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Fat Grafting for Breast Augmentation – What Women should know:
(press release from ASAPS)
The idea of taking your own fat and repositioning it to augment your breasts
has captured the attention of both consumers and the media. Although there has
been some research on the safety and efficacy of this procedure, more research
is needed before concluding that the procedure's benefits outweigh the risks.
The American Society for Aesthetic Plastic Surgery (ASAPS) and the American
Society of Plastic Surgeons (ASPS) urge consumers to proceed cautiously since
temporary benefits may be offset by long-term problems with self examination and
mammography ultrasound and MRI evaluation of the breast in screening to rule out
breast cancer. Specifically, ASAPS and ASPS believe you should consider the
following before consultation with a board-certified plastic surgeon about fat
grafts for breast enhancement:
What is fat grafting?
Fat grafting, also known as fat transfer or lipoinjection, is a process
in which fat cells are harvested from one part of the body and injected into
another. It is a procedure with few surgical complications and is most commonly
used to provide the face and hands with a more youthful appearance which may be
permanent.
How long has fat grafting been used for breast augmentation?
Augmenting the breast with the body's own fat first became popular in
the 1980s; however, both ASPS and ASAPS initially cautioned its members against
the technique because of side effects such as oil cysts, calcification, and
tissue scarring. The calcification in particular made it difficult to
distinguish mammographically between calcifications associated with breast
cancer and calcifications associated with fat transfer.
What has changed since then?
More recently, radiology literature suggests that new generations of
mammography equipment are more sophisticated than their predecessors and better
able to distinguish cancer cells from benign ones. This is particularly true of
digital mammography, especially when examining dense breast tissue.
The methods for harvest and injection have also been refined. Today, fat
cells are carefully removed by liposuction using syringes and transferred to the
breast via dozens of small injections. This technique may result in increased
survival of the fat cells, although there remains a debate over how much of the
transferred fat remains long term.
Is fat grafting a better or safer alternative to saline or silicone
implants?
Little clinical evidence, pro or con, exists to suggest that fat
grafting is safer or better than saline or silicone implants.
What are the risks?
Fat cells removed from one body site and injected into another
frequently do not survive. Fat injected into the breast may be absorbed by the
body, may become liquid and form a cyst, calcify, or produce scarring within the
tissues. Seven to 14 ounces of fat injected into the breast, the amount required
for an average enlargement, can still result in calcifications, oil cysts and
scarring that can mimic or obscure breast cancer.
What are some of the other issues involved with fat grafting for
augmentation?
The process requires multiple sessions and typically increases breast
size at the most by only one cup. The recovery time may be longer than with
traditional implants, as both the breast and donor site must heal. You will need
to have an adequate supply of excess fat for the procedure. And it can take up
to six months or more for your result to take shape after the procedure as
opposed to implants where your final result appears in six to eight weeks.
Is there an acceptable application for this procedure currently in
use?
Yes. Fat grafting can be very effective in enhancing the appearance
after breast reconstruction. The procedure can also soften the appearance of
existing implants, particularly in very thin women and hide visible rippling. It
is also an accepted application for facial and hand rejunivation.
What do the Societies recommend?
The American Society for Aesthetic Plastic Surgery and the American
Society of Plastic Surgeons, in the interest of patient safety, do not recommend
fat grafting for breast enhancement at this time. Because there is little
clinical evidence available to document safety and efficacy, we urge patients to
consider the procedure as one undergoing continued evaluation.
The 2300-member American Society for Aesthetic Plastic Surgery (ASAPS)
is the only plastic surgery organization devoted entirely to the advancement
of cosmetic surgery. ASAPS is recognized throughout the world as the
authoritative source for cosmetic surgery education. U.S. members are
certified by the American Board of Plastic Surgery. Canadian members are
certified in plastic surgery by the Royal College of Physicians and Surgeons
of Canada.
Toll-free referral line: 888.ASAPS.11 (272.7711). Web site:
www.surgery.org
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