Breast augmentation remains one of the world’s most popular aesthetic surgeries. In the overwhelming majority of cases, either a silicone gel or saline based implant is utilized to provide volume enhancement, upper breast fullness and some firmness to those women who have either lost these characteristics or were not born with them. Yet for the past 15-20 years, “fat grafting” or “fat transfer” breast augmentation has become a popular as a way to increase volume to a number of areas (buttock, face, breast) to name a few.
“Fat grafting” or “fat transfer” breast enlargement uses liposuction to take fat from a patient, prepares the fat, and then places that fat into a desired region of the face or body during the same surgery. What started many years ago with great promises has like many things come back down to reality with known risks, complications and short comings.
The basic premise is that the particles of fat that were liposuctioned (harvested) and then placed back into the face or body will invite enough of the surrounding tissues blood supply to become “living” fat cells that act just like other fat cells in the body.
Specifically for the breasts, although there have been many various techniques to describe the process of harvesting and re-injecting fat in order to improve the fat “survival”, the bottom line is that there is no technique that has fully mastered this to an acceptable level in my opinion. So, why is this important!?
After that fat has been re-injected/transferred to the breasts, many of those fat cells do not get enough blood flow to survive as thus they die (become necrotic). Depending on the literature, only 30-70% of this fat is thought to live. Thus, only 30-70% of those fat cells will get enough blood flow to live. Even in best circumstances, a patient will still expect only 30% of all of the fat that was transferred into the breast to die (and become necrotic).
What happens when fat transferred into the breasts become necrotic?
- Those clustered fat cells will then turn into a hard lump(s) that can often times be felt by the patient (this can last for over a year or more)
- Those clustered fat cells then often get calcified (calcifications)
What Are The Downsides When Fat Grafting Into The Breasts Creates Calcifications?
- For many women, feeling lumps in their breast will lead to anxiety and fear of possible cancer or other concerning diagnosis
- Although a patient could assume that lump (those lumps) are from the surgery, most patients will become anxious enough to desire a more complete workup with radiology images, etc
- One of the hallmark signs of cancer on mammograms is calcifications.
- Remember, often times that fat necrosis contains calcifications which can lead to a confusing picture for the picture and the radiologist.
- Thus, if a radiologist sees a calcification on mammogram (even if it is from the fat grafting), this will often times lead to biopsies and further more invasive testing to ensure these findings do not represent cancer.
Here’s An Aesthetic Perspective on Fat Transfer Breast Augmentation
- Since fat has a variable living percentage, it is much more difficult to attain optimal symmetry between breasts when injecting the fat volumes.
- It is essentially a guestimate to how much fat to transfer to each breast
- Most women have asymmetric breasts to begin with and transferring a selected amount of fat with various “take” and “living” percentages will often lead to continued or worsening asymmetry of the breasts.
While fat transfer does have some advantages, for the reasons above I have chosen NOT to perform this surgery and strongly recommend any woman who is thinking about this to carefully weigh her options prior to proceeding.
I have performed many fat transfer procedures and still do so for facial rejuvenation as the issues seen in breast fat transfer are not seen nearly as much in the face due to the significantly more robust blood flow in the face versus the breast.
If you are researching the fat transfer breast augmentation enlargement technique and wish to know more about it, we invite you to Request A Consult, where we can discuss in full detail the pros and cons, your goals, and our expert advice – tailored to you.
