Videos

Liposuction of the abdominals and flanks with fat transfer to buttocks (BBL)

DR. BATAL: “So this is Dr. Batal. Today I’m doing a one month follow up for Courtney. We have done a fat transfer to the buttock, buttock augmentation using the fat from her torso. So we did liposuction 360. See how nice the finish in the midline. Some definition in the abs, you can see the abs is defined and was showing the oblique muscle here. And you can see how nice the curve from the ribcage all the way to the spine. And also in the back here can see how nice the slope from the back all the way to the buttock. And the same here from the ribcage to the posterior in the spine.”

DR. BATAL: “How was the operative experience?”

PATIENT: “Everyone made sure I wasn’t feeling any pain and kept asking how I was feeling during the whole procedure.”

DR. BATAL: “So. Okay. Well, we have a home run.”

PATIENT: “Yeah, this is exactly what I wanted.”

DR. BATAL: “Yeah. Okay.”

Part 1 Gynecomastia Surgery

DR. BATAL: “Today we are doing gynecomastia surgery, which includes liposuction of the chest. And also, I’m going to do a liposuction of the lateral auxillary or lateral chest here. But also we have the gynecomastia tissue, which is the glandular tissue it enlarged. And those cannot be suctioned out and it’s kind of rubbery tissue. It used to be excised via an incision through the nipple or around the nipple. Right now, I have a technique that I can use special machines that allow me to drill those tissue and take it out without causing an incision using the same small incision of the liposuction. And so this if we’re going to do the coagulation of the soft tissue with a helium plasma that help me shrink the tissues and bring the skin together and tighten it. Good chance this will do the trick likely 95 percent will work and produce a nice tight skin. If we have a 5 percent gentle skin is a bit loose, then we can make an incision around the nipple and, uh, and make it a circular incision. And this will take the extra skin out, but that’s in the later stage. We’ll do this under local anesthesia with some I.V. sedation and oral sedation. We’ll show you the results after we finish.”

Part 2 Gynecomastia Surgery

DR. BATAL: “Right now we have completed the liposuction of the pectoral area to the chest and also the lateral axillary to clean it from all the fat we took about more than a liter and 200. However, there is big gland, big rubbery that you cannot suction that gland via liposuction. You cannot do that. We used to do a skin excision around it, and this would sometimes change the sensory characteristic of the nipples. So right now I use different technique using a cartilage shaver using the same incisions of the liposuction, adding no extra incisions. And this cartilage shaver is able to intrude into the tissue, the glandular tissues and distruct them and remove them. So right now, after we did the breast glandular resection, you can see there’s almost no thickness of the tissue or the rubbery tissue has been taken out using the very small incision without having any excess incisions using the machine we talked about. And we did complete liposuction for the lateral tissue and also for the pectoralas area. Thank you.”

DR. OBAIDA BATAL DISCUSSES THE TROPHY MODEL MAKEOVER

DR. BATAL: “Today we are doing almost one week follow up or ten days follow up  after almost a torso, liposuction our patient she is a trophy model. She’s actually a trophy model. She had work done before in…”

PATIENT: “Had some bad work done a long time ago.

DR. BATAL: “It worked for then. But it’s been a long time. I revised the previous work and the torso and the back and the bra fat and how, how do you find it?
PATIENT: So far? It’s amazing, honestly. Ten days. I’m not as sore for one thing, but just the results I’ll be honest with you guys. I don’t have the long mirror, but when I got here and he looked at it, I saw with different eyes too. And I was absolutely amazed I can’t believe it.
DR. BATAL: “And now you want to do more work?
PATIENT: “Yeah, because of that. Now I want to do more work because now him and I are on a journey and we’re calling this because, as he said, I am his trophy model I used to work on awards shows and bring the trophies out to all the celebrities. So now we’re doing a trophy model makeover. So all the work with him is called Trophy Model Makeover.”
DR. BATAL: “So now we’re going to do more stuff. I’m taking more praise than I need that I deserve, because most of the work been done by by you because I recommended you do plant based whole food diet. And it was just something you took passionately and you likely lost some weight with it. And I helped with the contouring and the kind of disguised the internal curves that you have and the internal features. I think you should be proud more than what I am proud.”
PATIENT: “But he started it. So neither one of us can take all the credit. That’s what is called trophy model makeover. And that’s something that we created together. And we’re going to keep going because as we just said, I’m going to do more work, but I’m also going to continue the plant based diet. I have to tell you guys, like he said, I totally agree that that helped because it gave me these three weeks before the surgery to eat right and to, you know, have some better results and…
DR. BATAL: “It helped adjust the metabolism for perfect healing. But more importantly is likely the whole food part and then up that plant based part.”

BEHIND THE SCENES: Arm Liposuction Consultation with Dr. Obaida Batal

DR. BATAL: “Obviously we have a fat pad here in the lower part. Most of the surgeons, when they do arm liposuction they do the lower part only here. I mean, the way I do it, I do high definition. So I actually go up two-thirds. And then actually in your case, I’m going to go 360 arm lipo because I can see the skin is going to tolerate because of this and going to do some form of skin tightening or coagulation of soft tissue with J-Plasma. So you have a great core. And this thick pad here we can actually now show the deltoid muscle, the biceps muscle, and we can remove that pad. We’re going to be careful here because there are nerves that passed through here. So I’m going to clean the fat around here, avoid this. I think you make perfect let’s show the back for the camera. Yeah, we’re going to need to also liposuction of the arm 360, with helium plasma skin tightening to maximize the effect. I think you make perfect candidate for that. So you don’t have that much loose skin. But you want the skin to glove the new arms it’s good to coagulate the tissues All right. You can do this under local sedation as we did this. How was your experience with with a local sedation?
PATIENT: “Oh, that was great. I never had that before. And when you were talking to me, I’m like, wait a minute. Is he got to start now? I didn’t think I could do it or I was going to feel a bunch of stuff, and I didn’t I knew I was there.”

PART 1: Arm Lift Correction

DR. BATAL: “This is Dr. Batal and today I’m doing a revision of an arm lift. The patient had received an arm lift by an another surgeon in the Los Angeles area. And I’m a bit disappointed. She’s also disappointed by her result. The reason is the surgeon did not do enough liposuction into or many did not do any liposuction of the arm. That’s why the arm is still full. And also someone who did not remove enough skin. And third, the way he created her scar is wasn’t very neat to the point that caused widened scar. I think he only used one layer and with short observable sutures that likely he melted and left with a patient widened scar. So that’s and also the design of the scar. The patient in the resting position this car visible. This scar here should be more interior. The way I do it. I do extensive liposuction 360 and when I remove it remove the skin only so I will not interrupt the lymphatic system and have minimal risk of lymphedema. The way likely he did it, he just remove the skin and the subcutaneous tissue altogether. Without addressing the rest of the arms. And although she did not have lymphedema but she had a bit higher risk of that. When I revise it, I will do extensive liposuction 360 and then remove this skin only without interruption to the current lymphatic system. And we’ll show you the results after we finish.”

PART 2: Arm Lift Correction

DR. BATAL: “So right now we have completed the procedure both arms are done. But I want to show you the left arm. We did the liposuction and then we have designed our incision. And we can see that. You can see how small the arm is. I already removed the old scar and moved the incision a bit more remedialy so it can be well-hidden where the patient had her arms down. Very well hidden and actually the scar will be very thin. And if she want to tattoo it later after a year or something with the nice designs, you can actually hide it with that. How did you do today during the procedure? How do you find it?
PATIENT: “Me? Yes, I feel very good and very glad to be here with you.
DR. BATAL: “Yeah, great. So did you… Were you comfortable doing the procedure?
PATIENT: “Very comfortable.”
DR. BATAL: “The way so we do our procedure under our local tumescent with sedation, so the patient is actually awake and relaxed, I can actually adjust precisely the dose of sedation of the patient. If the patient did not want to be fully asleep. So she want to be light and with us but she was comfortable. And you slept on your own. Yeah?
PATIENT: “Yes. A bit.
DR. BATAL: “Yes. Okay. Great!”

BEHIND THE SCENES: Neck Liposuction Consultation with Dr. Obaida Batal

DR. BATAL: “As we start to go to the jawline and above the jawline, however your jawline doesn’t look like it is where the problem is, right?
PATIENT: “Right.”
DR. BATAL: “So you have a small amount in here, which is these very small folds in terms of liposuction only. However, if we just do a small touch with the liposuction in this area, this may produce like some difference. But again, you don’t have a lot. You know, you see that the distance between my fingers is actually not that compared to here, the bit of a smaller. So the amount of fat that you have in this area is like kind of not that big. However, like, I have several patients who still get good results because the skin tightens up when to produce inflammation. The other part that they can naturally decide is underneath the platysmal muscle. So the platysmal muscle is a muscle that curtains the neck we store fat behind that too and the fat behind the muscle cannot be accessed by liposuction. It can be it can be accessed by a small incision here, which is a case like I did yesterday. But the guy had so much the majority of the fat that he has is underneath the muscle, and that is it’s like a surgical removal. And sometimes there’s also like a gastric muscle, which is the… the muscle that furnish the floor of the mouth. It could be a bit bulkier. And I trim that too to make it to give it like an right angle to produce this right angle. And that’s only can be seen if I open the muscle. So in terms of improvement via just liposuction alone, you can do a small amount of chin lipo stuff its not like a jaw line lipo. And that’s rarely close the… irregularity in the speech or smile because you’re just going behind or below the jaw line and moving the platysmal okay.”

Liposuction Body Contouring by Dr. Obaida Batal, MD, FACS

DR. BATAL: “So this is Dr. Batal and I want to show you my design when I do the love handles and flanks area. You can see how the buttocks now showing more prominence. There is a curve actually far from the midline of the spine all the way to the lumbar muscles into the posterior of the spine. There’s another curve around the curve of the buttocks here. That make it prominent. And now there’s also another curve from exterior spine to the posterior spine. And all this get delineated with a nice design of lipo all the way to the deep layers. Most of the surgeons that I see them perform the surgery, although it could look simple, but they go to the superficial fat and you will never achieve those results unless you go to the deep fat especially the fat that goes between the ligaments. So once I finish also the the aux area, I’m going to eliminate the ligaments around the interior spine and make it stick. Thank you.”

BEFORE AND AFTER OF A TUMMY TUCK WITH DR. OBAIDA BATAL

DR. BATAL: “So we have completed the procedure. We have done liposuction 360 along with a tummy tuck, with muscle tightening along with high definition lipo, with rectus muscle plication and also oblique muscles plication now she has a great waistline, great midline definition and the waist is small… and symmetrical.”

BEFORE AND AFTER NECK LIFT WITH LIPOSUCTION AND PLATYSMAPLASTY

BATAL: “Right now, I’m doing a one month follow up for a patient who received a neck lift with a single incision underneath the chin. We did, uh, superficial liposuction with the surgical fat removal, and then we made an incision, created a flap, went beyond the muscle and took good amount of fat pad, dissected of the gastric muscles and of the, um, hyoid fascia. And this created a very nice right angle, um, along the jawline and along the midline here. Um, this is only a month, so we expect this to further improve in the next few months when the swelling cool down. Um, actually, the patient may need further contouring in her face, especially above the jawline here. That could further improve the result.”

PART 1: NECK LIFT AND LIPOSUCTION PROCEDURE

BATAL: “Today we are evaluating and planning to do a neck contouring. We have a fat pad subcutaneously underneath the skin and there’s also likely some fat pad underneath the muscle. So the plan today is to do liposuction with helium plasma skin tightening. And if we found there’s a fat pad behind the muscle, we’re going to make a small incision and go behind the muscle and clean the pad.”

PART 2: NECK LIFT AND LIPOSUCTION PROCEDURE

BATAL: “So today is day three after a neck lift. We just removed the two drains the patient on her way back to drive back to Northern California or to fly back to Northern California. I can see this residual swelling not a lot of it but most of it because the drains helped with the cyanosis or with the bruising, but there’s swelling which is still expected, that soft tissue swelling in the skin level, the muscle level and some muscular level. But we can see the definition start forming up the level of the neck. Can we lower the neck a bit seeing like this nice definition here. Once that goes away, the skin will curtain and glove, the subcutaneous tissue and the new muscle forming a nice jawline. And we did this procedure under local anesthesia with some sedation. The patient was sleepy, but she was breathing on her own. Not in pain at all. How was your experience with the sedation?

PATIENT: “It was. Good. It was really easy. It felt like I was in and out of nap time. But I was aware of what was going on. But I didn’t feel anything.”
BATAL: “Yeah. Comfortable and very relaxed.”
PATIENT: “Yes.”
BATAL: “That’s that’s what the best way to do it.
PATIENT: “Yeah, I think so.”
BATAL: “Right.”

MALE BUTTOCK AUGMENTATION (under local sedation)

BATAL: “Good morning. Today I’m doing a buttock augmentation using a fat transfer from the torso, including the love handles and abs and also the chest. The patient had a previous implant into the buttock, which got the capsular contraction so it was extracted several years ago and led to deflation of the buttock. So right now we are going to correct that deflation by first doing liposuction in the torso area and the flanks and the love handles. Also, the abs and the pubic area and transferring some of that between 300 to 500 ccs into the buttock, a bit into this area just to blend it in. And you can see the majority of the volume is actually the love handles and also in the lower abs patient already had previous liposuction. So expect some scar tissue and with some minor gynecomastia here and we can do this today under spinal anesthesia.”

ARM LIPOSUCTION AND ARM LIFT (2 MONTH FOLLOW-UP)

BATAL: “So right now, we are a two month follow up after a revision of an arm lift. The arm lift originally was done by another surgeon, but there was sagging skin and a bigger scar. The patient wasn’t happy with it. And then we came. We did liposuction 360. And you can see some nice definition of the arm. And we took the excess skin out and the skin is kind of hidden like here. The incision was hidden and nice and narrow for almost like a two months. I mean it’s, it’s thin and we expect in the next few months it will thin up more and more and more and the patient is happy with it. Are you? Yes. I’m very happy. Thank you. Right. Thank you!”

HELIUM PLASMA SKIN TIGHTENING DEMONSTRATION

BATAL: “See how the probe goes underneath the skin and the gas which is electrified deliver the energy, the heat energy into the surrounding collagen and elastin, allowing the tissue to contract underneath. Again, so we pass each centimeter or each tissue once or twice. Once is enough. Sometime maybe twice. Pass it slowly. Allow more contact with the tissue. I believe the patient really doesn’t need a back lift any more. Normal pinchable skin which is unfolding and opposing any normal… stop.”

ARM LIFT BEFORE AND AFTER
(Under Local Sedation)

BATAL: “This is Dr. Batal. Today I am doing an arm lift along with liposuction. My method of doing an arm lift is doing is to do a comprehensive arm lift involving 360 of the arm which is what I started to do right now. I infiltrated the arm. After I finish, I design the incision and I just remove the skin and not the subcutaneous tissue or lymphatic so the risk of having lymphedema after the arm lift is usually minimal with this technique. I will show you the results after I finish. I have completed the arm lift along with 800cc of fat, liposuction. I did this technique which includes liposuction followed by only skin incision. And when I excised the skin I did not remove any lymphatic tissue with it, which ensure adequate lymphatic drainage through the arm and minimal chance of lymphedema.”

BREAST LIFT MASTOPEXY WITH FAT TRANSFER (Under Local Sedation)

BATAL: “Today I’m doing a mastopexy with fat transfer to the right breast. The patient had already mastopexy, just a skin mastopexy like a shape mastopexy in Irvine about several years ago. Did not produce any actually any fixation or any lift to the breast. And she also had previous fat transferred to the right breast at the same time produced some volume effect. However, she had asymmetrical breast shape and breast volume so our work today will be we going to de-bulk the arm going to do arm contouring 360 with J-plasma with liposuction. We are going in high def and high def meaning helium plasma definition of the muscle. Then we are going to do a mastopexy which is a breast lift I already explained to the patient we are not expecting the upper breast corner to change at all with the breast. So this will stay low, regrettably, the way it is. So this will not be like this. It will be like this with the fat. Okay? Then we’re going to do minor lifting here and we going to transpose some of the fat and the inferiac fold with the ribiri flap into the upper medial fold or to produce some fullness in here. Same with you again, some fat in here and then we’re going to do some fat and use some of the arms into that breast as a safe procedure. We may need to do more later.”

NECK LIFT AND NECK DE BULKING FAT REMOVAL (Under Local Sedation)

BATAL: “So today we are doing, uh, a neck lift which includes liposuction and, uh, surgical subcutaneous fat debulking along with, uh, opening the platysmal muscle debulking any fat or muscle and any gland that’s underneath it. And doing platysmaplasty and also tightening the jawline here with some sutures. However, the patient had loose skin in the area. We, there’s about 50% chance we’re going to do this incision here to pull the skin up. However, the patient’s hairline is very thin here. So the mark of the line will be behind the ear lobe uh, with the right angle into the hair line here within the hairline uh, with the right angle into the hair line here within the hairline about six, five to six centimeter to create the flap that gets pulled, um, same thing on the other side we will do the same thing on the other side. Okay. The hairline and the incision will be here along this area.”

LIPO 360 WITH BUTTOCK AUGMENTATION FAT TRANSFER (Under Local Sedation)

BATAL: “Today we are doing buttock augmentation using the fat from the torso. We’re also doing high definition 360, which start from the flanks, the love handles extending the flanks about an inch into the bra roll area. And then we’re going to do the abs with high definition. Patient may need some form of a mini tummy tuck later in the future, but she didn’t want to do it right now. So we’ll do this under sedation. So we’re going to try to define the midline and also the ab lines. And then we going to augment merely the buttock proper and a bit into the hip dip. She doesn’t have a big dip, but we can try to transition the hip here to the cavity here. That’s created by the high definition 360.”

LIPOSUCTION & BUTTOCK AUGMENTATION FAT TRANSFER
(1 Week Follow Up)

BATAL: “Right now we are doing one week follow up for a patient who received buttock augmentation BBL along with liposuction 360 with helium plasma for the abs you can see the definition starts showing up in the midline and also around the abs. It’s only one week but we still still see the definition here and also the definition around the anterior iliac spine. On both side and the anterior inferior iliac spine here too. And you can see the nice roundness and the projection of the buttock that’s going to likely come a bit down. But the torso also will come down magnifying the difference and the contrast in the body parts It’s only one week, as we said, so we expect the result to finalize and mature in about three months. I think the patient was very pleased with that initial results.”

GYNECOMASTIA GLAND REMOVAL with LIPOSUCTION
(3 Month Follow Up)

BATAL: “Today’s a three month follow up after a gynecomastia correction with liposuction and gynecomastia gland removal. Minimally invasive technique. We suction the fat in the pectoral area here and also underneath around the gland. Obviously, the gland cannot be suctioned out. So we use the special technique we described before using the very small incisions here. And those incision just disappear in the next few months. Instead of making the incision here and surgically removed the gland, we just do them and use a cartilage shaver that’s actually now there’s almost no more gland there’s no loose skin here. The patient is very happy about it and painless and very smooth and very natural. Thank you.”

THE BATAL METHOD FOR BUTTOCK AUGMENTATION FAT TRANSFER (BBL)

BATAL: “Good morning. Today we are doing a buttock augmentation video via fat transfer from the torso, especially the bra fat, the flanks and the love handles and the abs. We’re going to have more fat than we need to transfer. What my point today of this video. There is always a layer of soft tissue above the muscle which you can transfer the fat into and that you have some thickness which mean has some blood supply. That varies with many people and my evaluation varies between patient to patient. If that fat pad above the muscle is thin, you can put less amount of that if it’s thick, you can put more fat. But if it is thin and you put more fat, then more likely the more fat you put, the more fat will die because there’s less blood supply and there’s less nutritional supply to the new migrated of fat. What used to be done, especially in other states, that they inject the fat into the muscle and that actually will increase the fat survival because it has plenty of blood supply. But this will tremendously increase the risk of fat embolism. We do not inject fat into the muscle we injected only to the subcutaneous tissue below and above the gluteal fascia. Usually above the gluteal fascia. However, if we put, for example, 500cc which is what I expect, that’s the sweet spot for this patient in each buttock. About 60% of fat will stay. If I put about 800. Maybe only 40% will stay. At a certain point the more you fat you put, it’s going to be counter intuitive and you’re risking the whole area as it grows. So every patient has his own limited amount that dictated by the original anatomy. We’re going to transfer some fat into the buttock and also the two in the hip area. We get to also start our suction very low. This will engage the torso and give concise and projected buttock. Thank you.”

BREAST REDUCTION AND LIFT (Narration)(Under Local Sedation)

BATAL: “This lovely patient had received a vertical breast reduction, with lift under local anesthesia with sedation. With this technique, we use a lollipop incision which is an incision around the nipple and a small vertical incision, keeping the scar small. There is no scar underneath the fold of the breast. With this technique, we use the upper part of the breast at the main pedicle, which is the upper medial pedicle, which keep the gravity working on our end and has much lower recurrence rate as opposed to the Y shaped breast lift, which give a flatter and wider look for the breast and also use the lower part of the breast as a pedicle which works against gravity, giving it a much higher recurrence rate. This procedure and this picture was taken right in the operative table. So there’s minor skin wrinkles around the nipple, which caused by the tension on the skin, which fades away with time.”

TUMMY TUCK with LIPOSUCTION OF ABS AND LOVE HANDLES
(3 Month Follow-up)

BATAL: “So today I’m doing a three month follow-up after a tummy tuck along with liposuction of the love handles and the upper and lower abs with muscle tightening including rectus muscle tightening. I also did oblique muscle tightening, which shows a nice definition. See how the patient have, uh, hourglass appearance and uh, she is very pleased with the results. We did not do the flanks, so but I took some of the love handles, so she may need to do the flanks later, but at least a love handles did enough work for the angle view and the patient is very happy. What do you think of the work?

PATIENT: “I am very happy. Yes, it’s worth it.”

BATAL: “Absolutely. Okay. Thanks.”

THE IMPORTANCE OF MARKING BEFORE A TUMMY TUCK

BATAL: “So right now I’m showing my marking. The most important landmark I have is the midline. Once you are inside of the surgery, things can change, especially when the patient in different position. So the abdomen need to be defined by the midline. So you can see some irregular I mean, some asymmetry between both part of the abdomen. The other important part here is also the incision initial marking that could change. But the most important part here, I make it very low and anchor to the inguinal ligament. So no matter how much tension on it, it’s take tuck in and stay low. Because those fibrous connection there, I often we fix it, especially in the midline to the fascia, I often see tummy tuck that the incision migrate here become in the middle of the abdomen. And that’s a reason caused by the lack of fibrous fixation and down deep here. All right.”

BBL BEFORE AND AFTER WITH NARRATION BY DR. OBAIDA BATAL (1 week post-op)

BATAL: “This patient is one week post-op after a buttock augmentation, using a fat from the back and the flanks, the love handles and the upper lower abs liposuction 360 with helium plasma for the abs, you can see the contrast of the torso compared to the hips and the buttock and the roundness achieved by the smooth fat taken by special cannula and processed in a sterile fashion. This procedure again was done under local and anesthesia was sedation. And this result is very immature yet it’s only one week, so we expect the result to finalize in about two to three months. But despite that, you can see the promising result.”

HIGH CONTRAST LIPOSUCTION WITH NARRATION BY DR. OBAIDA BATAL

BATAL: “This patient is a 25 year old who received liposuction with a helium plasma of the abdomen, love handles and flanks along with the bra fat. You can see the beautiful contraction of the skin and the abdominal folds and also the three folds in the back and the significant contrast between the abdomen and the hips and also between the back and the buttock. This part of the lower love handles and flanks is often neglected by most sculpting surgeons. Leaving that part undone will lead to shortening of the torso and elongation of the buttock. Therefore, I trim that part which give a long torso with magnificent contrast between the torso and the buttocks and also the hip. This result is about ten month after surgery, which also expect to mature further more in the next couple of years. Thank you.”

BREAST IMPLANTS SIZING W/DR. OBAIDA BATAL

BATAL: “Today we are doing the preoperative sizing for breast augmentation. The patient doesn’t know exactly what size she wanted. So we’re going to help her by doing a demonstration of what to expect with what size. We’re using the Mentor external sizing system. What we do is we have a special bra a sport bra we add the different sizes and we’ll see how the patient feels about it. Okay, so this is 250. We’re going to start with this random number, and then we are going to advance it here. Take a look at the bra size. Okay. Well, you want bigger or smaller?

PATIENT: “Bigger.”

BATAL: “So now we’re going to go. How big? A lot bigger or not. So that’s 350. You can make it a bit bigger or a bit smaller and we can we can adjust it. Okay, so that’s now 400.”

PATIENT: “Yeah.”

BREAST IMPLANTS SIZING W/DR. OBAIDA BATAL

BATAL: “Today we are doing a follow up for our beautiful bodybuilder and personal trainer. We have done a buttock augmentation using the fat from the bra fat and the auxillary area The patient just wanted to increase the volume here. You already had a round before. She just wanted increase in the volume and the projection a bit into the hip area that have hip dips. But the major concern was actually the bra fat area where if I want to show I choose to have like a skin laxity here and fullness. As I say, the patient is very highly disciplined. But she had this in this area, so we were able to clean that and clean the auxiliary area, producing very smooth skin tone. No skin laxity at all. And that’s compatible with the nice slope of the back and increased production of the buttocks here so that helium plasma, with that superficial high definition liposuction produce a great result How do you how do you see the results?

PATIENT: “I love that so far. So far I think for what is it, six weeks?

BATAL: “Six, eight weeks.”

PATIENT: “It looks pretty good. Yeah.”

BATAL: “So in the next six weeks, it will be better and will keep tightening and get smaller. All right. Great. Yeah.”

BRAZILIAN BUTT LIFT (BBL) BUTT AUGMENTATION

BATAL: “Today we are doing a buttock augmentation along with liposuction 360 and neck and jawline contouring along with some skin tightening we’re doing the upper abs lower abs the pubic area love handles and the flanks. We’re not doing the bra fat but we also augmenting the buttock and also be adding some volume to the hip area to augment the contouring. We’re going to do some helium plasma for the abs and for the for the side. So I give the patient gabapentin the day before a single dose of gabapentin which is a nerve agent can cut down the post-operative pain in half. So I give a protocol of three doses of gabapentin before which relaxes the patient. What do you feel? Yeah, yeah. So you don’t have the anxiety. The same time the nerves get poked and kind of blunted have less reactions during the procedures and also postoperatively. So I think we’re going to have a good time today, right? So you afterward.”

PART 1: FAT TRANSFER TO BREASTS (NATURAL AUGMENTATION)

BATAL: “So today I’m doing a fat transfer to the breast using the fat from the medial thigh. Medial thigh and the medial knee and a bit of the outer thigh and some of the flanks. I expect it to have half cup to a full cup increase. I’ll show you the results after we finish.”

PART 2: FAT TRANSFER TO BREASTS (NATURAL AUGMENTATION)

BATAL: “So right now we are done under local anesthesia with sedation, which serves two purposes we sculpted the thigh and the knee. And we use that fat to augment the breast with natural breast augmentation. We did a fat transfer to the breast 250 cc in each breast and we almost achieved from size A to hopefully to size B or full B. Likely this breast will due to the fluid which shrank a bit. But I think she’s going to have a good improvement because there’s not much tension still in the breast. I think the vast majority will take and it looks very natural much more natural than implants. And the patient was under sedation. She was comfortable. How did you feel?

PATIENT: “I feel I feel like I feel good I feel sleepy. I feel like I’m like asleep. I want to sleep right now.

BATAL: “Yeah. Yeah. So the patient is not awake, but they are breathing in their own. They’re relaxed. We can give them sedation as they need. And also we have the local anesthesia. All right. I think we’re going to celebrate a good result in a few months. Thank you.”

PART 3: FAT TRANSFER TO BREASTS (NATURAL AUGMENTATION)

BATAL: “Right now we are using the fat that we harvested from the thigh and we processed into about 20 syringes each syringe is about 20 CC. We are planning to do a natural breast augmentation using about 15, I mean 150 to 200 cc of fat the patient doesn’t have ptosis. So this may actually produce half cup, the full cup increase which is what the patient wants. We are doing about 12 or maybe about 12 incision around the breast like a clockwise And this will allow us to find a network of placement of those tissues in an eloquent fashion without increasing the risk of having a oocyst or necrosis.”

FULL NECK LIFT WITH PLATYSMA FAT REMOVAL

PREPARING BREAST IMPLANTS FOR AUGMENTATION

BATAL: “Right now I’m just injecting some antibiotic solution with iodine into the implant so you can wash the implant with it prepare it. Okay. Can you put some more in?”

STAFF REACTIONS TO DISAPPEARING SPIDER VEINS

FAT TRANSFER TO BREASTS: DR. BATAL COMMENTARY BEFORE/AFTER

BATAL: “This patient is a lovely 57 year old lady who came to the office with a primary purpose of sculpting her medial and lateral thigh along with her medial knee. Then she asked me, “What can I do with the harvested fat?” Patient had size A breast and no ptosis and she never wanted to put an implant in the past due to a psychological barrier and the fear of developing capsular contracture or an infection or an unnatural appearance of the breast. So we decided to do a fat transfer to the breast. As you see, the patient has a size A and we created a 12 needle pricks kind of incision that will leave no visible scar. We processed the harvested fat sterilely through many filters. Then a final layer of a micro filters. Then we use those needle pricks incisions to implant the micro cannulas of fat into multi plane of tissues starting from underneath the skin all the way into the gland and underneath the gland, then underneath the muscle layer. This result is immediately after the procedure. There is no visible incisions and the patient will not have a future risk of any capsule contraction because there’s no implant. We expect this breast to lose some of its volume due to the absorption of the fluid in the fat. But still the patient will enjoy a beautiful, nice result. I injected about 250 cc of fat in each breast. The tensions on the tissue could allow me to use a bit more up to 325 CC, but the patient wanted just size B to a full B cup, so I felt 250 cc in each breast more than adequate. And I will update you about the progress of the patient in the next few weeks and a few months. Thank you.”

The Batal Method of doing a BBL (Brazilian Butt Lift)

BATAL: “So today we are starting the fat transfer process for buttock augmentation and we already have completed the 360 with high definition. The fat doesn’t leave the canister it is a sterile canister and go through sterile tubes into the canisters and it gets processed directly into the pump and into sterile tubes into the buttock. So it doesn’t touch hand and doesn’t touch air. And we already process the fat and remove all the fluid from it through a streamlined process. Okay. So we are going to start with a pump like this, and I use the forked cannula. The fork cannula has a couple of advantages. It contains the fat and allows smooth flow. And also it doesn’t penetrate the muscle, so it will have a minimal risk of fat embolism into the muscle. Okay. So we started this, so we starting at 2100 (ccs) and go very low. Right now. We’re continue to… The patient is just very sleepy with some sedation.”

GYNECOMASTIA GLAND REMOVAL WITHOUT SURGERY (BEFORE/AFTER)

BATAL: “So right now we have completed the gynecomastia case. We have done liposuction of both chest can see the chest is completely evacuated from all the fat content and also the lateral auxiliary area here. There is some fluid accumulated here. And also we remove the gland. You can see compared to the previous video how the glands completely removed without making any extra incisions. Then we did this skin tightening with helium plasma. So well, we have done the procedure under local anesthesia with sedation and the patient was comfortable doing the procedure. How did you feel during the procedure?

PATIENT: “Oh, really good. I felt noth– no pain, nothing.

BATAL: “Great! And you’re breathing on your own and you’re going to be ready to go home soon. Okay, great. You will enjoy that beautiful result soon. Thank you.”

HIGH-DEFINITION ARM LIPOSUCTION (over 900ccs of fat removed from each arm)

BATAL: “Good morning. Today I will be doing, uh, 360 high-definition arms, which includes liposuction of, uh, 360 of around the arm, which is done only in about less than 15% of the centers require more awareness of the anatomy and, and the tendon and the muscle anatomy. The patient had a large volume here. And we can also do J-plasma helium plasma to minimize the skin laxity. And, uh, we’ll show you the result after we finish. Thanks. Right now we have completed the liposuction 360 of the arm, along with the helium plasma skin coagulation and soft tissue tightening. You can see a better improvement in the contour of the arms. We can see compared to the pre-op video, there’s a good reduction. We took about 900 cc of fat for like a short arm That’s that’s many. Average liposuction in about the majority of the service, they take about 2-300cc I took about 900. And once everything mature you can see the definition of the muscle structure and the tendon structures on the deltoid, the biceps and the brachioradialis here and hopefully the triceps once everything mature down and yeah, I’ll show you those up in three months too.”

MASTOPEXY WITH FAT TRANSFER (non-implant breast augmentation)

BATAL: “So right now we have completed a mastopexy with a breast lift with transposition of the breast tissue and fat from the lower pole into the part of the medial pole. We also have done a fat transfer from the upper back into the upper and medial and also lateral pole. So this technique has a couple of merits. First, the scar is very short, so it’s only around the nipple and short scar here. There’s no big scar arou… underneath the breast. This technique also produces more perky and narrow breasts as compared to wide and compressed breast with a wide technique. Also with this technique we use the upper pedicle as the main source of supply to the nipple so that gravity doesn’t work against it. So the upper pedicle remains intact as opposed to the inferior pedicle technique, which used in about seven 60 to 70% of the surgeries in the United States. That’s a that’s the gravity work against the pedicle and pull it down was done. But this procedure was done under local anesthesia with sedation. The patient was very comfortable and we expect the result to mature in the next few months. Thank you.”

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