This procedure is also referred to by different names such as fat injection, Lipofill, lipomodelling and liposculpting. Essentially the procedure involves harvesting of fat cells by liposuction of fat in fat reserves areas such as abdominal walls, flanks and thighs. The lipoaspirate is then prepared using different techniques ( Coleman centrifuge or fat washer or just the filter technique) and pure fat cells grafted into the breast using special cannula in a careful multi layer matrix into the subcutaneous space of the breast and behind the breast gland. One of the key limitations of this procedure is that NOT all the fat cells that is grafted survives as each cell that is injected will have to secure its blood supply for nutrients. The best estimate of fat cell survival is around 60% uptake but this can vary. The success rate of fat graft survival depends on whether the patient has any medical conditions such as diabetes or if the patient is a smoker. Therefore in some patients more than one fat grafting procedure may be required of get the desired outcome.
Fat grafting can be used in the following situations,
- Corrections of Breasts asymmetry on its own or in combination with mastopexy or implant.
- Corrections of breast deformities either inborn or acquired after breast surgical procedure
- Enlargement of breast coupled with implants (composite breast augmentation)
- Enhance the breast on its own without implants – primary fat breast augmentation. Whatever the objective is the procedure of fat harvesting and grafting is exactly the same. The procedure requires a general anaesthesia and can be done as a day case. Like all surgical procedures this procedure is also associated with some complications which as are follows
Donor site complications
These are complications that may occur at areas where liposuction is carried out:
Bruising – this usually settles in few weeks
Numbness of skin
Fat necrosis – these are small hardened areas which should settle in few months
Breast injection site limitations and complications
Fat necrosis and Oil cyst – fat necrosis and oil cyst tend to present as area of hardening or discreet lump in the breast and should be clinically assessed with ultrasound scan of the breast. Oil cyst requires aspiration with a needle and syringe under ultrasound guidance where as fat necrosis area usually settle down with time.
Loss of injected fat – as alluded earlier, some loss of fat is normal but in some patient there could be suboptimal or poor uptake of fat cells and may require more than session of fat grafting.