Plastic Surgery Talk
Fat grafting breast augmentation is a procedure using fat from areas where fat is not desired, such as the abdomen, hips, outer thighs; less commonly, inner thighs, inner knee and arms and transferring the fat cells to the breast for a natural, autogenously (from yourself) breast augmentation effect.
Fat Grafting Breast Augmentation Before and After Gallery
What is Fat Grafting to the Breast and Natural Breast Augmentation?
Fat grafting breast augmentation can be performed alone, to increase the upper pole and lower pole of the breast by 1/2 cup size to 3/4 of a cup size. Fat grafting breast augmentation is also commonly performed at the time of breast augment surgery with implants to enhance upper-pole fullness with natural fat grafts while the breast augmentation itself helps fill out and project the lower pole of the breast.
Fat grafting alone for breast augmentation is commonly performed to the breasts for individuals who want a modest increase in projection and size without breast implants and is also performed for those individuals that already have breast augmentation and want to camouflage certain areas of their otherwise nice breast augment procedures, such as the take-off of the breast implant from the chest wall or any visible ripples that may be present on the inside or outside aspects of the breast.
How is natural fat grafting breast augmentation performed?
During the consultation with Dr. Mulholland, the advantages and disadvantages of fat grafting breast augmentation will be discussed. The donor site for the fat is selected and then prepped and draped in a sterile fashion and local anesthesia is instilled into the region. Common donor sites include the hips, abdomen and outer thighs. Once the local anesthesia is instilled, a device called the Vaser is inserted to gently separate the fat cells with ultrasound energy. See Figure 1.
Figure 1. The tip of the VASER probe emitting gentle ultrasound waves that gently separates fat cells for easy removal BUT, does not destroy adipocyte fat cells, so they can be transplanted successfully to the Breasts after Vaser Liposuction, also called Ultrasonic Assisted Liposuction.
Vaser Liposuction is then performed on the donor site. The Vaser ultrasound energy is gentle and will keep the fat cells and stem cells alive for successful fat grafting breast augmentation. Once the fat cells have been loosened and separated by the Vaser, a suction device is used to remove the fat cells into a canister, where the fat cells can be collected and prepared for your fat grafting breast augmentation procedure.
Following harvest with the VaserLipo, the fat graft material is prepared. Preparation generally includes centrifugation and separation of the fat cells and stem cells from unwanted blood products, serum and local anesthesia. Once the prepared fat cells and stem cells have been prepared, they are transferred in an a-traumatic fashion to small injection syringes.
The breasts are then prepped and draped in a sterile fashion and a small, blunt-nose injection needle is used to expertly place the fat grafts in the aesthetic areas required for optimal contour shape and projection and form. The injection technique with fat graft into the breast is extremely important and involves multiple small toothpick-shaped fat grafts layered throughout the deep tissues such as the pectoralis major and subcutaneous tissue in the breast gland. It is important that each fat graft be no more than one millimeter away from a blood supply; hence, very small toothpick-like structural fat graft is performed throughout the breast tissue and underlying muscle.
Figure 2. A small blunt tipped micro-cannula, millimeters in size, is used to insert the fat grafts during the fat grafting breast augmentation procedure. The gentle, blunt-tipped micro-cannula is gently advanced forward through the breast tissue pushing the breast tissue away and leaving a potential tunnel of tissue around the micro-cannula. The micro-cannula is then withdrawn slowly and small “toothpicks” of fat grafts are slowly expelled from the syringe during the retrograde movement (pulling back movement). As soon as the fat grafts are deposited, the host tissue envelopes around them, stabilizing them and bringing in nutrients and a blood supply.
Can the Fat grafts move around once the Natural Fat Grafting Breast Augmentation has been performed?
The Fat grafts transplanted through injection into the breast tissue through natural fat grafting breast augmentation cannot move, or become displaced. By placing the grafts with a cone of host tissue on retrograde with drawl of the micro-cannula, the surrounding breast tissue collapses around the fat grafts, enveloping them and stabilizing their position, so that any physician forces, such as lying on the stomach, high impact aerobic activity or intimacy, will not harm, disrupt or shift any of the fat cells in the least.
Figure 3. The fat cells are shown in yellow and are deposited gently in the breast tissue, using the blunt micro cannula and a retrograde (pulling back) technique the graft tissue is expelled in tiny micro droplets, creating structural columns through the breast tissue to be augmented. The host tissue collapses around the grafts providing 360 degree stabilization and fixation, so that the fat grafts cannot be, be disrupted or displaced. This delicate and methodical technique ensure a high percentage of fat graft transplant survival for patients.
Figure 4. A picture showing the small “toothpick” sized columns of fat grafts (depicted in yellow) that are placed in the breast tissue in a retrograde fashion to optimize the stability as well as viability as each fat cell is within 1 mm of a blood supply
Who is a candidate for Natural Fat Grafting Breast Augmentation?
Good candidates for fat grafting breast augmentation are patients that want an increase in volume and proportion of segmental areas of the breast like the upper pole or inner aspect of the breast. Some patients want to camouflage underlying breast implant irregularities. Well-selected candidates understand they will not get the same projection, shape and form that could be achieved through breast augmentation surgery using a cohesive gel implant or saline implant, but are happy with a more modest-to-noticeable and pleasing increase in breast shape, projection and form using their own fat tissue grafted to their breast creating a fat grafting breast augmentation.
Good candidates are also those individuals who already have breast implants and have underlying visible irregularities or palpable irregularities such as rippling or sharp takeoff of the breast implant from the chest wall. Importantly, patients must have an adequate amount of fat in the donor sites, to enable the harvest of enough fat.
Candidates who have undergone a previous lumpectomy with a depression or one-sided irregularity or have one breast that is smaller than the other as a result of hereditary factors may also be good candidates.
Figure 5. Dr. Mulholland is performing the fat grafting breast augmentation procedure. The yellow cells inside the syringes are purified fat cells and stem cells that were removed from the patients tummy and hips. The Fat grafts were then prepared by centrifugation and separation of the unwanted segments and the purified Fat Graft and stem cells are place in the syringes. Dr. Mulholland then uses a small blunt cannula to gently place the fat grafts and stem cells in the breast tissue where they will pick up a blood supply and then live, act and feel like normal breast tissue.
How much of the Fat Grafts will survive following the procedure?
Optimal survival fo the fat grafts depends upon several variables. First gentle harvest and handling of the VaserLiposuction fat graft tissue is critical. The preparation of the fat grafts must include gentle handling, centrifugation and separation. Finally, the actual fat grafts themselves need to be inserted gently and expertly into the breast tissue, such that each fat and stem cell is within 1 mm of a blood supply.
The first 3-4 days the fat cells survive on passive diffusion of nutrients. The process of each fat cell getting a blood supply is called neovascularization and the process takes 72-96 hours and is dependent upon the experience of the surgeon and his placement technique. By selecting Dr. Mulholland you are ensuring the skill and experience to optimize your natural fat grafting breast augmentation results.
Figure 6.A. Fat grafts have been placed in the breast tissue, in delicate rows or toothpicks. The fat grafts are stabilized in the host tissue so they don’t move and B. Have enough space between them to allow the growth of new blood vessels to proliferate around them over the first few days ensuring a blood supply and survival of the fat grafts and a long term result.
What Kind of Anesthetic is Used for Natural Fat Grafting Breast Augmentation?
Most fat grafting breast augmentation can be performed under simple local anesthesia and oral sedation. Local anesthetic is used in the donor site where the fat grafts are harvested and also into the breast site where fat grafting is performed. The most common donor sites used to harvest fat grafts for natural breast augmentation include the hips, tummy and outer thighs.
For some patients, who are more anxious, or don’t want to be aware of the procedure being performed, general or IV anesthesia can be used for fat grafting breast augmentation.
Is Natural Fat Grafting Breast Augmentation Painful?
Once the local anesthetic is injected, the procedure is not as painful. After the procedure, the discomfort feels more like a “bruise” and non-steroidal anti-inflammatory usually suffice to treat this discomfort.
Can I have Liposuction at the same time as Fat Grafting Breast Augmentation?
Yes, it is very common for patients to request more fat be taken from the donor sites than is needed for the natural fat grafting breast augmentation. It is important to note, however, that occasionally a second fat grafting breast augmentation procedure may be requested to the breasts 1-2 years after the first session and preservation of some fat is necessary.
How Long does the Fat Grafting Breast Augmentation Procedure Take?
The procedure takes approximately 1.5 hours. Usually one, two or three body zones are selected, depending upon the amount of fat in those zones and the harvest takes approximately 45 minutes to an hour. This will be extended if patients also want post-harvest liposuction contouring to be performed in the donor site. The fat grafting to the breast takes approximately half an hour and the average time for a fat grafting breast augmentation is 1.0 hours.
Figure 7.A. Before fat grafting to the breast. Fat was harvested from the abdomen and hips and 300 cc of prepared fat grafts were transplanted to each breast, for a total fat graft volume of 600 cc. B. The results for the natural fat grafting breast argumentation at 12 months showing a nice improvement in projection, volume and contour.
How Long is the Recovery Following the Fat Grafting Breast Augmentation?
Most patients following fat grafting breast augmentation can return to normal activities of daily living the following day. The breasts will be somewhat swollen and a little bit bruised and sore, but this is well-concealed in a soft sports bra and the swelling and bruising usually returns to normal within two to three weeks. Natural fat grafting breast augmentation is far less painful than artificial breast implant procedures performed under the muscle.
What Kind of Results Can I Expect from My Fat Grafting to the Breast and Natural Fat Grafting Breast Augmentation?
Patients who undergo fat grafting breast augmentation can expect a very nice improvement in breast contour with a modest and pleasing increase if projection shape and contour. The result is excellent in properly selected patients who are looking to achieve a ½ to ¾ cup size improvement or augmentation to selected areas of the breast or implant or irregularity camouflage, but the results for primary augmentation are only modest in comparison to breast implant augmentation surgery using a cohesive gel or saline implant.
Well-selected patients have fat grafting to the breast and natural fat grafting breast augmentation specifically because they want to avoid saline or cohesive gel breast implants or want to improve the results overlying their saline or cohesive gel breast augmentation. In general, most patients can expect a half to three-quarter cup size improvement and a noticeable improvement in the upper pole or lower pole if localized fat grafting is performed.
Figure 8.A. Patient presented with decreased breast volume in the upper poles. B. 1.5 liters of fat were removed through Vaser liposuction from the abdomen and flanks achieving an excellent abdominal-hip-flank contour improvement. The VaserLipo fat was then prepared and purified and then 400 cc (800 cc total) was then injected and transplanted into each breast. B. The 12 month result show a nice, natural increase in volume and proportion, contour and projection of each breast following the natural fat grafting breast augmentation.
What are Patients Saying About Their Fat Grafting Breast Augmentation?
Patients who undergo fat grafting breast augmentation are generally well-selected and are very happy with the results of their natural fat grafting breast augmentation procedure. Very unique and individualized contour shape, projection and form can be achieved with the use of fat grafting to the breast, with or without underlying breast implants and patients who have undergone this procedure with Dr. Mulholland are generally very happy with their results.
Figure 9.A. Patient who had the surgery performed at our Toronto clinic with a previous breast augment procedure using silicone gel implants that result in some volume asymmetry, a sharp take off of the chest wall-augment junction. B. VaserLipo fat graft harvest and Vaser Ultrasound assisted Liposuction was performed removing 2.2 liters of fat from the abdomen and flanks resulting in a pleasing liposuction contour improvement. The VaserLipo fat grafts were prepared and purified and then 400 cc of prepared fat grafts and stem cells were injected and grafted into each breast (800 cc in total). Patient was pleased with the results of her natural fat grafting breast augmentation.
Figure 10.A. Toronto patient who presented following a previous lumpectomy surgery for a right sided breast tumor. The lumpectomy resulted in a loss of volume and contour depression in the lower quadrant of the right breast. B. The patient underwent a breast augmenation procedure using a cohesive silicon “gummy bear” breast implant on each side and then additional fat grafting to the right lower quadrant of the breast over top of the breast implant itself.
Is There Any Maintenance Required Following Fat grafting Breast Augmentation?
There is no specific maintenance required for fat grafting breast augmentation. Generally, 30% to 60% of all fat grafts will survive and Dr. Mulholland generally over-grafts, accounting for the fat grafts that will not take. Most patients are happy with their volume, shape, projection and form enhancement following a single procedure.
However, most patients are warned, prior to selecting fat grafting breast augmentation as a procedural option that a second session performed 12 months later may be required to optimize the breast volume and project and overall aesthetic improvement, and results.
How Much Will Fat Grafting to the Breast and Natural Fat Grafting Breast Augmentation Cost?
Fat grafting breast augmentation costs range depending upon the number of body areas that must be harvested and the amount of fat that is required for the fat grafting breast augmentation result. In general, the cost of the procedure is approximately the same as cohesive gel augmentation to the breast, with the advantage that you can have some body liposuction contouring done on the donor site at the same time as natural fat grafting breast augmentation which you do not get using standard breast implant surgery.
Why Choose SpaMedica and Dr. Mulholland for Your Surgery?
By choosing Dr. Mulholland and SpaMedica in Toronto, you will be choosing one of Canada’s most renowned plastic surgeons with over 20 years of fat grafting experience to the breast, face and body areas. You will get not only the technical expertise required to get the highest possible graft take, but also the aesthetic judgment necessary to get natural and attractive improvement in the body, shape and form.