What are the current issues and benefits concerned with lipotransfer in breast reconstruction?

Breast Fat Transfer: Fat transfer has been used for years to address minor contour deformities in breast reconstruction. More recently, some are increasing the volume of fat used to address larger areas or even provide primary volume replacement. These techniques are constantly being studied and refined and long term studies on outcomes are still underway.

Fat grafting breast: Reconstruction requires healed, well-vascularized recipient tissue to allow the transferred fat globules to survive. Large volumes may not be possible, which is why muscle/fat flaps (with blood supply), microvascular free flaps (blood vessels attached by microscope), and expanders/implants remain the usual and best choices. Also, not all the grafted fat survives, leaving scars and lumps in places.

Emerging option: This is becoming an increasingly popular technique with a variety of different possible approaches used by different practitioners. For a full reconstruction, it is not uncommon for multiple sessions to be used in order to achieve satisfactory volume. The picture to the right shows one of my patients who experienced pain with her implant reconstruction and underwent one stage fat transfer. Go to http://www.Fattransferbreastaug.Com.

Emerging option: And an increasingly popular technique with a variety of different possible approaches used by different practitioners with risks like any other surgery related to the donor sites and variability in fat graft survival and concerns with alteration in residual breast tissues and potential interference with imaging. For a full reconstruction, it is not uncommon for multiple sessions to be used in order to achieve satisfactory volume. The picture to the right shows one of my patients who experienced pain with her implant reconstruction and underwent one stage fat transfer. Go to http://www.Fattransferbreastaug.Com.

Emerging option: And an increasingly popular technique with a variety of different possible approaches used by different practitioners with risks like any other surgery related to the donor sites and variability in fat graft survival and concerns with alteration in residual breast tissues and potential interference with imaging. For a full reconstruction, it is not uncommon for multiple sessions to be used in orde.

Fat grafting: Immediate breast reconstruction can be performed with fat grafting alone. The transfer amount is usually between 150 to 200 cc of fat transferred to the pectoral is major muscle at the time of mastectomy. Between 2 to 3 months after this the final evaluation of fat graft take can be evaluated. At that point. External expansion with the brava can performed or fat grafting alone. No bridges burned!

Some: I feel lipotransfer can be useful for contouring and fine tuning of the final reconstruction. For example, areas of residual depression after flap or implant placement can be improved with lipotransfer however, i feel lipotransfer is not suitable for complete breast reconstruction alone.

Fat graft for breast: The benefits of fat transfer is that it provides the body with its own cells, without requiring a discrete blood supply, unlike a flap. There is also evidence that percentage of the cells are stem cells, which may improve long term durability. Fat grafting is used liberally to fine tune results, such as step offs and areas of depression. Complete reconstruction with fat is controversial.

Own : Your own cells vs synthetic. Long term vs short. Fat transfer typically: less recovery, less pain, fresh blood supply, continued growth factor secretion by stem cells, breast cancer screening: fat necrosis different appearance to breast ca. Repeatable. Volume at a single stage usually far less. Preparation for fat tf (brava system). Less morbidity usually (loss of function, less recovery).

Controversy....: The main questions relate to: (1) the ultimate fate of the transferred fat (does it heal or die?) (2) might that fat that doesn't heal mask the detection of breast cancer later (3) cost.