“Do you use fat grafts for breast augmentation?”
March 9th, 2009 Dr. McKaneIn clinic today I had a patient ask me, “Can you do some liposuction to my thighs and then inject that fat into my breast?” She was basically asking if I use fat grafts or fat grafting for breast augmentation. In theory, this seems like it would be a great procedure to perform. The patient would benefit by removing volume from a troublesome area and then putting it into another one that she would like to increase the volume of. While it is possible to perform a breast augmentation this way, it may not be the best option at this time.
Fat grafting has been used for over 100 years for both reconstructive and aesthetic purposes. In the breast, frequent complications including tissue scarring, cysts, and in particular, calcification had lead some to postulate that fat grafting may delay the diagnosis of breast cancer. For aesthetic purposes, the procedure was largely abandoned in the breast. There has been renewed interest amongst Plastic Surgeons in aesthetic applications for the breast due to the promising reports ”Structural fat grafting: More than a permanent filler,” and the followup paper “Fat grafting to the breast revisited: Safety and Efficacy,” by Dr. Coleman. This interest has led some surgeons to offer the procedure to their patients as a means of breast augmentation.
At this point, I don’t personally recommend the procedure to my patients considering breast augmentation. My reasoning is as follows: First, the procedure is probably best suited for a woman seeking a very modest increase in the volume of her breast and in one that is willing to tolerate multiple surgeries to achieve her goals. The technique needs to be performed using numerous injections of very small volumes of fat to reduce the risks of large fat cysts and volume loss due to graft failure. This also usually involves a secondary or even tertiary surgery for additional fat grafting. This does not fit the profile of my typical patient who wants an immediate significant change to the volume of her breast. This rapid change is easily afforded using saline or silicone implants. In addition, the technique is highly surgeon dependent and there is a learning curve for the procedure. My patients demand reliable results and implants deliver this type of reliability. Furthermore, the evidence in the literature surrounding the safety, efficacy, and outcomes of fat grafting for breast augmentation consist of case reports and opinion. To date, there are no randomized controlled trials demonstrating that fat grafting is superior to breast implants for breast augmentation. Because there is limited scientific evidence supporting fat grafting I am hesitant to offer it at this point.
Does this mean that I don’t offer fat grafting? Absolutely not. I use fat grafting frequently for reconstructive purposes. Would I use fat grafting in the future for breast augmentation? Yes, once additional research is conducted on the subject that demonstrates equivalent safety and efficacy to implants.
Our websites www.beauty-surgeon.com and www.drmckane.com have additional information and before and after photographs of breast augmentation for review. I invite you to schedule a consultation with me if you would like to learn more about breast augmentation or fat grafting. Please feel free to contact our office at (713) 661-5255 if you have any questions.
-Brice W. McKane, M.D.