Breast reconstruction by lipofilling (fat injection)
Injection of purified fat is an ancient technique that was revived around ten years ago and has revolutionized breast reconstruction and facial aesthetics.
Its use in breast augmentation is growing rapidly, but requires a medical team specialized in this technique. It therefore offers an alternative to breast augmentation by prosthesis, enabling natural breast reconstruction.
Breast reconstruction by lipofilling: principle and techniques of fat injection
Breast reconstruction by fat injection(breast lipofilling) begins with the removal of fatty tissue during liposuction. This can be done in the traditional way with a medical aspirator, or more precisely with a syringe.
The fat collected is then treated to remove blood, infiltration fluid and altered oil-forming fatty tissue.
We use 2 methods to treat 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.
Breast reconstruction by fat injection: How is the procedure performed?
Breast reconstruction by lipofilling or fat injection is performed in the operating room, usually under general anaesthetic. Small-volume fat injections may be performed under local anaesthetic plus sedation (neurolepnalgesia).
The anaesthetist will be consulted at least 48 hours before the operation.
The procedure 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 for 10 days prior to the operation. Smoking cessation is strongly recommended at least one month before and one month after the procedure (smoking may cause the fat graft to take less well).
In the case of large-volume fat transfer, a compression girdle must be worn permanently for 1 month, and compression stockings must be worn during the week following the procedure.
Questions and answers about breast reconstruction by fat injection (breast lipofilling)
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.
Price of breast reconstruction by lipofilling: Rates and reimbursement of fat injections
The cost of breast reconstruction by lipofilling is reimbursed by the French health insurance system as part of breast reconstruction for the treatment of breast deformities.
We charge fees ranging from €1,000 to €2,000, depending on the volume of fat injected.
For aesthetic breast augmentation, each session costs €3,500. One or two sessions are required to obtain a one-cup increase.
Have a question? Please contact us!
Cosmetic surgery in Paris
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France