Cosmetic breast surgery
Natural breast augmentation by fat injection
Excess fat from the patient can be used to increase breast size
The Brava system is a medical device comparable to 2 suction cups that are applied to the breasts 11 hours a day for several weeks to obtain enlarged breasts. This system increases the ability to receive breast fat, so larger amounts of fat can be grafted. The rate of engraftment is also improved (up to 90%). In some cases, your surgeon will suggest the BRAVA system.
This technique involves removing fat by liposuction from areas where there is an excess of fat and then re-injecting it into the breasts.
The re-injected or grafted fat must first be purified by centrifugation, filtration or decantation. All steps take place during the same procedure (collection, purification, re-injection).
Part of there-injected fat will disappear during the first months following the procedure so that the percentage of remaining fat varies between 50 and 70%. This means that we must inject more fat than necessary in theory to achieve the desired volume (for example, for an augmentation of 100 ml about 150 ml needs to be injected).
To obtain asignificant gain in volume, we must have a "reserve" of sufficient fat and sometimes need to perform several sessions of lipomodelage several months apart. The result is permanent afterthe partial reduction phase is completed. However, breast size will fluctuate with any significant weight change.
The advantage of this technique is the natural and definitive characteristic of the fat injections. Scarring is minimal. In addition, the patient benefits from two procedures at the same time, aesthetic improvement of the breasts and the silhouette. And lastly, the fat improves skin quality.
For the breasts, the ideal outcomes from this method are :
- improving the neckline ;
- moderate increases in size ;
- correction of defects or imperfections after breast implants (folds or waves of the implant, cicatrises invaginées...) ;
- correction of asymmetries and malformations (Poland syndrome, tuberous breasts).
This natural breast enhancement cannot however replace all breast augmentation surgery and implants still have their place in the therapeutic arsenal. Scars induced by lipomodelage are almost non-existent and are limited to several incisions 1 to 3 mm in the breast and areas where the fat was removed. The procedure is performed under general anesthesia and takes between 1 and 3 hours depending on the amount of fat being handled. The hospital stay is 24 hours. The risk of complications and postoperative pain are similar to those caused by conventional liposuction.
Frequently Asked Questions
Can fat injections in the breast increase the risk of developing breast cancer ?
There is, to date, no evidence to suggest that the transfer of fat may promote the development of breast cancer.
However, it does not prevent the occurrence, if it should appear. Each patient has their own risk of breast cancer that depends on their age (there is a 1 in 218 chance after the age of 40, and a 1 in 40 chance between the ages of 50 to 59 years old), family medical history, and breast density.
The patient must also understand that every precaution should be taken to limit the risk of coincidence between the occurrence of cancer and lipomodelage (rigorous assessment done before the lipomodelage procedure by a radiologist specialising in breast imaging; rigorous assessment after 1 year). Taking this into account, the patient requesting breast lipomodelage consents to have the preoperative assessment of breast imaging (mammography and/or ultrasound depending on the age of the patient) and agrees to have the required examinations (clinical examination, mammography and/or ultrasound) at 1 year after the surgery.
Can fat injections in the breast reduce the quality of mammograms ?
No, on the contrary.
As with any breast surgery, aesthetic or other (excision of benign or malignant tumor, breast reduction surgery, augmentation mammoplasty ...) calcification may occur (related to tissue healing). These calcifications (macro and micro calcifications) however, are different from those observed in the breast, and do not pose diagnostic problems for experienced radiologists.
In addition, the modern techniques of fat transfer allow a more harmonious distribution of fat, hence reducing the risk of oily cyst formation or of poor fat graft setting (cytostéatonécrose). Currently, we can consider that breast lipomodelage, according to the guidelines of an experienced plastic surgeon in this area, does not cause any particular diagnostic challenge for an experienced breast imaging radiologist.
Can you still breastfeed after fat injections ?
Yes. Pregnancy and breast-feeding are possible but can alter the result of the fat injections. A period of 6 months is recommended before or after surgery.
What will happen in the case of extreme weight change ?
The fat that was injectedin the breast will follow the weight changes. In the case of significant weight gain the breasts get bigger, conversely, in case of weight loss, the breast volume decreases.
The French Health Autority (HAS) issued recommendations for fat injections to the breast : read.
Author: Dr. Christophe Laveaux
Specialist in aesthetic surgery - Antibes
Reproductions, even partial, of the texts are allowed on the express condition cite the author (Dr. Christophe Laveaux) with a direct link to the article mentioned.