Seattle Plastic Surgeon is seeing some very nice results from fat transfer to the breast.
Left side : before fat transfer. Right side : 3 months after fat transfer. She has gone from a B to a C cup.
It takes quite a bit to get me enthusiatic about “new stuff” because “new stuff” pops up every day and more often than not, the reality does not begin to live up to the hype. This tends to make one (me, for instance) a bit skeptical.
As discussed on my website and previous blogs, fat transfer to the breast is a new procedure that I am now offering to very carefully selected patients. And now I am starting to get some sort of longish term follow-up and I am starting to get, well, a little bit excited.
This lovely mother of two darling boys had her fat transfer last fall and her size is holding steady. She was a B cup before transfer and a C cup three weeks after transfer and today is a C cup three months after transfer. She is thrilled and so am I.
She not only has no implant to maintain, she has virtually no scars on her chest and she has a subtle improvement in her breast shape. No, she’s not going to stop traffic with this chest but that was never her intent.
And another cool thing about fat transfer – it’s really a twofer. In this patient’s case, I took the fat off of her posterior hips and she is much slimmer in that area and with the increase in her breast volume, is much better balanced between her upper and lower body. SWEET!
Before and after fat transfer from the abdomen and hips to the breasts. Note the increased fullness of the upper pole of the breast and the uplifting effect.
Seattle Plastic Surgeon blogs about her early results of fat transfer to the breast.
Lately I am getting a lot of inquires about fat transfer to the breasts. There must be a “BUZZ” out there. And I am soooo glad that I have started doing this procedure. I was skeptical (it’s my Germanic nature) until I attended the annual meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) last May in Boston.
I attended every presentation on fat transfer to the breast and became convinced that, in the right patient, this was a procedure I wanted to add to my practice.
I am now starting to see some of my early postoperative results and I am even more convinced that this procedure has a place among the many breast operations I do.
This lady on the left has given me permission to use her photos. The after photos were taken 3 months after her surgery. Her breasts are completely soft and natural feeling and looking. I do not think she had any significant residual swelling. I will be following her and all of my fat transfer patients closely for several years to observe the long term size and shape of the breasts.
I am eternally grateful to this lovely young mom who agreed to be one of my first patients. I do not take the trust she showed in me lightly.
Breast enhancement with your own fat? Well, maybe.
Fat transfer to the breast: Seattle Plastic Surgeon adds her two cents worth.
One of the hot topics at the annual meeting of the American Society for Aesthetic Plastic Surgery(ASAPS) in Boston which I attended last week was fat grafting to the breast. This procedure has a very interesting history. Back when the earth was cooling and I was training to become a plastic surgeon (1983-1991), fat injections were considered fringe surgery and fat injections to the breast were for all practical purposes panned by the American Society of Plastic Surgeons (ASPS) and ASAPS. Fat injections to the breast were considered ineffective and dangerous. Well, that was then and this is now.
Fat grafting is now a well established procedure that has been used for facial rejuvenation, hand rejuvenation, the treatment of liposuction divots, buttock enlargement and a few other indications. Much of the early work done with fat grafting was performed by Dr. Richard Ellenbogen in L.A. and Dr. Sydney Coleman in New York and these two doctors were subject to ridicule and disbelief for several years. I remember in 1993, when I took my plastic surgery board exams, the correct answer to any question about fat grafting was that it didn’t work. That is not the correct answer any more.
Fat grafting to the breast started with surgeons, myself included, using fat around the periphery of a reconstructed breast. For example, if there were contour defects at the edges of a breast reconstructed with an implant, some fat would be used to smooth that area out. Then we started using it for patients who had thin areas anound the breast following cosmetic breast augmentation.
Now we are using fat injected into the breast itself for breast enhancement. After taking several instructional classes on this topic in Boston, I am convinced that this is an appropriate and safe procedure for a very select group of patients.
Fat injection, at least currently, will not acheive the same volume of enlargement that implants can. Most fat injected breasts go up only one cup size. That eliminates a lot of ladies wanting to go a lot larger. One of the doctors who spoke in Boston (and who has the most experience with cosmetic fat transfer to the breast) still uses implants in 90% of the patients who present to him for breast enhancement and uses fat in only 10%.
For the best results in patients with very tight breasts and chest tissue, it is necessary for the patient to undergo breast expansion to stretch the breast and skin and to increase the breast vascularity prior to the fat transfer. This is done using a gigantic breast pump called the Brava System.
They should have called it the Brave System because it takes a brave lady to strap one of these babies on and then go out grocery shopping. The plastic surgeons who have the best results in thin, tight patients with fat grafting have their patients wear the Brava 10 hours a day for about 4 weeks. This is no small task. This Brava requirement also eliminates some patients wanting fat grafting. The experts (and who am I to question them?) tell these patients who want fat grafting “no Brava, no breasts”.
For patients who have experienced breast atrophy following breast feeding or weight loss, the tissues are loose and this preoperative stretching is not as important. These patients will likely do okay without the Brava.
My week in Boston at the ASAPS meeting really opened my mind to this new way to enhance the breast and I am looking forward to offering this procedure to selected patients. But remember, if you are “tight” – “no Brava, no breasts”.
Seattle Plastic Surgeon Discusses the Wide Variety of Breast Size and Shape.
I saw a patient recently that brought this cartoon to mind. She was requesting breast surgery and knew just what she wanted to look like; like a playboy centerfold. The problem was that she was over 50, a little overweight, and a lot saggy. I had to tell her in the nicest possible way that there was no way I could make her look 20 something, nulliparous (meaning not having given birth), naturally gorgeous and, to top it off, airbrushed! We plastic surgeons call this “deflation of expectations”. I have a jillion before and after photos of patients I have operated on and I arrange them by age and by body mass index. When I see a patient for surgery, I show them examples of patients who resemble them, not some idealized nymph. If I don’t do this little reality check, I can be assured that the patient will be unhappy with their outcome and unhappy with me and behind every unhappy plastic surgery patient is an unhappy plastic surgeon.
@lisalynnsowder
