Women have said for years: “if only I could take some fat from my tummy or thighs and put it in my breasts.” Now it is possible.
Breast Fat Grafting Has Come Of Age
Breast augmentation with fat grafting has been under development by plastic surgeons for the last 30 years. After years of refinement in technique and assessment of the safety of breast fat grafting, breast augmentation using a woman’s own fat is now possible.
Fat transfer can now be considered for primary breast augmentation (in place of breast implants), combined with implants, combined with a breast lift, used for treatment of ripples around breast implants, and for breast reconstruction following breast cancer surgery.
Dr. Connall embraced breast fat grafting early in its develop and has performed hundreds of breast fat grafting procedures for aesthetic and reconstructive breast surgery. Dr. Connall was the first to perform total breast augmentation with fat grafting and total breast reconstruction with fat grafting in Portland, Oregon and Southwest Washington. There are few surgeons in the U.S. that have Dr. Connall’s level of expertise with breast fat grafting.
Breast Augmentation And Liposuction
Breast augmentation with fat is a two-step process.
First, liposuction is performed in areas of your choice. The “donor” liposuction sites are typically the abdomen, flanks, and outer and inner thighs. The liposuction sites are sculpted to give you the contours you desire. The liposuction is performed with the body-jet system which is very gentle and maintains the viability of fat cells, which is ideal for fat grafting and prepared for injection into the breasts.
Next, the fat is meticulously injected into the breasts. The fat is injected in very tiny tread-like passes to facilitate the integration and growth of the fat cells in the breast tissues. The fat is blended into all levels of the breast, but especially under the skin and above and into the pectoralis major muscle. The breasts are swollen for several weeks, similar to after breast implants. In time the breasts become soft and natural and the results should be permanent.
Are You A Good Candidate?
Portland women that desire a modest increase in breast size are generally the best candidates for breast fat grafting. The breasts should start with a nice shape and have good skin tone. Patients that have poor skin, sagging breasts, or desire a large increase in breast size are not good candidates for breast augmentation with fat transfer.
Breast shape, especially the cleavage and upper part of the breasts, is enhanced. The breast size is typically increased by about three-quarter to one full bra cup size. Patients considering breast fat grafting must be realistic about their expectations. For those patients desiring large, round, augmented-appearing breasts a breast augmentation with implants will be required.
Breast Implants Plus Fat Grafting
In complex cases fat grafting can be used during a breast implant procedure to optimize the breast shape. In some patients, the breasts can be very misshapen and implants alone cannot create normal breast aesthetics. However, residual irregularities of the breasts can be filled in with fat grafting to achieve an aesthetic shape. We have found that the addition of fat grafting to complex breast augmentation cases has led to superior results that could not have been achieved with implants alone.
Breast Lift Plus Fat Grafting
One of the chief goals of a breast lift is to create more fullness in the upper portion and cleavage of the breasts. Such fullness is difficult to accomplish with a breast lift alone. Hence, the most common solution is to include a breast implant, with the breast lift, to provide more volume in the upper breast. This can result in the use of overly large breast implants that can put excessive stress on the breast tissues and skin. And, in some cases, placing large implants would result in breasts that are larger than desired by the patient.
We have found that adding fat to the cleavage and upper breast is an ideal way to sculpt the breasts during a breast lift. Whereas an implant puts undue stress on the tissues (sometimes causing recurrent sagging of the breasts), fat grafting is gentle on the breasts. We have seen superior results in breast lift patients that also had fat grafting.
Fat Grafting For Implant Problems
Uneven breast shape, asymmetry in shape and volume, and visible implants ripples are a few of the unfavorable conditions associated with augmented breasts that can be helped with breast fat grafting. Our surgeons have treated many types of implant problems by leaving the implants in place and adding fat to select areas around the implants.
Breast Reconstruction With Fat Grafting
Breast defects following lumpectomy for breast cancer can be filled with fat grafting, leading to normal breast shape.
Total breast reconstruction following mastectomy can be performed with fat grafting. Fat grafting after mastectomy is a revolutionary procedure and spares the patient from the traditional methods of reconstruction which require implants or complex tissue flaps. Total reconstruction is a multi-stage process in which 2-4 sequential breast fat grafting operations are required.
Dr. Connall was the first surgeon in Oregon to perform complete bilateral breast reconstruction with fat grafting only (following nipple-sparing mastectomy) in 2012.
A Rapidly Growing Procedure
Breast fat grafting continues to be an emerging procedure in plastic surgery. The procedure and its applications are growing rapidly around the world and in the United States. Dr. Connall is at the forefront of this revolutionary technique.
With new procedures, new risks and concerns must be evaluated and discussed openly with Portland patients. Like any surgical procedure, breast fat grafting has risks and adverse events can occur. A key issue for surgeons and patients is the possible impact of injected fat on the feel of the breasts and the appearance of the breasts on mammogram, ultrasound, and MRI. Breast lumps, cysts, and calcifications can occur after breast fat grafting, just as they can after other breast procedures. The consensus is that grafted fat looks distinct on breast imaging and is generally distinguishable from lesions suspicious for breast cancer.
In our experience the most common adverse event is the creation of fatty cysts within the breasts. These cysts can sometimes be felt and on rare occasion can be painful. Most cysts can be aspirated with a needle during a simple office procedure and improvement and sometimes resolution can occur.
The most common unsatisfactory outcome is insufficient “take” of the fat. That is, simply not enough fat survives to create a desirable volume and/or shape of the breast. We are very open with patients about the unpredictability of fat grafting and emphasize that only mild to moderate changes in the breasts should be expected from any one treatment. With multiple treatments, larger volumes and more dramatic results can be achieved.
Breast Cancer Risk
The other key issue is theoretical concern about the effect of transferred fat on breast cancer development. Simply put: can grafted fat cause breast cancer? Since fat contains hormones, growth factors, and multiple cell types (such as stem-cells), this is an important question for surgeons, scientists, and patients to consider.
Presently, there are no data in humans showing that fat injected into the breast causes breast cancer. Thousands of breast fat grafting cases have been performed world-wide, many in breast cancer patients, and an increase in breast cancer rates has not occurred. In addition, surgeons have been transferring blocks of fat to breasts for breast reconstruction for three decades and increases in breast cancer have not occurred. However, it will take many years and experience with thousands of patients before the scientific community can determine with certainty that breast fat grafting will not contribute to breast tumor growth.
Breast Health Follow-Up Is Critical
Portland patients considering breast fat grafting must understand and accept the risks and be diligent in following their breasts with routine breast exams and imaging studies. We require breast fat grafting patients to obtain a mammogram before surgery and 9-12 months after surgery. If irregularities from the fat are seen on the post-op mammogram then those are documented, providing a “map’ that radiologists can reference for comparison with all future mammograms.
Fat Grafting And Your Consultation
If you desire breast augmentation (or other breast procedure) with your own fat, then your consultation with one of our surgeons at our Portland office will be directed to that approach. Their experience with major breast fat grafting is one of the greatest in the U.S. They will give you an honest and realistic appraisal of the role of fat grafting for your specific anatomy and goals. Even if breast implants are your first choice, they will inform you about this exciting option if you are a suitable candidate.
Get larger, natural-looking breasts with breast fat grafting. To schedule your breast augmentation with fat transfer consultation, contact our Portland office at (503) 783-0544.