Fat transfer, GLP-1 agonists, Ozempic, Wagovy, Mounjaro, Zepbound with Dr. Robert Whitfield

Welcome to this episode of the drive. Dr. Whitfield. Make sure and go to bio and click the link. Sign up for our free downloadable guide on inflammation and immunity. Sign up for the email newsletter. We're starting that this year in 2025, so get on the list for that. Today we're going to talk about fat transfers. I field a lot of questions about fat transfers and there's a lot of, I think confusion around f. Fat transfers have been around for over a hundred years. They're, they're not a new form of treatment for augmentation. So think of first experiences that we had using fat were to really volumize and they were in the late 1800s they were done with thermal fat graphs. So these were larger composite graphs. And then fast forward, basically the harvest of fat was done via liposuction. Spread over in the early 1900s from France. And then throughout the course of decades, you know, fat has been moved from one area of the body to the other. People like Dr. Sydney Coleman, very famous for fat grafting the face and using Coleman canyons, people started using that kind of technique and transferring it more and more all over the body. Brazilian butt lifts became very popular and were done many, many decades ago in South America, became popular in, especially in Miami, Florida in the United States. Then there a lot of concern over fat grafting and safety and actually wrote a report about buttock augmentation. So Brazilian butt lift augmentations with fat and safety. You can look my name up, Dr. Whitfield and buttock augmentation safety and you'll find a paper that I wrote about it just expressing how it can be done safely. It's not very difficult to do. It's more of a technical exercise size. But there are some distinct differences when you're doing fat transfers for both breast and buttock. The buttock is a huge space and if you don't transfer at least typically 500cc's per side, it's very hard to see an improvement in the size, shape, volumization of the buttock. Given its size. You think of how large the surface area is. It's a significant area. So conversely, when you're doing breast augmentation with fat, there's not that much space and it can be even more challenging. But really important when you're doing a explant case, the outcome, because the patient obviously got an augmentation for purely speaking about augmentation cosmetically, because they were looking for more, we'll just say volume. And typically the most common comment I get from patients is they woke up and had too much volume, Much, much more than they anticipated or wanted or discussed for that matter. So they've now did the opposite for many, many years where they've tried to almost obscure or hide the size of the breast. But still, when they go and discuss with me explant, they don't want to go back to the situation where they had very little to little volume to fill out clothing or the bra itself. So I still offer fat transfer. Simultaneously, we do a very thorough discussion and evaluation. We look at toxicity burden, discuss the capability of somebody to detoxify and work on that with them for ya. And. Even if in our experience, every situation is obviously individual, we're trying to individualize our treatment plans in every situation to meet people where they're at. I constantly discuss, you know, fat transfers in the context of our, you know, age and how we're from a health perspective. Typically, you know, we'll speak in more generality when we're in our, you know, 20s and even 30s. It's a much different biologic situation. And we can say, for instance, take fat out of a, you know, love handle or tummy area in patient in their 20s and the area will tighten up. And I'm using that as an example because when we're younger, everything is better in terms of our capability to heal and recover and restore. And as we get older, that capability diminishes. It's not as efficient. And there can be a host of reasons why, you know, I always start with someone's genetics. You can't pick your parents and you can't outrun a bad diet. So paramount to healing is something that I discuss a great deal. And I just did a Show yesterday with Dr. Will Cole and discussed gut absorption, taking more dietary protein. He's written several books about inflammation, the gut, how to really overcome some of the issues with that to live a healthier life. It's not a quick fix. Typically when I have somebody come to me now, I've not only got all of their baseline inflammation that they may have from breast implant illness type symptoms, chronic inflammatory symptoms, but in addition, there are other toxic toxins that they get faced with all the time. For instance, something like microplastics. Let's take a moment and talk about microplastics. So microplastics are 100 nanometers to 5 millimeters. So that's a very, very wide spread in terms of what is a microplastic. And microplastics are, you know, from the lining of paper cups, the lining of Plastic materials, comes off of tires. So it's going to be in the, they can be in something as simple as sea salt. And when you look for microplastics, they've done these autopsy studies and they found it basically in every tissue of the body. And so as it relates to my patients and toxicity, we have this elaborate filtration system called the lymphatic system that helps filter the toxins in our system, obviously get them back into our main detoxification organ, you know, predominantly the liver. But so we want to, you know, detoxify. But think of those things as being microplastics being, you know, particularly obstructive and clogging up these channels, you know, including your lymph, your lymph nodes. But they're deposited in all these tissues, including your brain, your liver, your kidneys, your lungs. I think they've looked at every sort of tissue and found microplastics. So I just use that example as a toxin that we don't really talk about much, but it's been in the media more and you're hearing about it on, you know, podcasts and other shows. So it's cumulative over time. So, you know, much like I've discussed on my show and, and other show, including with Lauren Bostic, a patient of mine, on her show, that's getting confidential. It's all these habits where you have to, you have to make small adjustments to you're, you're gonna lower your toxin burden. So for instance, you know, Lauren Bostic had a very, very high triclosan level. We discussed it on her show, as well as high, high, high heavy metals. And she did a lot barrel sauna, got it up to 212 degrees routinely and was causing chemical leaching. So it's leaching the chemicals out of the shell. So she had a bigger toxic burden for her body to deal with from heavy metals. There can be a lot of toxin burden from mycotoxins. Mycotoxins come from fungus, molds of fungus. Those mycotoxins can be in our food supply, grains, cereals, nuts, coff. And they can also be found on fruits and vegetables. They can be in the wine. Ochratox in particular can be found in wine. And then just in someone's home, if they had a water leak, there's moisture somewhere building up that will create an environment for mold. And then in those, you can breathe in those toxins, especially when you sleep. So we're always talking about leveling up, trying to get your air quality better, using air filters. Like Jasper Co, you can go, I recommend this in my list. If you can click the links in my bio on YouTube, you'll see this. So the, you know, there's a ton of things that we can do that we evaluate and look at to try to improve upon. So like don't drink out of plastic. I had a patient come to me and give it their water situation where they live. They were drinking out of plastic water bottles because they were told by the officials in the area they got a notice that their water was not good enough to drink. So that's a very scary situation. Then you have to have control of your water supply. So I talked about air and water and then to the best of your ability, you got to put higher quality foods into your. Some foods trigger a lot of histamine responses. So depending on the diet you're following, you may get more inflammation and swelling. In the GI tract. People discuss different amounts of volume of the lymphatic tissue, which is akin to your immune system. There is a very large amount of lymphatic tissue around your GI tract, so that's around your intestines and it's the gut associated lymphatic tissue. And you can get a large amount of swelling just from having problems with your GI tract, with your, with your gut, your intestinal tract. So we don't want to ever underestimate that. It's one of the main reasons that in our supplementation, I'm so specific about using liquid supplementation. I want is many of the nutrients that you can absorb to be done higher up in the GI tract and really, you know, focus in and hone in on those to help support your immune health. So circling back to, you know, fat transfer, technically we take fat from one area of the body and using a harvest collection and transfer system, we use Wells Johnson. It's been around for a very long period of time. It's very efficient. So those are the, you know, technical, you know, aspects and then really trying to get the environment, the patient's environment, you know, both from a, you know, mind, body standpoint, get that really ready to accept a fat transfer balance out as much as possible their, you know, their system. I don't, I find people out of balance, you know, with high amounts of inflation, inflammation all of the time. And it's, you know, our job to work with them, to meet them where they are to try to lower that inflammation and set them up, you know, for success. I don't think, you know, these situations are easy. Everyone is a little bit, bit you know, different because I have people coming from all over the world. Yesterday I spoke to someone in Istanbul, Turkey who wants a fat transfer. And so that poses a whole set of different challenges. And they're relatively lean, they take very good care of themselves, they eat a very, you know, already higher protein diet. They, they, they do things to support their immunity and lower their inflamma. They have access to hyperbaric oxygen therapy, they have access to red light therapy, they use the nanov. They have options for lymphatic massage. Because there are going to be different options all over the world. There's companies out of Germany that produce lymphatic massage devices. There's companies out of New Zealand that produce lymphatic massage devices. We've used them all and really like the lymphatic massage device from Flopresso out of New Zealand, the, The fat transfers, you know, themselves, we want to get them performed when it makes sense for the patient and always try to optimize them and every situation, just like I said, it's going to be uni. I do get asked a large, you know, volume of questions about how much can be done at a given time and what is the healing of that and will it last over time. And I'm going to qualify this and say there's a lot going on right now with GL1. Sorry, GLP1 agonist. So these peptides are meant to help lower blood sugar and really help with diabetes. And now they've been marketed and adjusted to help with weight loss. There are a number of people microdosing these. There are a number of people using these at higher doses. So if you're gonna have a fat transfer, it's in my opinion that you should not be taking a GLP1 agonist. It doesn't serve us physiologically. I'm trying to balance all these things out and I like people off of those three to six months prior so that I'm not trying to regulate something I have no experience with. Because we haven't had patients on GLP1 agonist because those are counterintuitive. Right? If we're going to have someone on a weight loss medication that burns fat or is associated with fat burning and it definitely works, you will have results then we don't obviously want you on that medication. So that's one thing. We do like our patients increasing their protein. So the dietary source of protein, that works best for them. And there's different protein sources. So if I say roughly start by trying to get 100 grams a day. That seems like a lot right off the bat. You have to supplement it either with a protein powder which works for you. We use a pea protein, you know, it's a plant based protein. So we're using different levers here. Right. We're trying to balance all the physiology out, lower the toxic burden, increase the protein in the diet. We haven't gotten to the most important thing, you know, yet, which is your sleep. To recover you really have to get the quality and quantity of sleep. So we want a quantity of seven to nine hours, basically as a minimum. We definitely want a quality of sleep. So you have to get into enough REM and non REM sleep and depth of sleep to help promote recovery. You want to really try to stay on a pretty consistent schedule that makes it easier for your body. And then you have to know kind of also when to go to sleep. Some people do better earlier, some people do better later. Once you have those figures, have that figured out, it makes it easier for you to recover. So there's a lot of variables that go into it. But sleep is incredibly important, especially as it relates to glymphatic and lymphatic drainage that promotes and helps recovery. Heart rate variability, all these things that you may hear about, others talk on different shows about, they, they help you from a trend standpoint. I've tried all the different heart rate variability measuring devices. A polar beat, a polar watch, ultra human rings, aura rings, boop straps and I typically have used consistently ultra human. There's a link to it in the bio. I've used Whoop consistently since 2016 and I use a polar beat chest strap. I don't use it every day, but those are all ways to, you know, better measure heart rate variability to get a trend on, you know, what is going on with that. Sleep's incredibly important in terms of promoting recovery. So for everybody listening, it's not about whether or not plastic surgery can perform a fat transfer. There's patient variables and timing and just really optimizing and helping people get in better balance. Certainly makes sense. It's logical in terms of how we approach a plan for each patient. Hey, look forward to the next video. Great. Have a great day.