Breast lipofilling and breast augmentation with fat transfer

Lipofilling is an advanced surgery technique. It uses the patient’s own fat, harvested through liposuction, and reinjects it to permanently fill in hollows, or create volume in other parts of the body. The surgeon performs thus an autologous graft of adipocyte cells.

This technique is also called: lipostructure, liposculpture, lipomodelling, micro-fat grafting, fat injection, autologous fat transfer, fat grafting, autologous adipocyte graft, autologous fat grafting… they are all synonyms.

Lipostructure was first used in breast reconstruction (also called lipofilling or lipomodelling). With this experience and efficiency in breast reconstruction, lipofilling has been used in other parts of the body (face, hands, limbs…), including esthetic breast augmentation.

Fat transfer in the breast is recognized as being reliable and predictable when performed by a board-certified plastic surgeon with experience in breast lipofilling.

Breast lipofilling is for patients who need:

• A modest breast augmentation
• To restore shape and volume in their breast after pregnancy, breastfeeding or weight loss…
• To improve the shape, the curve and the feel of their breast augmentation with implant (hybrid breast augmentation)

Breast augmentation with lipofilling requires enough excess body fat to be removed from other parts of the body for one or two lipofilling sessions.

Very slim patients are not good candidates for a breast lipofilling.

• Breast augmentation with lipofilling uses your own fat to add volume to your breasts in a very natural way and with a perfectly natural outcome.
• Once the graft has settled, the result is permanent and the size of your breasts will vary like any other fat in your body.
• The breasts feel natural and soft to the touch.
• It’s a scarless breast augmentation.
• Breast lipofilling is an autologous and 100% natural procedure as it uses the patient’s own fat.
• As the procedure doesn’t involve a foreign body, there is no implant-related risk (scar, capsular contracture, implant rejection…)
• Inharmonious fatty areas of the body are treated and sculpted as part of the lipofilling procedure as unwanted fat is harvested.
• The procedure doesn’t only benefit breasts but the whole body as it enhances its overall proportions, remodeling body contours.

• Two preoperative consultations with a board-certified plastic surgeon will be conducted as well as a consultation with an anesthetist.
• You will get a mammography or/ and an ultrasound.
• Before and after comparison photographs will be taken.
• A post-surgical compression bra, wireless and front opening, will be prescribed.
• Preoperative instructions are as follow:
  • Quit smoking at least one month before the surgery and up to 1 month after the surgery to avoid any complication or necrosis risk.
  • Discontinue any anti-platelet or blood-thinning medication 15 days before the surgery.

• It is, most of the time, performed under general anesthesia, depending on the number of areas where the fat is to be removed.
• The patient is in a sit-up position to create an optimal result.
• It lasts about 2 hours depending on the volume of fat to harvest and inject.
• Dr Vincent Nguyen performs liposuction and lipofilling himself on both breasts.

• Breast lipofilling is not a painful procedure. Only light analgesics will be prescribed.
• Patients may go home the following day or even the same day.
• Swelling and bruising appear on the breasts and on the collection sites the following days.
• No nursing care is required after the procedure.
• You may have a shower the following day.
• You will have to wear a contention bra for 4 weeks night and day as well as a compression garment on the areas where liposuction is performed, to help remodel contours.
• Most patients may go back to work after 5 to 10 days depending on the nature of their job.
• You may resume physical activities after 4 weeks.
• Follow-up consultations with Dr Vincent Nguyen will be planned (1 week, 1 month, 3 months, 6 months and a year after the surgery).

• If breast lipofilling can’t be an option for you, you may consider breast augmentation with implants for a larger augmentation and different shape.
• Both procedures, breast augmentation with lipofilling and with implants, may be combined. It is called hybrid breast augmentation. (see information sheet)

It may be combined with a breast lift (that comes with scars) if the patient’s breasts are sagging after pregnancy, breastfeeding or weight loss. (see information sheet)

All the fat that survived the transplant after 3 months will be permanent, but the fat will be affected by weight gain and weight loss as in any other part of your body.

• The volume of injected fat depends on the fat tissue stock. Some very slim patients may not have enough excess fat to have a succesful lipofilling. Dr Vincent Nguyen will evaluate your needs and the quantity of fat that can be removed and will discuss your options.
• As the procedure involves autologous fat graft, a certain amount of fat is absorbed by the body. After 3 months, up to half the fat injected may have been reabsorbed.
• Breast lipomodelling is not for patients who want a large breast augmentation as it only modestly enlarges the breasts.
• A second lipofilling procedure will be necessary if the patient wants to augment her breasts more significantly, the size of an implant (300cc).
• The final outcome is not entirely predictable as fat is absorbed by the body. So, if the patient wants to have larger breasts, implants should be considered.

• Breast lipofilling may be performed in case of congenital defects or breast or chest deformity (Poland syndrome, breast aplasia, tuberous breast and pectum excavatum): see mammary abnormalities.
• Breast lipofilling may also be performed in breast reconstruction after breast cancer. See breast reconstruction

No.

With the benefit of 25 years of hindsight, many studies have shown that lipofilling is a safe procedure that doesn’t increase the risk of breast cancer.

However breast lipofilling doesn’t prevent the patient from developing breast cancer.

In the past, lipofilling was not performed on women over 35 as microcalcifications (due to the graft) could affect the interpretation of ultrasound imaging.

Nowadays radiographic changes following fat grafting are easily differentiated from breast cancer.

If breast lipofilling is performed by a board-certified plastic surgeon, there won’t be any diagnostic issue for the radiologist. The calcifications can’t confound mammography and routine breast cancer surveillance.