The pieces of the puzzle regarding fat grafting for breast reconstruction and breast enhancement keep coming in, a little at a time. Here is a press release from ASPS, which summarizes a recent French study on mammography after the micro-droplet method of fat transfer to the breast, which was published in the recent issue of PRS. In short, fat grafting in this study did not get in the way of interpreting a post-operative mammogram.
ARLINGTON HEIGHTS, Ill. – Lipomodeling – a relatively new approach to breast augmentation in which fat is transferred to the breasts from other parts of the body – doesn’t interfere with routine screening mammograms, reports a study in the March issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
“Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure,” concludes the new study, led by Michaël Veber, MD, of University of Lyon-Léon Bérard Cancer Center, France.
Originally developed for breast reconstruction surgery, lipomodeling is now being used by some plastic surgeons for cosmetic breast shaping. In this procedure, small amounts of fat are taken from one part of the woman’s body (such as the hips or thighs) and transferred (grafted) to the breasts. The new study was designed to determine whether lipomodeling caused any problems with routine mammograms to screen for breast cancer.
First, the researchers reviewed mammograms performed an average of 16 months after lipomodeling in 31 women. In more than half of cases, the mammograms showed no abnormalities.
Some women had small calcifications or cysts as aftereffects of the fat transfer procedure. A few women had other abnormalities related to scarring from their breast surgery. However, none of these changes were considered likely to raise suspicions of breast cancer on routine mammograms.
Dr. Veber and colleagues then analyzed mammograms performed before and after lipomodeling in 20 women. Based on standard criteria, there were no significant differences in the mammographic results from before to after the procedure. In particular, there was no increase in abnormal results that would spur suspicion of breast cancer.
There were no major changes in breast density after lipomodeling. Perhaps most importantly, it was no more difficult to perform and interpret follow-up mammograms in breasts that had undergone the procedure.
Although the study is only preliminary, it provides important information for health care professionals performing mammograms in women who have undergone this new approach to breast augmentation. Dr. Veber and coauthors suggest that women undergoing lipomodeling have a complete evaluation-including mammograms-before and after the procedure. This will provide reassurance that any new abnormalities are a result of the lipomodeling procedure, rather than a possible sign of breast cancer.
My thoughts: fat transfer to the breast is an exciting new option for women for both reconstruction and augmentation. But it’s a lot different than using implants. I’m part of an IRB-approved study for this technique. One of the key factors for success of this process seems to be the preparation of the breast, otherwise the fat just disappears. So far, the BRAVA system, cumbersome though it is, seems to really help in this way. Also, the surgeon has to be very particular about the harvesting and injecting methods. The various methods are certainly not all the same, in terms of how well they work. This particular study used the Coleman system.
I’ll be attending a workshop on this topic in Boston in early May. I’ll report back with all the latest details!!