Fat grafting to the breast

Recently, there has been a resurgence of interest in the idea of using a person’s own fatty tissue to enhance the breast. It seems like the ideal combination: “take a little off there, and put a little bit more up here”.

The truth is: it’s still a work-in-progress. Until recently, fat grafting to the breast had been considered a bad idea. Lumpy breasts, with oil-filled cysts, could occur. And worse, the scar tissue which sometimes formed after fat injections could exactly mimic the appearance of a breast cancer on a mammogram, leading to needless anxiety and additional biopsies.

Lately though, there has been a re-appraisal of this idea, both here in the USA and abroad. A breakthrough study from Japan found that the key factor to making the fat injections work in the breast seems to be the addition of stem cells.

By “turbo-charging” the injected fat with the person’s own adult stem cells (also found in fatty tissue), the combination of fat cells and stem cells worked much better, successfully surviving the move from the donor site to the new location in the breast without the problems listed earlier.

Some pretty clever machinery is used to harvest, centrifuge, and purify the stem cells from liposuctioned fat. Some far-sighted biotech companies have already submitted automated versions of this machinery for FDA approval.

The Japanese group made fairly modest changes in the patient’s breast size – averaging about 200 cc, which is small compared to the typical breast implants that we use here (commonly 300 – 500 cc), but their results show that the technique is promising. The fat-grafting surgery also takes much longer than a typical breast augmentation: about 6 hours of anesthesia time, compared to about 1 hour when implants are used.

Nevertheless, it’s an exciting surgical innovation that someday (I hope) will be in common use. Currently, the technique is not FDA-approved, and is still in the “experimental” stage.

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