Yes I do breast fat grafting. It has many applications in cosmetic breast surgery.MRI studies have shown that with appropriate technique grafted fat persists long-term as living, vascularized tissue in the recipient site.For one, it is an excellent alternative to an implant for a patient who 1.Wants a modest-volume breast augmentation2.Has a donor site or sites that are sufficient to provide enough fat to enlarge the breasts. Fat grafting is not just injecting mass amounts of liposuctioned fat. Structural fat grafting is a procedure in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. To perform fat grafting successfully and reproducibly a surgeon must employ careful preoperative planning, appropriate instrumentation and meticulous surgical technique. It is not something you can 'rush through' or spend just a few minutes on during a larger surgical procedure. The unfortunate reality is that not everyone who performs fat grafting is willing to put in the level of education, training, investment in instrumentation and operative effort required to produce aesthetically ideal results. There is a limitation to how much bigger one can make the breasts with fat grafting unless you ‘pre-expand’ them. Most patients can increase about a cup size in one procedure, unless they are starting out as a very small A. You certainly could achieve a ‘two cup size’ augmentation (i.e. A to C or B to D) with a series of two or three SFG procedures. One can add enough fat to provide a ‘two cup size’ augmentation in one surgery only if you ‘pre-expand’ the breasts using the Brava device, which I don’t think many women would be willing to do.. The Brava is a pair of large suction cups that go over the breasts and have to be worn 8 hours a day / 7 days a week for 3 weeks. Also I do not like the aesthetic results of Brava augmentation as the device expands all of the breast skin and as a result tends to elongate the breasts. It actually can create a little ptosis and that is definitely not ideal. I am not interested in doing Brava augmentations. It works beautifully, though, for breast reconstruction after mastectomy. I also perform breast fat grafting in some mastopexy patients, especially those who do not have enough lower pole tissue for an auto-augmentation mastopexy. It is a very effective means for providing additional cleavage area fullness in such patients. The patients for whom I have done this have been very pleased with the outcome.Just like structural fat ghrafting to the face, this is a very technique dependent procedure. Looj for a plastic surgeon with expertise in both aesthetic breast surgery and structural fat grafting.
