Fat transfer is increasingly used in cosmetic breast surgery and is a valuable additional tool to have.
Put simply, it involves taking some fat from the thigh or tummy by liposuction, processing this fat and then injecting it into the breast. This is performed under general anaesthetic usually as a one night stay, sometimes a day case. The main indications for fat transfer in cosmetic breast surgery currently are:
- Adding volume to a breast
- Correcting deformities or asymmetry of the breast
- Improving the quality of the tissues overlying implants and reducing implant visibilty and rippling
- Revising cosmetic breast surgery and correcting previous surgery
The main limitation of fat transfer is absorption of the injected fat and the fact that there is a limit to the amount of fat that can be injected at one go. Absorption of some injected fat will always happen to some degree and it is reckoned that about 20 - 50% of the injected fat will be absorbed over the first 3 months after the operation. Hence, if a large volume of fat is required this will be transferred over 2 or 3 operations and if a small volume is required, the deficit may be slightly over-corrected initially.
For women who wish breast augmentation by fat grafting, approximately 1/2 to 1 cup size enlargement can be achieved safely. For a larger increase in cup size, multiple fat grafts are required (or an implant).
A combination of breast implant and fat grafting is called "Composite Breast Augmentation" and is a good option for some women, although it is more expensive than simple breast augmentation with just an implant.
Fat banking involves storing fat that has been harvested with liposuction so that it can be used at a later date. This is a particularly good option in women who require multiple fat grafting procedures. It means that after the first operation, any subsequent fat grafts do not require liposuction and hence the recovery is very quick. Injecting the fat is a daycase procedure, which can sometimes be performed under local anaesthetic.
This is usually quick, with the main adverse effect being some bruising and tenderness in the areas where liposuction was performed. Overall, fat transfer is very well tolerated and you are back to full normal activities within a few days.
Apart from some bruising to areas where liposuction was performed and absorption as mentioned above, other rare but possible complications are: anaesthetic problems, infection, small fat cysts and some lumpiness either in the breast or at the site of liposuction. If fat is injected into breast tissue it can occasionally cause little specs of calcium to appear on mammograms. This does not interfere with screening.