Breast reconstruction by fat injection
The injection of purified fat is an ancient technique that was revived about ten years ago and has revolutionized breast reconstruction and facial aesthetics.
Its use in breast augmentation is strongly developing but requires a medical team specialized in this technique. It therefore offers an alternative to breast augmentation by prosthesis.
Fatty tissue is removed during a liposuction. This can be done in a traditional way with a medical aspirator or in a more precise way with a syringe.
The fat collected is then treated to remove blood, infiltration fluid and altered fatty tissue forming oil.
We use 2 methods to treat the fatty tissue:
- centrifugation according to the technique described by Coleman. This technique is adapted to small volume fat transfers, especially for facial aesthetics.
- Cytori's Puregraft® filter. The fat is injected into a bag with a filtration membrane. This technique allows for the treatment of large volumes of fat and we use it in breast or buttock augmentation.
The fatty tissue is then injected into the recipient site using very fine cannulas. This is a real fat graft. It is called adipocyte grafting.
Like all grafts, which are transfers of tissues that do not have their own blood supply, a variable part of the fat will not survive. The body will therefore gradually reabsorb the non-viable fatty tissue. This explains the loss of volume varying from 20 to 30% in the 2 months following the procedure.
However, once the graft is taken, the fat behaves like a living tissue and is not reabsorbed in the long term.
The indications of this technique in breast surgery are numerous:
- Breast augmentation for aesthetic purposes. It allows to obtain an increase of one cup (equivalent to a 200 cc prosthesis) in one or two sessions.
- Correction of excessive visibility of a silicone breast implant
- Correction of breast deformities, particularly in the treatment of breast asymmetry, tuberous breasts and Poland syndrome.
- Correction of the after-effects of conservative treatment (lumpectomy then radiation) of breast cancer: a delay of 5 years after the initial disease must be respected.
- Volume addition after placement of a dorsalis major flap without silicone prosthesis.
This surgery is performed in the operating room, usually under general anesthesia. Small volume fat injections can be considered under local anesthesia plus sedation (neurolepnolgia).
The anesthesiologist will be seen in consultation at the latest 48 hours before the operation.
The operation can be performed on an outpatient basis, i.e. the patient is discharged the same day after a few hours of monitoring. However, in some cases, a short overnight hospital stay may be preferable.
No medication containing Aspirin should be taken during the 10 days preceding the operation. It is strongly recommended to stop smoking at least one month before and one month after the procedure (smoking can cause the fat graft to take less well).
In the case of a large volume fat transfer, a compression girdle must be worn permanently for one month as well as compression stockings during the week following the operation.
Questions / Answers
What are the complications of a purified fat injection?
They are very rare. It is mainly an infection of the injected fat related to excessive necrosis of the tissue. It occurs in less than 2% of cases. Its treatment can be medical or surgical.
Fat reabsorption cysts (cytosteatonecrosis cysts) can be observed and may be palpable if they are located under the skin.
The radiological aspect of the fatty tissue injected into the breasts must be checked 3 months after the operation. A digital mammogram and magnetic resonance imaging are then performed. This check-up will serve as a reference in the subsequent screening of a possible breast cancer.
In addition, fat harvesting has the same complications as liposuction (phlebitis, asymmetry, waves).
It is necessary to remember that the purified fat graft has taken, that is to say at 1 month, the volume and the aesthetic result remains stable over time, unlike the hyaluronic acid injections which disappears in a period varying from 4 to 18 months.
In summary, fat injection is a reliable surgery with very few complications that often needs to be repeated two or three times to obtain the desired result.
How much does a purified fat injection cost?
The procedure is covered by health insurance as part of breast reconstruction and treatment of breast deformities.
We charge fees ranging from 1000 to 2000 € depending on the volume of fat injected.
For an aesthetic breast augmentation, each session is billed at 3500 €. One to two sessions are necessary to obtain a one cup increase.
Have a question? Please contact us!
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France