Breast augmentation via fat grafting
Doctor Answers 17
Los Angeles Fat Graft Breast Augmentation
Thanks for the question.
Fat grafting remains in its infancy in terms of being a formidable procedure for breast augmentation. Its applicability remains limited to women with ample fat for harvesting who have soft-tissue/skin which is amenable to augmentation. For example, women with ptotic (saggy) breasts are not ideal candidates for this procedure. Further, the amount of retention of fat is not predictable and secondary and sometimes tertiary fat transfer procedures are necessary to obtain optimal results.
Additionally, as some of my colleagues mentioned, controversy has surrounded fat transfer to breasts, as it could hypothetically obscure mammographic readings. More recently, however, there is literature to suggest otherwise. Nonetheless, with the growing presence in the media of stem cell transfers, this procedure is gaining media attention with a growing inquiry to plastic surgeons.
In my practice, we utilize this procedure in select patients who are ideal candidates. Our patients are thoroughly educated on the risk, benefits and the probable necessity to require supplementary fat transfers at a future date. Thus far, we have been very satisfied with the results and will continue to offer this procedure on select patients.
Glenn Vallecillos, M.D., F.A.C.S.
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Fat Grafting Breast Augmentation: natural breast enhancement
Fat Grafting procedures have been performed for several years to augment and reconstruct various parts of the body. Common procedures are the Brazilian Butt Lift, fat grafting to the face, and fat grafting for breast reconstruction. As techniques advance and with new technology to better purify and transfer fat, breast augmentation with only fat grafting is now becoming more common. Women who desire a mild to moderate increase in size and have areas on the body where fat can be harvested are ideal candidates. It is an effective surgery and a good alternative to implants. Make sure to have a detailed consultation with a board certified plastic surgeon that is trained in fat grafting.
Fat grafting instead of implants
The technique of fat transfer to the breasts is still quite controversial, and the method of doing it is not yet standardized. That being said, there are 2 methods that have impressed me. Both, however, are quite involved.
1) pre-expansion with the BRAVA device prior to fat grafting. Drs. Khouri and delVecchio have shown some beautiful results. But the BRAVA system requires a lot of diligent use by the patient prior to the surgery, and it's not especially easy to put up with.
2) turbo-charging the fat grafts with stem cells using the Cytori Celution machine. This is not yet FDA approved in the US.
In either event, there are limitations. Even these experts only recommend about 200 cc augmentation. Some of the fat may re-absorb, or become lumpy. This can be confusing on a mammogram. If you have this done, it should really be part of a IRB-approved study.
I would not, however, simply recommend taking the fat out "here" and pumping it in "there". That older approach is not reliable.
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Fat grafting for breast augmentation (instead of implants)
Certainly some people are beginning to propose the use of fat grafting for breast augmentation, but that requires an adequate source for harvesting fat, and a somewhat soft and loose breast is needed as an ideal recipient. And again as is noted by others, the survival of the transplanted fat is only partial, roughly 50%, and variable in location. It is important not to fall under the spell of what I call “the Oprah effect”. Procedures are developed and unlike years ago were they underwent rigorous evaluation over a period of time before entering main stream usage, they are now marketed as a gold standard particularly by surgeons who utilize or have developed these techniques. Unfortunately many of these procedures after initial enthusiasm, are discovered to be less efficacious over time. Breast augmentation with implants is still the safe and best way to achieve your desired result in this day and age. Both as a surgeon and as a patient, that old adage of not being the first to try something new rings true. There is a fine line between innovation and the desire to bring something new and exciting to the market, versus the wait and see approach to make sure that the procedure produces all that it is reported to achieve.
Fat grafting for augmenting breasts
It is now possible for women to enlarge their breasts without resorting to implants! Specially prepared fat taken from another part of the body, such as the stomach or hips, is placed under the breast tissue to provide increased breast size without the need for artificial implants. The technique is called autologous fat transfers and autologous simply means "your own." And who doesn't have a little fat to spare? It's safe because it came from you, so you can't have a reaction to it. The procedure is quick and not particularly painful and can be performed without the need for general anesthesia! However, it is difficult to say if this is the right procedure for you without a photo, so it is a good idea to consult with a board certified plastic surgeon.
Does Fat Grafting Work for Breast Augmentation?
Short answer is yes it does. However, only modest enhancement is possible with a single session, and there are several different techniques to choose from, each with different results. You can only get about a half cup size enhancement from a single session, and I find that is not enough to satisfy the majority of women looking for breast augmentation. It is just right, however, for women who need to top up the upper part of the breast following pregnancy, and this is often combined with a full tummy tuck in MM procedures.
Fat Grafting and Breast Augmentation
There are more and more reports of using fat grafting techniques for cosmetic breast augmentation not only in the USA but around the world. This procedure fell out of favor some time back because in some women the fat that did not survive could not be differentiated from breast cancers, thus subjecting women to increased numbers of biopsy procedures. However, the techniques for harvesting and injecting the fat are improving all the time.
That being said, there are still several issues with using your own fat:
1. It is hard to predict how much fat will stay and how much will be resorbed. This may lead women to having multiple sessions of grafting in order to get the size they want, which increases the cost as well as introduces risks with anesthesia with each procedure
2. The operation takes considerably longer than a breast augmentation which may also increase the risks from anesthesia as well as the cost.
3. Most women, yourself included, typically do not have enough fat to transfer. At 5 feet and 112lb, even though you do not want much bigger breasts, you may not have enough fat to harvest for this procedure.
For the time being the best way to augment the breasts, even if it's a minimal augmentation, is with the use of implants.
Hope that helps and good luck!
Dr. Babak Dadvand
Fat Grafting to the Breast
Although, fat grafting to the breast is gaining acceptance as an adjunct to reconstruction of the breast after mastectomy, it still has not gained widespread acceptance for cosmetic breast augmentation. This is largely because the grafted fat can mimic breast cancer calcifications on mammogram. In addition, it can be unpredictable as to how much fat will take and the distribution of fat survival. This can lead to assymetry in size and shape. My recommendation to you would be to visit with a board certified plastic surgeon to learn more about the use of an implant for cosmetic breast augmentation in regards to safety and efficacy. Then make an informed decision on which method to use.
Fat Grafting to the breasts
Fat grafting for breast augmentation is a great procedure, however at 5 feet tall and 112lb you may not have enough fat to be used for this procedure. It is impossible to say without examining you but I would suspect you do not have enough excess fat that could be used to give you a significant increase in breast size.
This is the most common problem in patients requesting fat grafting. They usually overestimate how much excess fat they have that can be used for fat grafting.
Martin Jugenburg, MD
Fat Grafting for Breast Augmentation: Too Good to be True in 2011
Breast augmentation using the patient's own fat is an unrealized fantasy.
The survival or 'take' of fat grafts is unreliable and unpredictable. The fat often disappears and patients are required to return for further procedures.
Moreover fat grafting to the breast can create confusing changes on mammograms that may mimic cancer.
I first saw breast augmentation using fat grafts in 1985. The procedure was a dismal failure.
While there is a great deal of research going on, breast augmentation using patients' own fat remains a long way off.