping you achieve them.

Also, you should know that the recovery process after liposuction varies from person to person. In fact, factors such as your age, prior medical history and overall health will determine how quickly you recover. What you do in the period leading up to the surgery—weight loss, healthy diet and quitting smoking—will also affect your recovery. So speak with your surgeon, understand the procedure and how to prepare for it, understand the recovery process, and then allow your body to heal at its own pace.

What should you expect soon after surgery?

Liposuction is an outpatient procedure. You should expect to go home the same day. However, if a large amount of fat is to be removed, you may be required to stay in the hospital overnight to be closely observed.

Immediately after surgery, you will be placed in a compression garment that was custom-designed and fitted for you before the procedure. Then you will be moved to the recovery room for observation and then discharge an hour or two after the procedure.

While you are in the recovery room, your response to the surgery will be monitored. Your vital signs will be checked, including oxygen levels and blood pressure and any signs of dizziness and nausea. If all signs are good, you may return home.

You should have the following supplies ready for you at home:

  • Pain medication
  • Soda crackers for nausea
  • Bottled water
  • Comfortable, loose clothing
  • Dark towels to place on your car seat to absorb leaking fluids
  • Pillows for comfortable rest

Regardless of whether you stay overnight in the hospital, you will need someone to drive you home. The residual effects of anesthesia and pain medication make driving unsafe.

What happens the first 3 days after liposuction?

On the first day, you will have compression garments or elastic bandages wrapped around the surgical sites to help reduce swelling and contour your body to its new shape. Be sure to wear them diligently.

During the first 24 hours, you can expect some fluid to discharge from the liposuction incisions. This is a common occurrence and no need for concern. You may also have small drains placed at the surgical areas to minimize fluid buildup around the incisions. If you have drains, your surgeon will explain how to care for them.

You can expect to have moderate pain and soreness during the first few days of your recovery. If your surgeon prescribes pain medication, follow your medication schedule closely. The pain should begin to lessen within 48 hours.

Be sure to limit your activity during recovery. While the compression garments will restrict your movements, it is up to you to limit physical activity whenever possible. Get some help around the house for this early part of your recovery, particularly if you take care of young children.

What should you expect during the first and second weeks after surgery?

During the first five days following your procedure, your compression garments stay on 24 hours a day. Move your body every two hours to prevent the formation of blood clots and reduce swelling, and then rest and drink plenty of fluids. You should avoid showering and bathing—give yourself a sponge bath and wash your hair over a sink.

After day 5 and for the next 9 days, you can remove the compression garment when showering. Light exercise, like stretching or showering, can now be part of your routine.

You can expect a massive reduction in pain and soreness a week or two after your procedure, which means you will probably be able to return to work by the second week. If you have a physically demanding job, you may need more time off to fully recover. Meanwhile, you still need to wear your compression garments.

What happens between week 3 and week 5?

One month after liposuction, you will most likely feel no pain or soreness at all. Slight swelling is normal and can take months to subside completely. As the swelling and bruising continue to heal, the results from the surgery improve. By the week 4, you can resume light exercise while still avoiding strenuous or heavy activity. At this point in the recovery process, compression garments are only required for 12 hours a day.

What should you expect week 6 and beyond?

The sixth week usually marks the end of bruising and swelling, though some swelling may linger for a while. You will no longer need the compression garments and you may enjoy unrestricted activity levels unless your doctor orders otherwise. By week 6, you are free to enjoy the full scope of results from your surgery.

What should you do to speed up your recovery?

Recovery should not be rushed, but you can take certain actions to speed up your body’s natural healing process:

1. Eat healthy

Proper healing requires good nutrition even if you are completely healthy when you undergo liposuction. Eat well, eat regularly, and include lots of fresh fruits and vegetables in your diet to reduce inflammation. Protein will aid healing and maintain lean muscle mass. It is a good idea to prepare some healthy meals before your surgery since you won’t be able to cook the first few days after liposuction.

2. Stay hydrated

Hydration is essential for faster recovery, so drink plenty of water after your surgery. For variety, try infusing the water with fresh fruit. Drink at least eight 8-ounce glasses of water every day.

3. Get enough rest

Take it easy on your body and get plenty of rest during the first few weeks after your surgery. Proper rest and sleep will speed up your healing.

4. Walk regularly

Though strenuous exercise is not advisable during recovery, light movement will actually speed up your healing. During the first few days, exercise without increasing your heart rate and take short walks to keep yourself moving without straining your body.

5. Reduce salt

Keep your salt intake low because excess salt will increase water retention in your body and promote swelling.

6. Avoid tight waistbands

Tight waistbands and belts will slow down the drainage of fluids from the body, increase swelling, and slow down the healing process. Avoid waistbands and belts until swelling and bruising are reduced to the point where you feel comfortable wearing them.

7. Ask for help

Before the procedure, recruit a family member or friend to help you with activities such as caring for young children, cleaning or running errands. Trying to perform these activities yourself after the surgery will wear you down and prolong the recovery period.

Liposuction is a great way to boost your confidence and make you feel happier with your appearance. At Politis Plastic Surgery, our experience has shown that patients who know what to expect during and after the procedure usually have the smoothest and fastest recoveries.

Do you have more questions about liposuction recovery? Call (813) 542-2587 to schedule your consultation with Dr. Effie Politis. As a board-certified plastic surgeon who regularly performs liposuction, Dr. Politis will be happy to speak with you about how to achieve a slimmer, more contoured body. For more information about liposuction and other cosmetic surgery procedures, visit the Politis Plastic Surgery website.

What you do before liposuction really matters

Liposuction is a versatile, safe and effective method of removing unwanted fat cells that do not respond to diet and exercise. For excellent results with the procedure, you need a knowledgeable and experienced surgeon, realistic expectations and overall good health. And what you do before the surgery will determine the results.Like every surgery, liposuction is a serious procedure that may come with unwanted complications. Before you opt for the procedure, you have to be sure it is right for you and, more importantly, prepare properly to get your desired results.

How should you prepare for liposuction?

1. Achieve your ideal weight months before the procedure.

Liposuction is neither a substitute for weight loss nor a remedy for future weight gain, and it is based on your current weight and body contours. Therefore, it is best to be at your ideal stable weight at the time of surgery to avoid seeing the results from liposuction erased when your weight cycles up again.

Exercise and a nutritious diet will help you achieve a healthy stable weight and make your body ready for recovery after liposuction. Ask your plastic surgeon to help you with diet and lifestyle changes that can enable you to achieve your ideal weight several months before the procedure.

2. Build your muscles.

Liposuction removes stubborn fat and often reveals underlying muscles in the area where it is performed. In some cases, revealing these muscles by removing unwanted fat may lead to undesired body contours. It is necessary to build and tone muscles several months before the procedure to ensure the surgery delivers the appearance you desire.

Apart from helping you achieve the look you want soon after surgery, building your muscles will also enhance your strength and speed up healing.

3. Change your diet.

Diet is critical as you prepare for liposuction. An appropriate diet will boost your health and enhance the elasticity of your skin, enabling you to heal faster after surgery and achieve desired results. In preparing for your surgery, drink plenty of water and eat foods that are high in antioxidants. The foods you should target include:

  • Squashes, like zucchini and pumpkin
  • Berries, including blackberries, blueberries and acai
  • Healthy oils, like walnut oil and olive oil
  • Omega 3 fatty acids
  • Cucumber
  • Celery
  • Spices, including turmeric and cinnamon

4. Quit smoking.

Plastic surgery is an extremely delicate procedure and anything that can sabotage the results should be avoided. Since nicotine restricts blood vessels and reduces blood flow throughout the body, you should avoid smoking.

By quitting smoking, you will enjoy improved blood flow, more oxygen transport to your tissues, reduced risk of developing blood clots, accelerated healing of wounds and reduced tissue scarring and tissue death. You will also reduce the risk for complications and enhance your recovery process.

It is best to stop smoking permanently. But if you can’t, then you should stop at least one month before your procedure and only resume after you are healed.

5. Make your home ready.

For a comfortable and speedy recovery, you should prepare your home in advance for the recovery period. Recovery after liposuction does not take long, but your home should allow for the rest and relaxation you will need. Ask your plastic surgeon for suggestions on how to equip your home for your recovery period.

Generally, you can prepare your home by:

  • Putting essential items near your bed for easy reach.
  • Getting longer charge cords for electronic devices.
  • Re-organizing your wardrobe to make comfortable clothes easier to find.
  • Buying foods that are easier to prepare.
  • Making arrangements for help with your children and pets.

6. Adjust your medication.

There are a number of over-the-counter medications, prescription drugs and supplements that may cause problems during liposuction surgery. They include drugs that inhibit blood clotting, cause excessive blood clotting or interfere with anesthesia. Generally, you should avoid taking blood thinners, aspirin, anti-inflammatory drugs and herbal supplements at least three weeks before surgery.

It is important to discuss medications with your doctor for specific instructions. After this discussion with your plastic surgeon, you may be taken off certain medications temporarily or instructed to take extra precautions against potential side effects during surgery.

Remember: Never to stop taking your prescription medications unless advised to do so by your surgeon.

At Politis Plastic Surgery, we give you the opportunity to have your liposuction done in an accredited facility by a surgeon who performs the procedure regularly. We believe that as a patient, you play a critical role in achieving lasting results from the surgery. These tips are intended to give you the best possible starting point for recovery and the most desirable and enduring results.

If you have specific questions or concerns, you can arrange for a private consultation with Dr. Effie Politis. For more information about liposuction and other plastic surgery procedures, visit the Politis Plastic Surgery website.