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Breast Augmentation Using Injected Fat

This is not exactly a new technique, but it is gaining steam abroad, and there are centers in the US which are studying it, while some surgeons are begining to incorporate it into their suite of techniques.  Fat injection, also known as fat grafting, or fat transfer, is a tool that plastic surgeons use to fill, or augment areas of the body or face.  Cheeks, nasolabial folds, lips, and buttocks are fairly common targets for the fat, which needs to be harvested from somewhere else (no, you can’t use it from another person).

Although I have previously written about fat injections on this blog , what I am talking about here is injecting fat into the breasts.  Seems like the perfect application for this, so why the big deal, right?  Well, the main stumbling block in my opinion seems to be the medicolegal fear.  When you inject fat into a breast, there can be certain changes on a mammogram for instance.  These include small oil cysts and calcifications.  It seems that radiologists have no trouble discerning these types of things from the calcifications that are associated with breast cancer, and yet most surgeons in this very litigious country of ours are a bit hesitant to embark on this procedure.  I’m sure any plastic surgeon could imagine how a patient developing breast cancer in the future, could claim a causal effect or a delay in diagnosis due to the effects of the previous fat injection.

I have actually used fat injection to the breast in Santa Barbara in the setting of breast reconstruction after mastectomy for breast cancer, but this is different in many ways from cosmetic breast augmentation.  It typically involves relatively small volumes of fat, placed around the edges of a prosthetic implant, in order to smooth the overall contour.  Augmentation with fat for cosmetic purposes would involve significantly more volume of fat, and for a purely elective procedure.

Breast augmentation with fat will have other issues.  It will be a longer, more tedious procedure than placing breast implants, so the cost will be higher, even though no implant is involved.  Harvesting that amount of fat safely and reliably will demand gentle technique, and most likely be facilitated with Body-Jet liposuction which harvests nice amounts of good quality fat for re-injection.  Breast augmentation with fat will likely be for women who have enough fat to be harvested safely, and who desire a modest, rather than a dramatic, increase in the size of their breasts.  In other words, there will still be a place for breast implants, and breast augmentation with fat will likely comprise a small group of the breast augmentation patients.

Douglas J. Mackenzie, M.D., F.A.C.S.

Santa Barbara, CA

Douglas J. Mackenzie, MD

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