Reshaping Trends for Rebuilding Breasts

Fat grafting for breast reconstruction gaining favor again

(RxWiki News) Using fat from a woman’s body to reshape her breasts is nothing new. In fact, the first so-called "fat grafting" was described in 1895! The procedure had fallen out of favor because of safety concerns. Now the trend is reshaping.

After many years of controversy, fat grafting has gained in popularity, according to a recently released study.

This study found that the operation is used mostly for breast reconstruction rather than for cosmetic purposes.

Fat grafting is particularly popular for use with breast cancer patients to repair defects following a lumpectomy in which only the tumor and surrounding tissue are removed.

"Research all your options for reconstructive surgery."

J. Peter Rubin, MD, FACS, chair of the Department of Plastic Surgery at the University of Pittsburgh, led a team of researchers who surveyed members of the American Society of Plastic Surgeons (ASPS) to learn their preferences in using fat grafting for breast surgery.

The technique's full name is autologous fat grafting. Autologous means using cells, blood or tissue from the patient’s own body.

Using liposuction, surgeons gather fat cells from one area of the body — usually thighs or abdomen — to enlarge or reshape the breast.

In the late 1980s, the procedure was not recommended due to concerns about the replaced fat cells interfering with the diagnosis of breast cancer. The ASPS issued a strong statement recommending against the use of fat grafting.

More recent studies have found that the technique not only provides good reconstructive results but the tissue changes are easily seen on mammograms.

For this report, the researchers distributed questionnaires to ASPS member surgeons and 456 physicians responded.

A total of 70 percent of the surgeons said they had used fat grafting techniques, along with implants and flap procedures in which tissue from another part of the body was used to rebuild the breast.

The majority (62 percent) of surgeons said they used fat grafting for reconstructive rather than aesthetic applications (28 percent).

"It has been used successfully as a primary method of treatment in the case of lumpectomy defects, with a greater than 90 percent satisfaction rate reported in this patient population," the authors wrote.

Gedge Rosson, MD, director of Breast Plastic Surgery at Johns Hopkins, told dailyRx News, "At our breast center, we have been using fat grafting to improve our breast reconstruction outcomes for many years. Typically, we use it to fill in small dents around the edges of an already completed reconstruction, such as a DIEP flap [which uses skin and tissue from the abdomen to recreate the breast] or an implant."

Dr. Rosson, who is an associate professor of plastic and reconstructive surgery at the Johns Hopkins School of Medicine, continued, "In spite of the fact that it takes several outpatient stages, some of our patients choose to do an entire breast reconstruction simply with the minimally invasive fat grafting technique (in other words, no flap and no implant). While this takes time, the end result is very natural."

He added, "It's terrific to read that fat grafting is gaining such widespread acceptance, particularly for the breast reconstruction patients, as it represents yet another excellent option for women with breast cancer."

The authors suggested that additional study is needed to optimize the procedure for breast reconstruction.

This report was published in the July issue of Plastic and Reconstructive Surgery, the official medical journal of the ASPS. 

The National Institutes of Health funded the study. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
July 3, 2013