Breast surgeries with fat transplantation: what are they

For which patients is this surgery indicated?

Fat autotransplantation is indicated in breast surgery for: breast asymmetries of volume, defects after breast tumors, reconstructions, breast augmentation with own tissue and replacement of implants in implant replacement surgeries.

From which part of the body is fat taken?

A good evaluation of each patient will be made and the fat will be extracted from the areas of lipodystrophy, that is, where there is an accumulation of fat. In this way, we will be able to obtain an aesthetic result or an improvement as if it were a conventional liposuction.

What is the postoperative period for this area and where is the fat extracted from?

The donor area will have to undergo a liposuction postoperative period: use of a girdle for 1 month, lymphatic drainage and radiofrequency. No pressure, manipulation or massage should be exerted on the breast during the first month. It is a fat graft that must be well vascularized and remain alive.

How is the fat extracted?

The fat is extracted with liposuction cannulas, through small incisions. There should be minimal suction pressure so as not to damage it. It must be washed and purified. Usually, there are devices such as the Revolve@, Puregraft@ or the centrifuges themselves that allow processing with maximum yield.

Replacement and removal of implants with other techniques

When is it recommended to change breast prostheses?

Breast prostheses should be changed when there is a deterioration or rupture in the control radiology (ultrasound and, if in doubt, MRI). It is rare that this happens before 10 years, but it is also rare that the average life of the implants is extended more than 20 years.

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How does the breast look like when the prosthesis are removed? Is another surgery necessary? What techniques are used? Does it leave scars? How is it performed?

When implants have been worn for years there may be an atrophy or deformity of the breast tissue due to compression of the implant, apart from the breast changes due to the passage of time such as ptosis, also known as sagging, or the increase in volume due to weight changes or breastfeeding.

In order to solve these defects it is not very frequent to opt for a simple explant. If there is not going to be replacement or repositioning of the implant we should associate techniques of fat autotransplantation and / or mastopexy or elevation.

To remove an implant the previous scar of implantation can be used, unless a mastopexy is recommended in the same surgery, so the scars will be those of the technique used. Some of them would be the complete periareolar, vertical or inverted T, depending on the case. For fat injection, the scars are millimetric and go unnoticed.

How can we choose a good prosthesis? Does it depend on the patient’s condition?

The implant must be personalized for each patient. The choice will depend on physical characteristics (type of skin, thickness of subcutaneous tissue or fat, chest measurements, height…), the patient’s desire for more or less volume, the degree of physical activity (pre- or retropectoral placement, textured or smooth surface), etc. On the other hand, if it is a replacement, we must assess whether it should be repositioned or solve any previous problem such as capsular contracture (assessing the micropolyurethane cover). It is important to have this procedure performed by a surgeon with extensive experience and knowledge, in addition to participating in the final decision together with the specialist.