The idea of taking your own fat and placing it in your breasts is not a new idea. It has captured the attention of both public and plastic surgeons. There has been some research on the safety and efficacy of this surgery, more research is needed and currently fat transfer breast augmentation is only at experimental stages and has not been indorsed as standard of care by American Society of Plastic Surgeons. Only a few academic hospitals and centers in the country are allowed to perform and collect data at present time.
The major limitations and problems with fat transfer to breasts will be discussed below and include:
1. Limitation in increase in breast cup size: maximum of one cup size increase.
2. The need for several sessions of fat transfer
3. Longer recovery time than tradition breast implant surgery
4. Unknown side effects, and most importantly interfering with mammogram study for breast cancer detection
5. Very expensive compared to breast implant surgery.
The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons strongly recommends women to proceed cautiously since temporary benefits may be offset by long-term problems with fat transfer to the breasts at present time. The problems include but not limited to self examination, mammography ultrasound and MRI evaluation of the breast in screening to rule out breast cancer. Specifically, ASAPS and ASPS believe you should take into consideration the following before inquiring with a board certified plastic surgeon
about fat grafts for breast enlargement:
What is fat grafting?
Fat grafting, also known as fat transfer is a process in which fat cells are taken from one part of the body via a liposuction surgery and injected into another area. It is a procedure with few surgical complications and is most commonly used to provide the face and buttocks with a fuller appearance which may be permanent.
How long has fat grafting been used for breast enlargement?
Fat injection to the breast first became popular in the 1980s; however, both ASPS and ASAPS initially cautioned its members against the technique because of side effects such as calcification and tissue scarring. The calcification in particular made it difficult to distinguish in a mammogram between calcifications associated with breast cancer and calcifications associated with fat transfer. In recent years, radiology research suggests that new generations of mammography machines 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 collection and injection of fat have also been refined. Today, fat cells are carefully removed by liposuction, processed and purified 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 safer alternative to saline or silicone implants?
At the time this article is written (Spring 2012) little clinical evidence exists to suggest that fat transfer to the breasts is safer or better than implants, either saline or silicone.
What are the risks and complications?
The main problem is that 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. 7 to 14 ounces of fat injected into the breast, the amount required for an average enlargement, can still result in calcifications and scarring that can mimic or obscure breast cancer.
What are some of the other issues involved with fat transfer for augmentation?
The process will most likely require multiple sessions and typically increases breast size at the most by only one cup. There is longer recovery time than with traditional implants, as both the breast and donor site must heal. You will need to have an adequate of excess fat supply 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.
In the interest of patient safety, American Society of Plastic Surgeons does 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 FDA approved implants for breast augmentation.