Fat transfer known also as fat grafting or lipofilling is a surgical procedure in which the fat is harvested by liposuction, and then used to restore the body contour by adding volume (augmentation) to a soft tissue deficit. It can also be used to improve the quality of the scarred tissues.
Thanks to recent technical advances in fat grafting breast augmentation using your own fat tissue has become a safe and viable alternative to implants. Fat transfer can be used in cases where mastoplasty with implants is either inappropriate or unacceptable by the patient. However, this method cannot be considered as substitution to augmentation with implants, as the degree of augmentation is still fairly limited.
The ideal breast augmentation or reconstruction will always be with the patient’s own tissue. However, currently in our hands the lipofilling is considered to:
Lipofilling is done in three steeps:
Studies have shown that as many fat cells as possible should have direct contact with the recipient tissues to obtain enough oxygen and nutrients to survive. Therefore we only transfer small volumes of fat into small pockets of the recipient tissues to obtain consistent results. Fat cells that survive the transfer grow and increase the volume of the breast.
Fat can be harvested from any part of the body where fat deposits accumulate, most commonly abdomen, waist, back, thighs and knees. There is an added benefit of improving the contour of these areas by liposuction.
Depending on the extent of the procedure the lipofilling can be performed under general anesthesia, local anesthesia with sedation or pure local anesthesia.
No, the result cannot be guaranteed. The survival of fat cells is influenced by different factors and many of them are still unknown. Due to variable take of the fat cells the procedure may need to be repeated to achieve the desired result.
We were born with a certain amount of fat cells. When we gain weight these cells get bigger, and when we lose weight they get smaller. Everything that reduces (liposuction) or adds (lipofilling) the amount of fat cells has a lasting effect.
The benefits of lipofilling are that your own fat and nothing foreign is placed in your body and that the procedure will sculpt other areas, too. The scars are unnoticeable, the recovery after the procedure is short, and the breasts have a natural look and touch.
The downside is that when transferring fat to other areas of the body some will be reabsorbed (approximately 30-70%). Therefore, the results are unpredictable, and additional procedures may be necessary for optimal result. However, it is known that fat cells that remain viable after three months will be there permanently.
One of the major potential problems after fat transfer to the breast is the possibility of changes on mammogram, which can mimic cancer. Recent studies suggest that, while there are changes on mammogram, experienced radiologists are able to distinguish these from cancer.
Breast augmentation with implants has for many years been the most common cosmetic procedure, which is testimony to its safety and ability to achieve satisfying results in most patients. The procedure offers predictable results and large volumes can be added to the breast in a single procedure.
The standard for breast augmentation remains silicone breast implants, but these are not without their own problems. A foreign body can get infected and needs to be taken out. In a small proportion of patients capsule forming around the implant can contract and distort the breast. In skinny patients, the edge of the implant and wrinkles in the outer shell can be visible. Implants cannot be expected to behave like normal breast tissue.