MUDr. Pavel Holuša
MUDr. Ivo Menšík
MUDr. Hana Zimovčáková
MUDr. Zdeněk Herzan

 

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Breast Augmentation with Own Fat – Lipo-Grafting

For the last couple of years the option of breast augmentation or another shape or volume alteration with the patient's own fat has become more and more prominent. The operation includes liposuction from places with sufficient or excessive fatty tissue and subsequent application of transformed fat into the breasts.

Advantages

The intervention brings double effect for the patient. Not only that her breasts are moderately augmented, filled, lightly uplifted or shaped but the liposuction at the same time changes the shape of the place from which the fat is taken. Transplanted fat does not represent any risk connected with rupture of the implant, capsule formation and the necessity of replacement and there is no foreign material tangible in the breast.

The fatty tissue is clearly more convenient than application of the implant in the following cases: for minor corrections of the breast shape, for repair of small differences in the breast shape or size – breast asymmetries, for various adaptations of contours or shape after augmentation with implants, for reconstructions after surgeries for health reasons, etc. In the abovementioned cases this method is today used most often.

Disadvantages

The surgery is relatively long (liposuction, fat preparation, fat application in the breasts). This method is virtually impossible to use in very slim women. The method is not recommended for breast augmentation by more than one bra size.

For illustration, augmentation of a breast by one bra size means application of about 200 ml of fat, i.e. 400 ml of fat to two breasts. To obtain 400 ml of adapted fat you need to take nearly double this volume and in addition some part of the fat may get absorbed in one year and so one more similar operation may be needed then. The procedure is therefore rarely singular for the reason of very individual absorption of the transferred fat. Potential further applications obviously increase the price of the whole operation.

Breast augmentation with own fat is a new modern alternative to application of silicone implants. It is not always the intervention of choice, though. Success depends on many factors and the scope of augmentation is limited. Despite that it is a much welcomed option for many women for absence of foreign material in the body.

Appropriateness of the intervention is always to be considered by the physician in detailed personal consultation with the client.

Lipo-Grafting: your surgery

The surgery is performed on the day of admission to the clinic, takes about 1 -2 hours and is performed in overall anaesthesia. Before the surgery you must undergo the usual preoperative examinations. For preventive reasons you will receive a couple of doses of antibiotics and an injection for prevention of thrombo embolism. Hospitalisation usually takes 1 day.

Injection of Own Fat Enriched with Stem Cells

The method is similar to the previous one. Only the obtained fat is specially processed to further increase concentration of stem – germinal – cells contained in the fat. Increased concentration of stem cells in the transferred fatty tissue is expected to assure more seamless healing and smaller volume of the fat absorption and therefore longer effect of the intervention. This method is not absolutely safe yet. Studies are in progress to find out whether the concentrated transferred stem cells may or may not cause tumour formation. Increased success of survival of the transferred fatty tissue has not been clearly proved either yet. The method is very expensive. It is often incorrectly called "auto-augmentation", which generally means "augmentation with own tissue". Breast filling with own fat therefore is auto-augmentation. Some clinics offer breast augmentation with stem cells, which only involves lipo-grafting, though. They make use of the fact that the fatty tissue as such naturally contains a certain proportion of stem cells.

Immediately after the intervention the places of liposuction are compressed with elastic liposuction sleeves. Elastic post-operative compression underwear including post-operative bra needs to be worn almost 24 hours a day with the exception of the times of personal hygiene for several days to weeks depending on the volume of the fat taken away. A shower is allowed for the first time about one day after the surgery but hot water is not permitted, just a short lukewarm shower. Heat increases the risk of swells. Ease mode is recommended before the first post-operative visit to the clinic 1-2 two weeks after the intervention. Sporting activities should only be resumed after a couple of weeks. Final result of the operation may only be assessed in 3-4 months post-operatively.

Like all operations this one also entails risks which need to be considered. They include general risks of operation under total anaesthesia (bleeding - haematoma, infection, pulmonary embolism, poor healing, operation wound splitting, development of colloid scars, etc.) plus intervention-specific risks.

The method of breast augmentation with own fat is very safe, as the breasts are filled with the patient´s own tissue without use of any foreign material or implant.

Despite that like every surgical procedure this one also involves the risk of infection, bleeding, nerve cutting, muscle or vessel rupture. These complications are very rare, though. The theoretical risk of application of a fat grain through the cannula directly to a blood vessel with the risk of fat embolism has not been reported in practice. The risk of complications in the points of fat taking is identical with the risk of liposuction of a minor scope.

The method cannot be used for extremely slim patients where there is no fat for liposuction and subsequent application to the breasts. It is also not recommended to patients wishing breast augmentation by more than one bra size.

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