Fat grafting and breast reconstruction

Fat grafting lips, fat grafting cheeks, fat grafting buttocks, fat grafting breasts have all been described over several years.  Recently I attended the Southeastern Society of Reconstructive Surgeons Meeting in Altanta.  One of the Hot Topics was fat grafting.  In particular autologous fat grafting for breast augmentation.  There are numerous considerations with breast augmentation including breast augmentation cost, breast augmentation recovery time, breast augmentation risks, breast augmentation size as well as concerns of the patient on how they will look after breast augmentation.  Concerns over the natural appearance have led many, but most notably, Board Certified Plastic Surgeons, to seek out new avenues to provide durable, natural results with fat.  Liposuction  allows a  Plastic Surgeon to harvest fat from the abdomen, flanks, hips and thighs in order to provide fat to augment a breast. A special centrifuge device is used to prepare the fat then it is injected into the breast tissue. Negative pressure devices are placed on the breast pre-operatively and post-operatively. Currently, several investigators are studying the technique and marketing devices such as the “Brava system” Short term outcomes displayed at the meeting look impressive. Controversy exists because of the worry of injecting fat into the breast may interfere in breast cancer screening…forming oil cysts, calcifications, etc. that may need a biopsy down the road. As of this meeting the American Society of Plastic Surgery does not support fat grafting to augment breasts…at least  until further research and long-term studies are performed. That’s not to say plastic surgeons will not stop doing this technique because ASPS doesn’t support it…many surgeons will market their special devices, perform workshops, and hopefully study their outcomes.

This technique shows great promise for women…how nice will it be to transfer unwanted fat in the midsection/buttucks to reconstruct breast tissue for oncologic or cosmetic defects. This awesome technique will come to fruition soon…probably  by the time I finish my residency.

Matthew W. Blanton, MD

Plastic Surgery Resident

Duke University

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