Preoperative Expansion Is Key to Improving Results of Breast Fat Transplantation

ARLINGTON HEIGHTS, Ill. - A plastic surgery procedure in which the patient's own fat is transplanted to the breasts - used along with treatment to expand the breast tissue before surgery - can achieve up to a twofold increase in breast size, according to a study in the June issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The procedure builds on previous fat transfer techniques to provide excellent outcomes of breast enhancement surgery. "Pre-expansion to the breast allows for mega-volume (over 300 cc) grafting with reproducible, long lasting results that can be achieved in less than two hours," according to ASPS Members Daniel Alexander Del Vecchio, MD, Boston, and Louis Paul Bucky, MD, Philadelphia, authors of the new report.

"Pre-Expansion" Maximizes Results of Breast Fat Transfer
The technique is an adaptation of the increasingly popular autologous fat transplantation technique. In these procedures, fat obtained by liposuction from one part of the body - for example, the thighs - is transferred for use in breast enlargement and reshaping.

In the procedure used by Drs. Del Vecchio and Bucky, the patient first undergoes several weeks of "pre-expansion" treatment. This is done with a bra-like device that uses gentle negative pressure to gradually expand the breast. The pre-expansion procedure provides extra room in the breast, which is "backfilled" using the liposuctioned fat.

The authors report their experience using pre-expansion and autologous fat transfer in 46 breasts of 25 women. Some of the patients wanted to increase their breast size or to replace implants; others were seeking treatment for certain types of breast deformities. On average, about 300cc of fat was transplanted per treated breast.

When evaluated after six months, the women had significant improvements in breast size and shape. On average, the treated breasts approximately doubled in size, with a "soft and natural...appearance and feel," the researchers write. Follow-up magnetic resonance imaging scans showed no cysts, masses or other abnormalities.

As they gained experience, the surgeons were able to perform the breast fat transfer procedure within less than two hours. There were no significant complications.

While the idea of breast fat transfer is not new, it has seen a resurgence in recent years, with several plastic surgery groups reporting good results. Drs. Del Vecchio and Bucky believe pre-transplant breast expansion is an important technical advance, providing increased space to be occupied by the patient's own fat. Patients also used a vacuum device for a few weeks after the procedure, which may act as a "splint" to help promote healing.

Further research will be needed to assess the results of the pre-expansion and fat transplantation technique - including not only the long-term outcomes, but also important safety issues. As reported in recent issues of Plastic and Reconstructive Surgery, there is some question as to whether breast fat transfer procedures interfere with mammographic screening for breast cancer.

In the meantime, Drs. Del Vecchio and Bucky believe their results - a twofold increase in breast size, achieved in two hours or less - demonstrate a significant step forward in the use of autologous fat transplantation for breast enhancement. They conclude, "These results serve as a standard to objectively compare other techniques of fat grafting to the breast in the future."

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. 

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