Fat Grafting to the Breast with Pre-Expansion

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An interesting new purpose for a strange and somewhat controversial breast enhancement device may be on the horizon. A recent study described in a June, 2011 article on the Science Dailywebsite explained that pre-expansion using a bra-like suction device may be key to plastic surgeons’ ability to deliver bigger breasts through fat transfer than has previously been possible.

These devices have been marketed for years, appealing to women who want bigger breasts without having to undergo surgery. A leading U.S. product is called the BRAVA Breast Enhancement and Shaping System, available for around $2,500. At the other end of the cost spectrum is a device called the Noogleberry System from a U.K. company, costing about $70.

Do these devices work? The answer is, well, sort of. Physician reviews on RealSelf.com indicated that the BRAVA system’s vacuum expansion does work in a limited way and for a limited time. Two plastic surgeons weighing in on BRAVA mentioned that the best results they have seen are when the device is worn prior to fat transfer. One plastic surgeon described the system as creating space for the fat injections (RealSelf 1).

That’s just what Drs. Daniel Alexander Del Vecchio and Louis Paul Bucky found in their study, published in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons, Science Daily reported. The two researchers injected fat into 46 breasts of 25 women after the patients used the expansion devices for several weeks. After six months, the plastic surgeons found that the women’s breasts showed both size and shape improvements, a natural feel and no evidence of cysts or other masses (Science Daily 1).

This study, as limited as it is, does uphold the notion that fat transfer may emerge as the wave of the future for breast augmentation, particularly as additional technology is found to support the approach. Pronouncing the results for their patients as “excellent outcomes,” the two plastic surgeons noted that they were able to transfer as much as 300cc’s of fat within about two hours (Science Daily 1). That’s more than twice the amount most doctors can currently transfer in one procedure, with just a little more time than required for the typical breast implant operation.

Fat transfer is not a new technique, but it has gained in popularity recently due to some advantages over traditional breast enlargement. These include the opportunity to avoid breast implants, which typically do not last a lifetime, potential cost savings and the appeal of having liposuction and essentially reusing and repositioning your body’s own tissues.

Aside from basic lingering questions about fat transfer, led by the possibility of necrosis, consequential lumps and the potential for interference with cancer screening, there are many more questions to be answered before the one-two punch of expansion/fat transfer becomes widely available.

One detail the Science Daily article did not reveal is which breast enhancement system was used by the researchers. Obviously there’s a big cost differential; would all the options on the market today be equally effective? And what would the ultimate package deal be for the patient—a purchased system combined with a fat transfer procedure? In the case of the BRAVA system and the average cost of fat injections reported on RealSelf of about $4,500 (RealSelf 2), that brings the total cost of surgery to about $7,000. This figure surpasses the average cost of breast augmentation with implants (RealSelf 3). Or perhaps plastic surgeons would loan a pre-expansion system to patients?

These questions and more will need to be put to rest before pre-expansion with fat transfer can become a widely available option. In the meantime, this recent news is sure to delight the manufacturers of the suction devices, especially given the mixed reviews these products have earned from patients and doctors in the past.

The good news for women considering breast enlargement is that this kind of research is being done, and it’s happening quickly. Given the popularity of breast augmentation, this trend is sure to continue.

Resources:

RealSelf (various plastic surgeon responses). Is the Brava Breast Enhancement System a Scam? Web. June 26, 2011. http://www.realself.com/question/is-brava-breast-enhancement-system-scam

Science Daily. New Technique Doubles Breast Size Using Patient’s Own Fat. Science Daily LLC. June 7, 2011. Web June 26, 2011.
http://www.sciencedaily.com/releases/2011/06/110607120558.htm

RealSelf (various plastic surgeon responses). Fat Transfer Breast Augmentation Cost. Web. June 26, 2011. http://www.realself.com/question/cost-fat-transfer-breasts-stomach

RealSelf (various plastic surgeon responses). How Much Do Breast Implants Cost? Web. June 26, 2011. http://www.realself.com/question/breast-implants-how-much-should-they-cost

Reviewed July 6, 2011
by Michele Blacksberg R.N.
Edited by Alison Stanton

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