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Breast lipofilling is a plastic surgery aimed at changing the size and shape of the breast, using your own fat tissue. Nowadays, breast augmentation with own fat has good prospects to replace silicone implants and become the leading method in breast volume correction.
Autologous fat injections are widely used in reconstructive surgeries and to improve breast aesthetics. Transplantation is often recommended for patients who have undergone removal of a cancerous breast tumor. In addition, breast augmentation with own fat is used in case of congenital breast asymmetry.
WHAT IS LIPOFILLING?
Lipofilling is an opportunity to look attractive without resorting to complex, traumatic procedures. The essence of the method is the transplantation of fat from one place to another, which is effective not only for improving the shape of the breast, but also for other cases. Autologous transplantation is recommended in case of muscle tissue atrophy, to correct post-traumatic defects and to change the contours of the body.
Compared to other plastic techniques, breast augmentation with own fat is considered the least traumatic operation. The advantage of this method over implants and biogel is the fact that fat is the body’s own material, and its use reduces the likelihood of immune reactions with subsequent rejection of the graft.
The very concept of using adipose tissue for breast augmentation is not new, but was proposed back in the 90s. At that time, the American Association of Plastic Surgeons was distrustful of the idea and believed that the transplanted fat would not be viable. However, modern technology has made it possible to increase the percentage of engraftment of own fat tissue and protect women from possible complications.
SPECIFICS OF PROCEDURE
Lipofilling should not be performed on women who have naturally large and beautiful breasts. In such cases, the operation is not only not indicated, but can also cause the formation of lipomas and calcinates, as well as lead to deformation and violation of the symmetry of the breast.
For breast reconstruction, autologous fat is used as an adjunct to standard reconstructive procedures, although recently the use of adipose tissue as monotherapy has been considered.
In addition, fat injection has been successfully used for a variety of indications:
- Volume increase.
- Correction of the shape and deformation of the contour of the breast.
- Treatment of irradiated breast tissue.
There are a number of studies proving the benefit of the procedure, which is in reducing the pain of mastectomy and in treating capsular contracture.
Fat is a very attractive material for transplantation and this is due to factors such as:
- Fully biocompatible.
- Available in abundance.
- Can be easily assembled and processed.
- Administered in regulated quantities.
PREOPERATIVE PERIOD
Two months before the operation it is necessary to completely exclude tobacco smoking and alcohol intake. Harmful habits will have a negative impact on the process of regeneration of damaged tissues, and may also reduce the engraftment of transplanted fat. Patients systemically taking acetylsalicylic acid should consult with their doctor about replacing the drug, otherwise it leads to blood clotting disorders.
Before lipofilling, the patient should perform instrumental diagnostics, and take a number of tests to fully assess the health of the woman. Standard methods of research include:
- Clinical analysis of blood and urine.
- Blood biochemistry.
- Blood tests for HIV, hepatitis and syphilis.
- Electrocardiogram.
- Fluorography.
- Mammography.
- Ultrasound examination of the mammary glands.
- Examination by a general practitioner.
SURGICAL TECHNIQUE
There are many points for fat collection, but typically the abdominal, thigh, lumbar, gluteal, or knee region. It is not known if there is an optimal point for collection, however, there is evidence to suggest that certain areas are favored over others.
In laboratory studies, it has been proven that adipose tissue in the lower abdominal region and inner thigh, contains a higher percentage of adipose stem cells. Comparisons were made with the upper abdomen, buttocks and lower back. Adipose stem cells are thought to play a significant role in graft viability, by forming a vascular network that provides normal nutrition.
Given these data, it can be stated that the lower abdomen and inner thigh are the most preferred sites for fat collection. Nevertheless, individual fat distribution and personal preferences of the patient should be taken into account.
An injection with a tumenescent solution consisting of a local anesthetic (lidocaine, ropivacaine or prilocaine) and adrenaline is required prior to collection. The solution provides good anesthesia and reliable hemostasis.
Syringe liposuction is considered the best method for harvesting material. Less viable adipocytes are damaged when harvesting adipose tissue through a syringe than with other techniques.
A syringe and a hollow cannula with a blunt tip connected to it are required to perform the sampling. The puncture site is treated with iodine solution and then the cannula is inserted subcutaneously. By pulling back the piston, the surgeon creates negative pressure in the syringe, which allows for localized and less traumatic fat sampling.
Another advantage of lipofilling over other techniques is the ability to «remove» fat from problem areas. Thus, while increasing the volume of the breasts, the patient can also reduce the size of the waist or hips.
Syringe liposuction does not require the special tubing traditionally connected to a vacuum pump. This feature allows the doctor to harvest the fat with greater precision, and without the discomfort of interfering aspiration tubes. At the end of the collection, the surgeon knows the exact volume of graft material as well as the approximate percentage of pure fat, which is not possible with vacuum aspiration.
POSTOPERATIVE PERIOD
Due to the minimally invasive nature of the procedure, the hospital stay is limited to one day. The surgeon will counsel the patient on proper breast care for the next few days.
Breast augmentation with own fat does not require the wearing of special underwear in the postoperative period, but it is still necessary to avoid hard bras with ossicles. If the collection of the graft material was performed in the thigh area, it is recommended to wear compression underwear for several weeks.
REHABILITATION PERIOD
After lipofilling can develop swelling, soreness, as well as the appearance of hematomas in the area of the surgical field. The degree of manifestation of these phenomena may vary, depending on the individual characteristics of the body and the amount of manipulation.
The length of the recovery period depends on the complexity of the surgery. Breast augmentation with own fat belongs to minimally invasive procedures, which means that the rehabilitation period itself does not take much time. On average, healing occurs in two weeks. During this time, hematomas completely pass, swelling and soreness subsides, and the transplant material sprouts a capillary network. If we talk about the final result, the effect can be assessed at the end of two months after the procedure.
In rare cases, the result is not what the patient expected. This is due to resorption processes and delamination of adipose tissue. All this leads to a decrease in the planned volume by half a size or more. In such situations, it may be necessary to repeat lipofilling of the breasts.
Prices for breast lipofilling in Germany start from 6,000 euros. This will include the services of an anesthesiologist and hospital fees.
Please note that this operation is performed not only to achieve a cosmetic effect, but also as a reconstructive after removal of the breast to eliminate its consequences. In this case, the operation gives a good result for the woman, restoring her attractiveness and emotional comfort, lost due to the disease.