Breast augmentation using the patient’s own fat - Medical Experts

Breast augmentation using autologous fat is a form of autologous fat transfer. In this procedure, fat cells are harvested from a suitable area of the body and transferred to the breasts. The procedure is also known as lipofilling or breast surgery using autologous fat. Unlike breast augmentation with implants, no artificial implant remains in the breast.

The treatment is particularly suitable for patients who wish to moderately enlarge their breasts and avoid implants. A prerequisite is sufficient autologous fat at a suitable donor site. Therefore, the desired enlargement and the available fat deposits must be considered together.

Possible donor sites include the abdomen and the inner thighs. The choice of site depends on where usable fat deposits are present.

Autologous fat is primarily suitable for moderate breast augmentation. It is not possible to reliably predict a specific cup size based on the initial volume of fat injected, as some of the transplanted fat cells will not survive.

The result of breast augmentation using autologous fat depends on how much of the transferred fat permanently takes hold. A meta-analysis found an average volume retention of around 54 per cent during follow-up periods of 3 to 36 months. A significant proportion of the transferred volume was therefore not retained.

Another review of aesthetic breast augmentation reported an average volume retention of around 62 per cent. The results of the various studies differ.

In the same review, many women were satisfied with the result. This applied to around 92 per cent of patients. However, satisfaction and volume retention describe different aspects: satisfaction reflects the patients’ assessment, whilst volume retention refers to the proportion of the transferred fat that remains.

How the breasts look afterwards also depends on the technique used and the experience of the operating surgeon. The procedure is not uniformly standardised. Realistic expectations regarding volume and cup size should therefore be clarified during the consultation.

It is not possible to guarantee a specific cup size or a volume that remains permanently unchanged. The key factor is whether the expected increase in size is explained clearly and comprehensively, and whether the possible breakdown of fat cells is taken into account.

Before the procedure, the desired outcome, existing fat deposits and personal risks are discussed. Smoking increases the risk of complications and infections in breast augmentation using autologous fat. The patient should therefore openly disclose her tobacco use during the preliminary consultation.

The extraction and transfer of fat are two parts of the same operation. The exact procedure may vary, as the technique for breast augmentation using autologous fat is not uniformly standardised.

1. The surgeon selects a donor site, such as the abdomen or the inner thighs, based on the patient’s existing fat deposits.
2. Fat is harvested from the selected site for transfer.
3. The harvested fat is then transferred to the breast, where it is used to augment the breast.

One study examined breast augmentation using autologous fat following prior tissue expansion. In this specific procedure, the operation lasted less than 2 hours. This is not a general guideline for breast augmentation using autologous fat or other techniques.

In the procedure examined, the tissue was expanded prior to the fat transfer. Whether this preparation is appropriate depends on the specific surgical plan. No general duration of hospital stay can be deduced from the study.

The risks recorded include fat necrosis and calcifications. In fat necrosis, the transferred fat tissue dies off. Calcifications may be visible as abnormalities on breast imaging.

A recent analysis found fat necrosis in around 9 per cent and calcifications in around 1 per cent of the cases studied. The frequency with which such complications occur may depend on the patient group, the technique used and how the findings are recorded.

Smoking increases the risk of complications and infections and should be addressed before the operation. Experience in plastic surgery also influences the outcomes of the procedure.

The recent analysis found no evidence that the detection of breast cancer was impaired by autologous fat augmentation. Nevertheless, fat necrosis and calcifications may still be visible in breast imaging.

There are no standardised guidelines for aftercare following breast augmentation with autologous fat. Among other things, there is debate over how pressure on the breast should be managed and whether a compression bra is advisable after breast lipofilling.

It is therefore not possible to provide a universal guideline regarding bras following the procedure. The doctor should explain which post-operative care is specific to the technique used and why it is recommended.

The result of breast augmentation using autologous fat should not be assessed solely on the basis of the amount initially injected into the breast. What matters is what proportion of the fat cells survives and how the shape and volume of the breasts develop as a result.

The guidelines to follow in the weeks following the procedure also depend on the technique used. The planned aftercare should therefore be clearly explained during the consultation.

The main alternatives are implants and, in the case of sagging breasts, a lift. The procedures have different aims. Autologous fat allows for moderate enlargement without an implant, whilst a lift primarily alters the shape.

In breast augmentation with implants, an artificial implant is inserted. In lipofilling, on the other hand, the focus is on the extraction, the integration of the fat cells and the variable retention of volume.

Breast augmentation using autologous fat falls within the field of plastic and aesthetic surgery. Whether liposuction forms part of the planned extraction technique should be clarified during the consultation, as the procedure is not uniformly standardised.

Experience with the specific procedure is important, as the technique is not uniformly standardised. The result also depends on the surgeon performing the operation. A term such as ‘breast augmentation with autologous fat’ does not, on its own, reveal anything about the method used.

Nor is the term ‘gentle’ in itself an indicator of quality. More meaningful are clear details regarding the technique, potential complications, aftercare and experience with the specific procedure.

During the consultation, the realistically achievable volume, the planned harvest sites and how to manage any potential loss of volume should be discussed. Equally important are the experience of the specialist in plastic and aesthetic surgery and the planned approach to aftercare.

These questions may help you make your choice:

• How often do you perform breast augmentation using autologous fat?
• In a liposuction procedure, is the fat extracted using a cannula and then injected into the breast, or is a different approach planned?
• How do you take into account the fact that some of the fat cells will not survive?
• What aftercare do you recommend during the first few weeks, and what should I do if swelling occurs?
• How do you manage fat necrosis or calcifications?

You can find specialists in breast augmentation using autologous fat at the end of this text.