Breast Fat Grafting - Does it work well?

Breast Fat Grafting in Sydney – Does it work?

Does breast fat grafting in Sydney work as a method of increasing breast volume?

The first question that needs to be answered about any new technique is “Does it work?” For fat grafting, the answer is “Yes, but ….”.

Does the grafted fat actually stay in the breast?

Depending on the health of the site that the fat is being grafted into, and the techniques used to harvest the fat, the take rates can vary widely. Rates as high as 80% are seen with Coleman technique fat grafting to the face, whereas results have been reported as being as low as 20%. It is likely that the differences in fat graft survival are highly technique dependent. Any reabsorption (or non survival) of grafted fat is usually evident within 3 months.

What is the BRAVA system?

Considering that it is expected that on average about 70% of the fat that is grafted will still be present at one year (therefore forever), the search has been on for methods to increase the rate of graft survival. Dr Khouri has been an advocate of the BRAVA system. This is essentially a vacuum device that is attached over the breasts and provides suction to increase the stretch on the breast, resulting in an increased volume and blood supply. It needs to be worn for most of the day for several weeks in preparation for the procedure, as well as for a period after the grafting. I’m happy for Dr Khouri if he can convince patients to wear the device, but most of my patients who seek breast fat grafting in Sydney cannot manage with the inconvenience.

Two-stage breast fat grafting in Sydney

As a result, most surgeons offering fat grafting need to inform their patients that it is likely to be a 2 stage procedure. After the first stage, patients will be about 70% there. The increase in breast volume and blood vessel density allows a second stage grafting with greater volume and results. It is essentially an alternative to wearing the BRAVA device. They both place the breast in a better position to accept and nourish fat grafts, much like fertilizing soil to increase the chance of seedlings growing. Because we know that grafts are mostly stable by 3 months, it seems prudent to space a second round of fat grafting at least 3 months after the first procedure.

Does hyperbaric oxygen therapy work for breast fat grafting in Sydney?

Another ancillary technique that is being thrown around as a useful adjunct is hyperbaric oxygen. Great idea, but is again lacking in evidence at this stage. Hyperbaric oxygen is used in the public hospital system for very limited applications, usually supported by strong evidence. It was initially only used to treat divers with decompression sickness, but has found a role in helping to heal tissues that are poorly oxygenated or infected such as necrotising fasciitis. It’s role in private practice is much wider – owners (not necessarily doctors, you do not need a medical license) need to repay their costs. I’ve seen it used for all sorts of sports injuries with minimal effect other than costing the user. Until there is greater evidence that hyperbaric oxygen does increase fat graft survival in a healthy patient, there is no need to spend extra money on this.

What are the results from breast fat grafting in Sydney?

The results are obviously the end result that will determine long term satisfaction to the patient. The advocates of fat grafting show great results with soft, natural appearing breasts. This is likely to be achievable with good technique and a bit of luck (in avoiding side effects and complications). It appears that results at one year are likely to be stable. The grafted fat will always behave like fat from the area that it came from – patients do lose and gain weight in their fat grafts. If the fat came from the abdomen, and the patient tended to store fat in the tummy, then it will still be the first fat cells to increase in size as the patient gains weight.

At this time, Dr Gavin Sandercoe is awaiting his medico-legal insurance company to allow fat transfer as a method of cosmetic breast augmentation. Until that happens, he can only offer breast implants unless patients satisfy criteria for reconstructive fat transfer.

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