Posted: Oct 26, 2009 6:48 PM
Oct. 26 -- Breast lifts can raise, shape, and firm sagging breasts. If a woman wants to add volume, she may need to get breast implants too, but fat injections can also do the trick, according to research presented at the annual meeting of the American Society of Plastic Surgeons (ASPS) in Seattle.
The ASPS and its sister organization, the American Society of Aesthetic Plastic Surgery, state that fat injections to the breast can be used to enhance breast appearance after reconstruction or to soften the appearance of implants, but the groups don't yet recommend fat injections for cosmetic augmentation.
In the new study, all 46 women who received fat injections in their breast after a breast lift showed improvements in the size and shape of their breasts after one year. The breasts were soft and had a natural look and feel, says researcher Kamran Khoobehi, MD, a plastic surgeon in Metairie, La.
Injecting fat from the buttocks, thighs, or other body areas where it is more plentiful into the breasts has been mired in controversy. There were concerns that the fat may calcify and obscure readings on breast X-rays for mammograms or possibly be mistaken for early breast cancer.
"There is not an issue at all with imaging of the breast," Khoobehi says. "It is easier to see breast tissue in breasts that were augmented with fat than implants." In the study, there were no abnormalities seen on mammograms compared to preoperative mammograms. There is also no evidence showing that injecting fat replete with stem cells into the breast will induce the growth of cancer cells, he says.
That's not to say that fat injections to the breast is for every woman. "The ideal is someone who is older than 30, has had multiple pregnancies and ... just wants a more natural-looking and feeling breast," he says.
Another study presented here showed that fat taken from the thighs via liposuction may be an alternative to breast implants. The study of 50 women showed that there was an average increase of 210 milliliters of breast volume after 6 to 12 months.
"That's not a lot of volume," says Walter L. Erhardt, Jr., MD, a plastic surgeon in private practice in Albany, Ga., and a past president of ASPS. "It is about seven ounces and the average glass of water is just eight ounces," he says, "We are talking about 14 tablespoons of liquid."
"The fat injection procedure is more expensive and takes much longer than a breast lift with implants or breast augmentation with implants alone," Erhardt says.
Other questions and concerns remain, he tells WebMD. It is also unknown how much fat is needed to adequately enlarge a breast because not all fat survives the transfer, and the success of the surgery is largely dependent on providers' skill and technique, he says.
"The fat has to develop a blood supply and if it doesn't develop a blood supply, it dies and goes away, and in the past that has been problem," he says. "If the fat does develop a blood supply, it becomes a living tissue and can grow if a patient gains weight or shrink if she loses weight," he says. This was also an issue in the liposuction study.
Put another way: "If the fat came from your abdomen, and you have tendency to gain tummy fat your breasts will grow."
That said, "Fat injections to the breast do eliminate some of the problems of an implant, like wrinkling and dimpling, but there are a new set of problems," he says. The bottom line? Injecting fat into the breasts "is a long run for a short slide, but there will likely be a niche for this surgery."