Fat Grafting (Lipofiling)

Yes I am. We perform a lot of fat grafting in our practice for breast reconstruction.

Fat grafting is a fairly new technique in breast surgery. Fat is liposuctioned from one part of the patient's body, purified and then injected into the breast.

Fat grafting can be used to fill-in partial breast defects after lumpectomy. It is also frequently used after mastectomy, mostly in conjunction with other reconstructive techniques, to optimize the breast contour and improve overall cosmetic results.

There are several fat grafting techniques that are used by plastic surgeons. There is no "set way" that has been shown to be the best in terms of long-term results. However, studies have shown that regardless of the technique used, the collection, storage, and transplantation of the fat cells and the fat stem cells must be optimized to obtain the best long-lasting results. Cell-assisted lipotransfer (CAL) is one approach to fat grafting in which the stem cells are separated from the liposuctioned fat, essentially concentrated, and subsequently re-attached to the fat that is going to be re-injected.

Studies have also shown that once the injected fat "takes", it can also help improve the thickness and quality of radiation-damaged tissue and skin.

Regardless of technique, some of the injected fat will be reabsorbed over time but this can vary depending on the exact clinical situation. Patients must therefore be prepared to require more than one procedure for the best results.

Several independent studies that have evaluated patients over a few years after the procedure have shown that fat grafting is safe. However, because the technique is fairly new, no long-term safety data is currently available.

Unfortunately not all insurance companies cover the cost of fat grafting so the procedure can involve out of pocket expenses for some patients.

I hope this info helps!

Dr C
http://www.PRMA-enhance.com

Fat grating involves taking fat from one part of the patient's body using liposuction, purifing the fat and then injecting into the breast. It is also known as "lipofilling".

Fat grafting is usually performed to fill in contour defects after lumpectomy. It is a particularly good option for small contour defects that involve less than 25% of the overall breast size. More than one fat grafting procedure may be required for best results as some of the fat typically gets reabsorbed. The likelihood of needing multiple fat grafting procedures increases as the size of the defect increases.

Fat grafting is also being used by some plastic surgeons to reconstruct the whole breast in conjunction with a breast device known as Brava. The device is worn in place of a bra for several hours a day. Brava essentially expands the breast by external suction. A series of fat injections is performed to fill in the breast as it expands, typically over a period of a few weeks/months (depending on the number of injections required).

Fat grafting is accepted as safe but more studies are needed. Like all surgical procedures, there are known risks. These include re-absorption, oil cysts, and firm areas.

From a breast cancer perspective, you must also know that fat grafting can cause calcifications on mammograms though these are generally easily differentiated from the microcalcifications associated with breast cancer. Also, while early studies are encouraging, there are no long-term studies that have looked at fat grafting and the risk of breast cancer recurrence.

I hope that helps.

Dr C
http://www.PRMA-enhance.com