Q: We found a lot of enquiry for people looking for Fat Transfer to the breast, but we find it hard to find a practitioner in Australia that does it. Are we lagging behind?
Dr Friedman: Well, this is an involving issue and I don’t want to say it’s being left behind; it’s just to see things in the right perspective. I don’t think that in medicine you should do everything that is coming out to the market, because you are not talking about cows or mice, you are talking about people so you need to do enough experience; you need to see what is happening in the rest of the world. I don’t think you need to adapt to everything that goes out, I think you need to have some time to appreciate what is happening, so I don’t think so. I think they are on the right track.
Q: Why do you think Fat Grafting is such a hot topic at the moment?
Dr Friedman: Because with that, there are many good things that you can have. First of all, we are not using something which is not a part of you, not an implant; we are using something that is a part of our body. And, what we found out in the last year is that with fat comes a lot of stem cells which will have an excellent job in treating many areas of the body not just the breasts. We can beautify the face, we can regenerate many parts of the body, and now we are even talking about using the stem cells from fat to treat the brain, to treat the heart and many other things, so the future is fat.
Q: I’ve heard fat as being referred to as Liquid Gold. Would you agree with that?
Dr Friedman: Yes, it is. It’s not just the fat; it’s the stem cells that come with it. Because if you are judging the amount of stem cells that you have, in the past we thought that bone marrow has the highest percentage of stem cells but we now know that in fact we have a 100 to 1000 more per square centimetre of fat, those cells then compare to bone marrow.
Q: Is there any particular technique used for Fat Grafting?
Dr Friedman: I think this is the main problem with fat grafting – that there are a lot of techniques now on the market. And the problem is you need to know what is the best technique and this is something that I think is still evolving because it is something connected to what we said before – you don’t need to be the first one who adopts the technique – let’s find which technique is the best and decide what we want to do.
Q: I’ve noticed in the presentation today as well, you mentioned the fact that fat transfer and injectables to the fact it’s important to understand the anatomy of the face; can you explain why it’s important?
Dr Friedman: It’s important for several reasons. The first one is if you are injecting to the face it’s not just taking a clay and molding it; in the face like in the rest of the body there are different levels, there are different organs inside you – the skin, the fat, the nerves, the blood vessels and other parts of your face, and you need to understand the dynamics of which part of it, you need to understand how muscles are moving the face, you need to understand the ageing process of our face and what does this ageing include inside you? So it’s not just taking the material and pushing it inside – you need to understand the difference between one person to the other. So there’s never one way of doing this. Each person is individual and you need to have individual treatment for him. It’s not the same thing for everybody.
Q: So it’s not one size fits all; it’s different for a 30yr old to a 50yr old?
Dr Friedman: And it’s different for every person until their 50’s, so it’s not just all the same. So you need to judge each person, you need to understand what is happening in this person, and you also need to listen to him because each person wants different things to achieve.
Q: What limitations would you say there are for Fat Grafting?
Dr Friedman: Well the limitation is that the procedure is much more expensive than using fillers; it will take more time; some of the fat will be absorbed so you won’t have the amount that you put there in the beginning; and it’s very technical and demanding. Because if you are putting inside bigger lumps of fat, then you have lumps so it’s a very technical and demanding issue.
Q: Is fat fat? For example, I’ve heard it said that if you get the fat from one part of the body it depends where you put it into another part of the body?
Dr Friedman: Now there are things that we can use but you need to understand that fat is not like fat that you see in supermarkets. It’s more like small grapes. So it’s a bundle of millions of small grapes. It’s not a completely like where you can mold it wherever as you like – you need to understand the physical properties of fat in order to avoid complications.