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The American Society of Aesthetic Plastic Surgery  recently discussed autologous fat grafting as a means to increase breast size in appropriately selected women patients, rather than using the current standard of care, silicone or saline implants.   What follows can be found at the official website for the American Society of Aesthetic Plastic Surgery www.surgery.org.

It is the cosmetic treatment many women have dreamed of –taking the fat from their hips and thighs and redistributing it to their breasts. But many people question whether this procedure is safe or effective. Breast enhancement using fat grafts (lipoaugmentation) rather than silicone or saline implants employs fat suctioned from the patient’s buttocks, thighs or other fatty areas. This type of breast surgery can be used to increase the size of the breast or to fill in defects or abnormalities in existing breasts, including enhancing the appearance after breast reconstruction and softening the look of existing implants. Lipoaugmentation of the breasts may offer patients permanent breast augmentation with a natural look and feel and the benefit of body contouring through liposuction—without the requirement for incisions or implants.

Sydney Coleman, MD, a plastic surgeon in New York City, is a leader in the field of micro fat grafting to the face, which has become a major part of facial rejuvenation as it is practiced today. The technique has recently been extended to the breast and body where much larger amounts of fat are injected. “Breast shaping and augmentation with fat grafting provides a more natural aesthetic result for aesthetic and reconstructive patients. The placement of the fat grafts allows for dramatic or subtle shaping of the breast in a manner previously not attainable,” said Dr. Coleman. “This type of shaping is extremely difficult or impossible with implants or surgery. The result is a natural appearing reshaped breast in which telltale signs of implants and surgery are absent – the resultant breast is completely fluid and natural appearing.”

However, long-term safety and efficacy data, and the effect of the procedure on breast cancer screening using mammography, is still being evaluated in clinical studies. Concerns about fat grafting for breast enhancement include typically low survival rates of the transferred cells (which are frequently absorbed by the body), development of cysts, calcification and tissue scarring, as well as long-term problems with breast cancer detection due to difficulties distinguishing mammographically between calcifications associated with breast cancer and calcifications associated with fat transfer. This procedure offers mostly a one cup size enlargement and the degree of enlargement will depend on the amount of spare fat that the patient has.

Numerous questions remain about this new technique: How much of the fat survives? Does the procedure have to be repeated? Are the breasts hard and uncomfortable for long periods after the procedure? Perhaps most importantly, what are the cancer implications of this technique?