A growing alternative to breast enlargement using silicone breast implants is to use the patient’s own fat. The fat can be taken from selected areas on the body using liposuction and carefully injected into the breast to go up around 2 cup sizes – although this sometimes requires 2 or 3 surgeries. This is known as fat grafting or lipofilling.
Too good to be true? Whilst not perfect, it has certainly provided a real alternative to silicone implants, that will need to be replaced at some point in the future. So how is fat grafting to the breast performed? We asked Consultant Plastic Surgeon, Mr Marc Pacifico, to talk us through the procedure, as well as some of the risks that might be associated with it:
Tell us a bit about the procedure of fat grafting:
Fat grafting, or lipofilling describes the process of taking fat from one part of the body (the donor site) using special liposuction techniques, processing it, and injecting it into another area of the body (the recipient site). It often requires more than one session (procedure) to produce the final desired result. This is because the fat needs to develop a blood supply from its new “home” in the breast and if too much fat is put in at any one time, it can give rise to otherwise avoidable problems. Therefore as much as is safe is injected at any one time to avoid complications, but this might not be enough to complete the final desired outcome in one sitting.
What does it actually involve?
Small volume lipofilling may be performed under a local anaesthetic (with the patient awake), but larger volumes usually require a general anaesthetic (with the patient asleep). First of all, fat is harvested from previously agreed areas, such as the abdomen, the flanks or the thighs. This is done through very small incisions using a technique similar to liposuction.
Subsequently, the fat is filtered and washed in saline, to purify it and remove any blood or excess oil. Once ready, it is put into syringes and can then be injected via tiny “stab incisions” around the breast and areola.
What do you perceive the benefits of lipofilling to be?
Lipofilling uses your own fat, which is therefore 100% natural. However, once injected a proportion of the fat will be reabsorbed by the body (20-50% in some circumstances), however the remainder will last as permanent filler. The final consistency is soft and pliable, replicating a natural breast.
How long does the surgery take?
The length of surgery depends upon the volume of fat to be transferred and may take between 1-2 hours.
What do you tell your patients to expect during the recovery period?
Initially there will be bruising in the area that fat was harvested from (this may last 2-4 weeks but continues to improve with time), and there may be some straw-coloured fluid leaking from the donor site wounds for a couple of days. Wearing a supportive pressure garment for 6-weeks following the surgery may help to speed up the resolution of any swelling at the donor site.
In the breast, where the fat has been injected, there will be swelling which lasts around 6-weeks. It is important for patients to be aware that this swelling will subside, which will then show the amount of fat that will permanently remain – if people are not aware of this, it can be disappointing to see the swelling disappear! As mentioned above, it is usual for more than one session of fat grafting to be needed to achieve the final desired result, so this is par for the course. Most people will be able to return to work at 1-2 weeks following surgery.
There has been much publicity about lipofilling to the breast – why is this different from lipofilling other areas of the body?
Lipofilling has revolutionised breast plastic surgery in recent years. As well as being used for breast enlargement, it has significantly improved the results we are able to achieve in breast asymmetry and women with abnormalities to their breasts. It also has a significant role in post breast cancer reconstruction.
However there have been concerns in the past, as a result of some laboratory studies, that there may be a connection between fat grafting to the breast and the development of breast cancer. We now have the results of several studies that appear to provide significant reassurance regarding the safety of fat grafting to the breast. However, in medicine we can never give 100% guarantees. Therefore we tend to avoid this procedure in women with a strong family history of breast cancer. We also recommend a pre- and post-procedure mammogram to act as baselines in women who are undergoing lipofilling for future reference.
In conclusion, fat grafting is an exciting technique that has provided plastic surgeons with a versatile way of addressing a variety of breast concerns. If you would like any further information on breast surgery or to see one of our Consultant Plastic Surgeons, please contact us on 01892 536960 or email us at firstname.lastname@example.org