Fat grafting has been around for years but is gaining momentum as a hot new cosmetic surgery and reconstructive surgery procedure. Early fat grafting dates back to the late 1800?s, however significant advances in technique have occurred more recently. The basic problem with fat grafting is trying to get the fat to survive. Newer techniques include micro fat grafting with smaller cannulas and meticulous handling of the fat from harvest to injection. Fat grafting is quite useful in facial rejuvenation for replacement of volume lost with facial aging. Popular areas for injection include the cheeks, nasolabial folds, and lip augmentation.
In 2007, a task force was formed by the American Society of Plastic Surgeons to look at the safety and effectiveness of fat grafting and set some general guidelines. The conclusion of this task force as it relates to fat grafting for breast augmentation was that it was an acceptable practice. There were several problems with fat grafting in breasts that need to be considered.
- There can be areas where the graft does not survive leading to calcification
- Calcification can potentially be misleading on mammography
- Physicians should be cautious with fat grafting in patients at high risk of breast cancer
- The amount of fat that survives can be difficult to predict, and may need to be repeated many times
- The procedure is very time intensive and as a result quite expensive
Personally, I do not do fat grafting for breast augmentation for these reasons. There is a tried and true alternative, breast augmentation which has been successful for many years. I would consider, and have done, fat grafting to the breast to correct deformities and irregularities caused by breast biopsies or after breast reconstruction.