Schematic drawing showing fat grafting to the breast. breast lipomodelling. fat transfer to the breast Melbourne breast surgeon.

Breast surgery has evolved significantly over the past few decades, offering patients a range of options for both aesthetic enhancement and reconstructive purposes. One technique that has gained popularity is fat grafting, also known as lipofilling or autologous fat transfer or lipomodelling. This procedure uses the patient’s own fat cells to enhance breast volume, contour, and symmetry. In this blog, we will explore the applications, benefits, risks, and technical aspects of fat grafting for breast surgery.

What is Fat Grafting for the Breast?

Fat grafting for breast involves the collection of fat from one part of the body (usually the abdomen, thighs, or flanks) using liposuction. The fat is then purified and re-injected into the breast tissue to enhance shape and volume. Unlike implants, which use foreign materials, fat grafting utilizes the patient’s own cells, making it a more natural option for breast augmentation or reconstruction. Fat grafting has three components:

Fat harvest and transfer to the breast. natural breast augmentation. Breast lipomodelling Dr Saam Tourani. — *The harvested fat is purified and drawn into syringes ready to be injected into the breast.*

Harvesting Fat: Liposuction is performed to collect fat cells from areas with excess fat.
Purification: The extracted fat is purified to remove impurities like blood and oils before being re-injected into the breast.
Injection: The purified fat is carefully injected into the breast tissue to improve shape, volume, and contour.

Applications of Breast Fat Grafting

Fat grafting can be used in various clinical contexts, ranging from aesthetic to complex reconstructive surgery. Its main use is as adjunct to other procedures to enhance the aesthetics. However, it may be used as the main procedure for volume enhancements.

1. Breast Augmentation:

For women seeking a modest increase in breast size or a more natural enhancement, fat grafting can offer an alternative to breast implants. The results are often more subtle and natural, eliminating implant complications such as capsular contracture and rupture. In cases of subtle breast asymmetry, it can provide a perfect choice as a balancing procedure.

before and after fat transfer to the left breast for breast asymmetry. Dr Saam Tourani fat transfer/fat grafting Melbourne. — ***Fat grafting for developmental asymmetry.*** Before (left) and 3 months after (right) a single session of fat grafting to the left breast for developmental asymmetry. The asymmetry had resulted in problem with bra fitting, which in turn led to nipple stimulation and left nipple discharge. The nipple discharge resolved following lipofilling.

2. Breast Reconstruction:

After mastectomy or lumpectomy fat grafting can be used to improve breast contour, add extra volume, correct implant rippling or fill in the lumpectomy defects.

Fat grafting to correct Breast implant rippling. Before and after fat transfer breast Dr Saam Tourani Melbourne. — ***Fat grafting for left implant rippling.*** Left column before; middle column after left breast two-stage implant reconstruction and right breast prophylactic mastectomy and direct to implant reconstruction; right column 1 year following fat grafting to the left breast to correct implant rippling.

3. Post Radiotherapy Complications:

Fat grafting has been shown to improve radiotherapy-related skin changes. In addition, reports have been promising for the use of fat grafting to address chronic breast and chest-wall pain after radiotherapy. It can also be used to correct the contour defects following radiotherapy. However, it should be noted that the survival of grafted fat after radiotherapy is unpredictable. Therefore, every effort should be made to prevent contour defects in the first place.

Challenges and Considerations in Fat Grafting for the Breast

While fat grafting offers many advantages, there are several challenges and considerations that patients and surgeons must keep in mind:

1. Fat Resorption:

Not all the transplanted fat will survive the grafting process. Typically, 20-40% of the fat may be absorbed by the body over time, so some degree of reabsorption should be expected. Surgeons often overfill the area to compensate for this loss.

2. Volume Limitations:

Fat grafting is not suitable for patients seeking large increases in breast size. The volume increase achievable through fat grafting is limited by the amount of donor fat available and the patient’s body type. In addition, there is limitation on the volume that can be transferred in each session to maximise grafted fat survival. This usually means that multiple operating sessions are required which will add up to the cost.

4. Risk of Fat Necrosis:

There is a small risk that some of the fat cells may die after the procedure, leading to the formation of hard lumps known as ‘fat necrosis’. These lumps may require further attention or drainage. In addition, they may cause confusion on mammographic screening, leading to unnecessary further workups and biopsies.

Conclusion

Fat grafting for the breast is a versatile, minimally invasive procedure that offers natural-looking results for both breast enhancement and reconstruction. It can be a valuable option for patients seeking to improve breast contour, restore volume after a mastectomy, or enhance the aesthetic of existing breast implants. As with any surgical procedure, it’s essential to have realistic expectations and work closely with a skilled, experienced surgeon to achieve the best possible outcome. Dr. Tourani has extensive experience in performing fat grafting for both aesthetic and reconstructive purposes. His expertise ensures that each patient receives personalized care and optimal results. If you're considering fat grafting or have any questions about the procedure, Dr. Tourani is dedicated to providing you with the most up-to-date information and tailored treatment options.

Fat Grafting: Sculpt. Restore. Rejuvenate.