Surgeons Can Replace Breast Implants with Fat in â??Reverse Liposuctionâ? Procedure

A reverse liposuction procedure may soon become a popular alternative to using breast implants and revision surgery. This procedure replaces breast implants with the patient’s own body fat, rather than new implants, providing natural-looking results, according to a report in the latest issue of Plastic and Reconstructive Surgery.

Properly known as simultaneous implant exchange with fat (SIEF), reverse liposuction is a conceptual paradigm shift of using natural fat for volumetric augmentation and breast reshaping, says report author Dr. Daniel Del Vecchio. He used the technique to help a 42-year-old woman who was dissatisfied with the appearance of her breast implants after seven years. She felt that they were too full and rounded, and appeared unnatural.

Although she wanted the implants removed, she was concerned about how her breasts would look afterwards. Dr. Del Vecchio designed the SIEF technique as a way to maintain the natural shape of her breasts after the removal of the implants. Here’s how the reverse liposuction technique works:

  • Over the course of three weeks prior to surgery, the patient uses a bra-like device to gradually expand her breast. The device uses negative pressure  basically vacuum suction to stretch the tissue.
  • Before performing the implant removal surgery, the surgeon harvest fat cells from the patient’s thighs and/or abdomen with liposuction.
  • The fat cells are injected into the space over the implants. This allows the surgeon to sculpt and reshape the breast.
  • The breast implants are removed, and the surgeon can inject additional fat beneath the skin.

When he followed up with his patient one year later, Dr. Del Vecchio discovered that her breasts were roughly the same volume as they had been with breast implants. He was also pleased to find that they looked better than before, with a smoother transition at the top.

Fat Transfer for Breasts Causes Confusion on Mammograms, Study Finds

mammogram confusion after fat transfer procedureFat transfer for breast augmentation can cause false suspicion of breast cancer on follow-up mammograms warns a new study published in the April issue of Plastic and Reconstructive Surgery (PRS) journal. It found that mammographic changes occurring after the fat transfer procedure â?? in which fat from other parts of the body is obtained through liposuction and transferred to the breasts â?? are indistinguishable from abnormalities associated with breast cancer.

Based on this “mammographic confusion,” the authors concluded that the use of fat injection for breast augmentation should be “prohibited continuously.”

The study by Dr. Cong-Feng Wang of Meitan General Hospital in Beijing looked at 48 women who underwent fat transfer, which the authors refer to as â??autologous fat injection for breast augmentation.â? They found eight cases (16.7 percent) with clustered microcalcifications in postoperative mammograms, and in all eight cases the microcalcifications were regarded as “highly suspicious” for breast cancer.

The abnormalities prompted surgical biopsy to remove and examine the breast area showing microcalcifications, but none of the biopsies revealed breast cancer. The calcifications appeared to be related to death of the injected fat cells.

The studyâ??s recommendation to discontinue the procedure conflicts with a study published in the March issue of PRS journal, the official journal of the American Society of Plastic Surgeons (ASPS), which concluded that “Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure.”

An ASPS release noted the conflicting studies and said that the results highlight the need for caution â?? and for more scientific evidence on the mammographic changes occurring after fat injection.

Study Says Breast Augmentation Using a Patient’s Own Fat is Possible

woman wearing a braA new study says that success for breast augmentation using fat grafting is possible. The study was presented at Plastic Surgery 2010, sponsored by the American Society of Plastic Surgeons’ (ASPS).

Fat grafting involves harvesting fat cells with liposuction from one part of the body and injecting into another. According to the American Society for Aesthetic Plastic Surgery (ASAPS), it’s a procedure with few surgical complications and is most commonly used cosmetically for the hands and face.

While fat grafting for breast augmentation has been a relatively obscure procedure, new studies, such as this one, are building evidence that it could be effective for breast enhancement.

The study, authored by Boston plastic surgeon Daniel Del Vecchio, MD, and Philadelphia plastic surgeon Louis Bucky, MD, was conducted over two years with 25 patients who had breast enhancement with fat grafting.

Before the procedure, patients were photographed and had MRI and/or 3D breast imaging, followed by three weeks of expansion, such as wearing a suction bra every day. Patients were again photographed and had the other breast imaging tests repeated six months after the surgery.

Results showed that at six months post surgery all patients had visible breast volume increase. The mean volume increase was 250 cc per breast.

The study concluded that patient selection and pre-expansion of the breasts are important variables in the success of the procedure. The authors add that the technique can be performed in a time efficient manner with reproducible, long-lasting results.

ASPS noted, While the procedure is gaining scientific validity and traction among plastic surgeons, it is not the same as having breast enlargement with implants.

ASPS and ASAPS initially cautioned against fat grafting for breast augmentation because some of the side effects, such as calcification, were difficult to distinguish mammographically between calcifications associated with breast cancer vs. those associated with fat transfer. However, more recent radiology literature suggests that new generations of mammography equipment, especially digital mammography, are better able to pick up the difference between cancer cells and benign ones, according to the societies.

Read the study’s abstract online at plasticsurgery.org.

Plastic Surgeons “Ramp Up” Fat Transfer Breast Augmentation

Marketing efforts for breast augmentation done with fat-grafting are being “ramped up” says the New York Times. Experienced plastic surgeons weigh in to warn potential patients about the unpredictable nature of this procedure. “Suddenly everyone is claiming to have 10 years experience,” says expert Dr. Sydney Coleman. [NY Times]

A British cosmetic clinic is showing off the cosmetic surgery results of their employees in a 2010 calendar. They’re calling the calendar “tongue-in-cheek, but tasteful, featuring “girls from across our company of all ages and they all look amazing.” [The Sun]

Can breast implants or lasik eye surgery be considered a marital asset? According to the Associated Press, attorneys in North Dakota thought the issue was worth debating. The judge’s ruling? “nonsense” [Star Tribune]

Giving cosmetic surgery for Christmas? Don’t surprise your significant other with a plastic surgery gift certificate unless you’ve discussed the idea in the past. Do it right and you’ve got an extraordinary gift! [RealSelf]

Japanese Fat Transfer Techniques for Breast Augmentation Aided by Stem Cells


CNN aired a news segment this week about the Japanese surgeon Kotaro Yoshimura and his innovative, but somewhat controversial breast augmentation method, which uses stem cells to successfully perform fat grafting during breast augmentation procedures. Yoshimura has received public notoriety for the technique and according to the news report, clinical trials are underway in the U.S.

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