Fat Grafting for Breast Enhancement
The concept behind fat grafting to the breast is simple: Move fat cells from one part of your body where they’re plentiful (tummy, buttocks and thighs) to your breasts, butt, hands or face to enhance their shape, youthful appearance and size.
Fat grafting — also known as autologous fat transfer or lipoinjection — was used to enhance or reconstruct breasts as early as 1895, but it wasn’t until the development of liposuction almost a century later that fat cells could be harvested efficiently. While fat grafting after harvesting fat cells during liposuction is widely used today to rejuvenate the face and hands, its application for breast enhancement has only recently taken off. Women are increasingly choosing the more natural approach, texture and appearance achieved by simply using their own fat to enhance and beautify their breasts.
Fat Grafting Breast Enhancement Candidates
Currently, fat transfer to the breast is considered a very good option for women who want to improve the appearance of their breasts after reconstruction or lumpectomy to treat breast cancer, for tuberous breast deformities, and to repair implant-related issues like rippling and wrinkling. The procedure can also be used to soften the overall look of existing breast implants by “blurring” the line between implant and breast tissue. As many Hollywood stars lead us to strive for enhancement with “plausible deniability” more and more women are choosing fat transfer as their primary means of breast enhancement. Potential candidates must also have adequate fat supplies in harvesting sites on their body. Plastic Surgery societies around the world strongly support ongoing research efforts to establish the safety and efficacy of the procedure for primary breast augmentation.
Fat Transfer to the Breast: The Procedure
Fat transfer to the breast involves two distinct procedures: harvesting and injecting. The fat cells are acquired through one of several types of liposuction, most effectively by liposculpture associated with SmartLipo laser-assisted liposculpture, which provides optimal results of skin tightening and speedy healing in the harvest areas. Once harvested, the cells are processed for transplantation. This involves removing anesthetics, lipids and medical fluids from the fat. The goal is to obtain healthy fat cells devoid of other tissue, which increases the likelihood of successful cell transfer and reduces the chances of injecting unwanted substances with the fat. The healthier and purer the injected material, the greater the yield of viable fat cells.
After processing, the fat cells are carefully injected, drop by drop in dozens of small injections, into the space between the skin and the breast capsule surrounding the breast and/or behind the breast between the breast and chest wall. This meticulous technique enables the plastic surgeon to sculpt the breasts as desired. The medical consensus is that if the fat is injected into these areas, it will be easier to monitor long term, and to avoid many of the problems that may arise from significant fat being injected into the breast tissue capsule itself. However, because these injection sites are limited in size, fat grafting to the breast can produce only modest augmentation.
Some surgeons help the process along by instructing their patients to wear tissue expanders prior to surgery. One such expander is the Brava System. This system creates a vacuum that applies gentle, three-dimensional pull on the breasts that’s similar to the action of a breast pump. This tension causes the cells to replicate and gradually create new tissue throughout the entire breast area.
Fat Grafting: Issues of Concern
A concern among plastic surgeons is how much fat is needed to get the job done. The consensus is that fat cells must be over-injected to compensate for any necrosis (cell death) that may occur, which results in loss of fatty tissue. Transplanted fat cells must establish a blood supply in their new location or they will die, taking any augmentation effects they may have had with them. Keep in mind that the living fat cells that remain will fluctuate with weight loss and gain, which means the area where they were injected will change size, too. Women with fat grafts to their breasts may end up with more (or less) than they bargained for if they don’t maintain their weight over the years following augmentation.
All women, whether they have large breasts, small breasts or breasts with implants, require mammography to effectively evaluate their breast tissue, and the techniques used depend on individual factors. In truth, foreign body implant breast augmentation surgeries pose potential problems for cancer detection. If you have implants, it’s important to let the technician know so that he or she can use the proper technique for imaging augmented breasts. Although there is no evidence that fat transfer for enhancement obscures or encourages cancer, you should always tell your mammography technician if you have had fat grafting to your breasts.
Pros and Cons of Fat Transfer to the Breast
One of the many benefits of fat transfer to the breasts is that there is no risk of rejection or allergic reaction, since the fat cells come from your own body. The procedure also allows the surgeon more latitude and creativity when it comes to shaping the breasts than saline or silicone implants do. There are no incisions because there are only several tiny openings from the injection points. These augmented breasts feel much more natural, because they are! There is no rippling or foreign silicone bag to feel and nobody need ever know you had your breasts augmented. Also, there is the advantage of having the area where your fat was harvested from end up slim, trim and sculpted following Smart-Lipo skin tightening and sculpting.
The downside of fat transfer to the breast is that some of the transplanted fat cells may not survive long term. They may be absorbed by the body, liquefy, form a cyst, calcify or produce scarring within the breast tissues. If this happens, you likely will lose some volume and may develop some lumps. Fat grafting also provides limited volume (only about one cup size unless pre-expansion is effective with the Brava system, enabling you to gain up to two cup sizes) as compared to traditional implants. Infection and fat migration are possible, as are a reaction to the local anesthesia. Liposuction must be skillfully performed to minimize the potential for creating deformities at the donor sites if too much fat is removed. Since your own fat tissue continues to grow and remodel, there’s no guarantee of breast symmetry, and you may find yourself dissatisfied with some aspect of the final results (size, shape, appearance, etc.).
Fat Grafting Breast Enhancement Costs versus implants
Fat grafting takes longer to perform than using silicone or saline implants, but recovery is often speedier because of the use of SmartLipo. It is less expensive than implant breast augmentation surgery. Breast augmentation with implants runs between $6,000 and $17,000; Plus, if SmartLipo liposculpture of the donor fat harvest area were added on to this, the total cost would usually total between $11,000 and $25,000. The grand total cost for your fat grafting breast augmentation will likely only be between $9,000 and $12,000, and it includes the SmartLipo procedures to smooth and contour the areas where the fat is harvested from. The saline or silicone implant surgery will require general anesthesia and carry higher risks from the anesthesia itself, whereas the fat harvesting and injections for breast enhancement only require local anesthesia and have quicker recovery and lower anesthesia risks. Success of the procedure depends greatly on the skill and technique of the surgeon performing it. This should only be attempted by very experienced and skilled cosmetic surgeons, like Michael McGriff, MD at Hawaii Medical Skin Care.
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