Breast fat transfer – Cannes & Nice | Dr. Victor Médard de Chardon
PRINCIPLES OF AUTOLOGOUS BREAST FAT TRANSFER
The treatment of breast hypoplasia (small breasts) most commonly consists of correcting the volume considered insufficient by inserting implants (prosthetic breast augmentation). In certain cases, this procedure can be in combination with a cure for ptosis (or mastopexy) to elevate the breasts.
It is now possible to augment or restore the volume of the breasts by transferring fat. This technique is called autologous breast fat transfer or aesthetic surgical breast lipomodelling or breast augmentation by fat transfer or reinjection. This technique was initially developed in breast reconstructive surgery in which it made an important breakthrough. The technique is derived from the technique of fat transfers to the face, which is also called lipostructure or lipofilling.
goals of breast augmentation by autologous fat transfer and breast
prostheses are different:
• Breast augmentation by autologous fat transfer is indicated for patients who wish to achieve a moderate breast augmentation, by means of a totally natural solution without a foreign prosthesis.
• Prosthetic breast augmentation is indicated for patients who seek a greater augmentation to the volume of their breasts or a greater modification to the shape of their breasts.
Fat transfer to the breasts must be considered as being a veritable surgical procedure and must be performed by a qualified, competent Plastic Surgeon, specifically trained in this type of technique and practising in a true surgical context.
must be under
35 years of age
Patients must have a sufficient amount of fat as to allow its collection in ideal conditions.
Thus, breast augmentation by autologous fat transfer is well indicated in the following situations:
• The patient is seeking a moderate volume breast augmentation, for acquired moderate breast hypoplasia or hypotrophy, especially among women wishing to recover a more harmonious shape to “empty” breasts following pregnancies, lactation or weight loss.
• Moderate breast asymmetry. If the need arises, in the case of notable breast asymmetry a reduction of the larger breast may be performed at the same time.
• Some imperfections from the results of a prosthetic breast augmentation implanted previously
- Insufficient volume
- Large intermammary distance
- Underfilled neckline
- Visible implant contours
Very slim patients who do not have enough fat reserves to enable a sufficient breast augmentation are not good candidates for this technique.
All suspicious radiological anomalies of the breasts will contraindicate this procedure and must be subjected to more detailed examination (microbiopsy and anatomopathological analysis).
Patients over 35 years of age or who have a family history of breast cancer.
augmentation by autologous fat transfer poses three major
• It enables a completely natural augmentation of the volume of the breasts, without introducing a foreign body.
• The scars are a matter of millimetres long.
• It enables simultaneously refining the silhouette treating any disharmonious excess localized fat by lipoaspiration (sites from which fat is removed).
The therapeutic project is designed through joint consultation between patient and plastic surgeon. In particular, the anticipated aesthetic benefits, the limitations of the technique with regard to increase in volume, the advantages, disadvantages and contraindications will be dealt with.
pre-operative assessment and planning are
necessary. Assessment is:
• Clinical, measuring and palpation of the breasts
• Radiological (mammographies and ultrasound, as well as MRI, if necessary). Radiological assessment must be thorough and performed by a specialist radiologist. Ideally, post-operative radiological follow-up examinations at 1 and 2 years should be carried out by the same radiologist as before the procedure. Although today it is clearly established that, as in all breast surgery, whether aesthetic or not (the removal of a benign or malign tumour, breast reduction surgery, breast augmentation…) calcification may occur (linked to tissue healing). This calcification (macro and microcalcification) is different from that observed in cases of breast cancer, and does not pose problems of diagnosis for experienced radiologists. With this in mind, patients requesting breast lipomodelling undertake to having pre-operative screening tests (mammography, ultrasound) and above all to have follow-up examinations (mammography, ultrasound) at 1 year, 2 years, and even 3 years depending on the doctor’s recommendations.
If all of these precautions are taken, the procedure can be approached without concern.
MODALITES OF THE PROCEDURE
or one night’s hospitalization
Anaesthesia: general anaesthesia. Breast augmentation by autologous fat transfer is usually carried out under general anaesthesia since fat collection by lipoaspiration involves several parts of the body in the course of the same operation: lipoaspiration of the buttocks, the hips, the abdomen, saddlebags, the inner knees.
Duration: from 1 to 3 hours. The duration of the procedure varies according to the number of fat collection sites, the amount of fat to be transferred, and any possible change in position during the procedure.
procedure takes place in several stages:
1. Selection and location of fat collection sites. The surgeon starts by precisely locating the areas from which to collect the fat as well as the target sites. The choice of collection areas depends on the patient’s areas of excess fat and her wishes, given that fat collection improves the areas in question appreciably as the excess fat undergoes an actual liposuction procedure. The choice of fat collection sites also depends on the quantity of fat deemed necessary and the available collection sites.
2. Fat collection via lipoaspiration. The fatty tissue is collected by soft, non-aggressive lipoaspiration, with small 4 mm incisions concealed in the natural folds, with the help of a fine aspiration cannula.
3. Preparation of the fat. The fat is centrifuged for some minutes in order to separate the intact fatty cells, which will be grafted, from the elements that cannot be grafted (serous fluid, oil).
4. Fat transfer using cannulas. The fatty tissue is transferred via 1 mm incisions with the help of micro-cannulas. Thus we proceed with the transfer of microparticles of fat in the different planes of the breasts according to a true three dimensional network, in order to increase the contact surface area between the implanted cells and the receiver tissue, which will best ensure the survival of the grafted fat cells.
to 15 days / Pain is, generally speaking, moderate and well
controlled by analgesics. It may transitorily be quite noticeable in
the fat collection areas.
Moderate oedema (swelling): 1 to 3 months / Swelling of the tissue (oedema) in the fat collection areas and in the breasts appears for the 48 hours following the procedure, and will generally take 1 to 3 months to diminish.
Ecchymosis (bruising): 7 to 21 days / Ecchymosis (bruising) appears during the first hours around the fat collection areas: it diminishes within 10 to 20 days after the procedure.
result is stable and definitive between
3 and 6 months. In fact, the immediate volume is increased by the
oedema and by the fat injected. During the following weeks, oedema
progressively diminishes and the engraftment of the fatty cells takes
place progressively. Engraftment is in the order of 60 to 70%. Then
the breasts present a greater volume and a more harmonious shape. The
silhouette is also improved thanks to the lipoaspiration of the fat
collection areas (hips, abdomen, saddlebags, knees).
Sometimes, a second session of surgical lipomodelling is necessary. A second session of lipomodelling is possible some months later, if necessary, in order to increase further the volume of the breasts or improve their shape.
THE EVOLUTION OF THE BREASTS WITH TIME
Normal ageing of the breasts is not halted and their aspect will change naturally with time. Also, a normal variation in breast volume will take place with variation in weight. Thus, weight loss will lead to a decrease in breast volume, just as weight gain will lead to an increase in breast volume.
BREAST AUGMENTATION BY FAT TRANSFER
Injection of 300 cc of fat into each breast
Consultations at the aesthetic surgeon's office in rue d'Antibes, Cannes
- Ideal for small breast augmentations
- Operation at the clinic in Cannes or Nice
- Hospitalisation: outpatient or one night
- Anaesthesia: general
- Duration: 2 to 3 hours
- No breast pain | Slight pain at the fat collection sites
- Time off work: 7 days
- No stitches to remove
- Millimetre scars
- Definitive, natural result
- No wearing of a brassiere