I have just attended the American Society of Plastic Surgeons national meeting in Toronto, Canada. As always, this was a great and educational meeting and I am planning on adopting a few new techniques into my practice.
One of the “hot” new topics in plastic surgery is fat grafting for breast augmentation. This is a seldom performed procedure and the vast majority of plastic surgeons still consider this a “taboo” procedure. For a few plastics surgeons (and many non-plastic surgeons), this has become a routine part of their practice.
I spent a good portion of this year’s meeting trying to separate the hype of this procedure from reality — Here are a few of the important points that I can share with a patient considering this type of procedure:
- It is very controversial!
- Whether fat grafting impairs the ability to detect breast cancer by radiographic studies such as mammogram is not entirely known.
- Whether fat grafting for breast augmentation will increase a woman’s risk of breast cancer in the future is unknown.
- The best method of fat harvesting and transfer is not entirely known or standardized.
- A period of breast expansion with the BRAVA system is necessary before grafting (3 weeks to 3 months).
- The procedure definitely works and a fairly significant increase in breast size is achievable.
- Often multiple grafting procedures are necessary to achieve significant change.
- The “feel” of the fat grafted breast is soft and natural (when things go well).
- It is more possible to “shape” the breast with fat grafting than is possible with an implant alone.
- Very few plastic surgeons currently offer this procedure.
I currently do not offer fat grafting for breast augmentation, mostly for reasons stated above. Stay tuned. When these procedures are proven safe and techniques are better understood, I certainly will.
For now I will continue to do breast augmentation with implants. This is a reliable, well understood procedure with a good track record of safety.