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Fat Grafting for Breast Augmentation What Women should know:

(press release from ASAPS)

The idea of taking your own fat and repositioning it to augment your breasts has captured the attention of both consumers and the media. Although there has been some research on the safety and efficacy of this procedure, more research is needed before concluding that the procedure's benefits outweigh the risks.

The American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) urge consumers to proceed cautiously since temporary benefits may be offset by long-term problems with self examination and mammography ultrasound and MRI evaluation of the breast in screening to rule out breast cancer. Specifically, ASAPS and ASPS believe you should consider the following before consultation with a board-certified plastic surgeon about fat grafts for breast enhancement:

What is fat grafting?
Fat grafting, also known as fat transfer or lipoinjection, is a process in which fat cells are harvested from one part of the body and injected into another. It is a procedure with few surgical complications and is most commonly used to provide the face and hands with a more youthful appearance which may be permanent.

How long has fat grafting been used for breast augmentation?
Augmenting the breast with the body's own fat first became popular in the 1980s; however, both ASPS and ASAPS initially cautioned its members against the technique because of side effects such as oil cysts, calcification, and tissue scarring. The calcification in particular made it difficult to distinguish mammographically between calcifications associated with breast cancer and calcifications associated with fat transfer.

What has changed since then?
More recently, radiology literature suggests that new generations of mammography equipment are more sophisticated than their predecessors and better able to distinguish cancer cells from benign ones. This is particularly true of digital mammography, especially when examining dense breast tissue.

The methods for harvest and injection have also been refined. Today, fat cells are carefully removed by liposuction using syringes and transferred to the breast via dozens of small injections. This technique may result in increased survival of the fat cells, although there remains a debate over how much of the transferred fat remains long term.

Is fat grafting a better or safer alternative to saline or silicone implants?
Little clinical evidence, pro or con, exists to suggest that fat grafting is safer or better than saline or silicone implants.

What are the risks?
Fat cells removed from one body site and injected into another frequently do not survive. Fat injected into the breast may be absorbed by the body, may become liquid and form a cyst, calcify, or produce scarring within the tissues. Seven to 14 ounces of fat injected into the breast, the amount required for an average enlargement, can still result in calcifications, oil cysts and scarring that can mimic or obscure breast cancer.

What are some of the other issues involved with fat grafting for augmentation?
The process requires multiple sessions and typically increases breast size at the most by only one cup. The recovery time may be longer than with traditional implants, as both the breast and donor site must heal. You will need to have an adequate supply of excess fat for the procedure. And it can take up to six months or more for your result to take shape after the procedure as opposed to implants where your final result appears in six to eight weeks.

Is there an acceptable application for this procedure currently in use?
Yes. Fat grafting can be very effective in enhancing the appearance after breast reconstruction. The procedure can also soften the appearance of existing implants, particularly in very thin women and hide visible rippling. It is also an accepted application for facial and hand rejunivation.

What do the Societies recommend?
The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons, in the interest of patient safety, do not recommend fat grafting for breast enhancement at this time. Because there is little clinical evidence available to document safety and efficacy, we urge patients to consider the procedure as one undergoing continued evaluation.

The 2300-member American Society for Aesthetic Plastic Surgery (ASAPS) is the only plastic surgery organization devoted entirely to the advancement of cosmetic surgery. ASAPS is recognized throughout the world as the authoritative source for cosmetic surgery education. U.S. members are certified by the American Board of Plastic Surgery. Canadian members are certified in plastic surgery by the Royal College of Physicians and Surgeons of Canada.
Toll-free referral line: 888.ASAPS.11 (272.7711). Web site: www.surgery.org


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