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Fat Transfer to the Breasts - Tissue Survival, Cancer Screening

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As the buzz in plastic surgery circles continues to build about breast augmentation through fat transfer, it may be ever more tempting to consider the procedure. That is, if you feel Mother Nature shorted you in the breast department.

(If you haven’t hard much of the discussion yet, you may want to browse an article from November at https://www.empowher.com/news/herarticle/2009/11/05/breast-augmentation-fat-transfer for some basic information on this topic.)

The American Society of Plastic Surgeons reversed itself late last year and declared fat transfer to be a viable means of breast enlargement, re-opening the doors to the attractive notion of enhancing your figure with your own tissue. However, it will be a while before thousands of these procedures have been done and the patient results have been tracked over a period of years. Breast augmentation via fat transfer is still far from mainstream.

Indeed, controversy still rages in medical circles about the procedure. One of the major concerns about fat transfer is long-term survival of the transplanted cells. When fat cells die, they can result in lumps, scarring and cysts—thickened tissue that can be hard to differentiate from cancer.

In an article in the San Jose Mercury News a week ago, Dr. Stephen F. Sener, a surgery professor at USC and a former president of the American Cancer Society, commented that he had seen enough post-mastectomy fat transfer patients to conclude that fat necrosis [death] is “a real problem.” Dr. Sener explained that, “It can result in a ‘palpable mass’ that needs to be biopsied to establish malignancy or infection.”

If fat transfer for breast augmentation is ever to be as popular as breast surgery with implants, then, it seems that conquering the necrosis problem is key. Not only will patients want to avoid lumps that may be viewed as potential tumors, women will not want to see their newly-enhanced breasts to shrink over time as the fat dies.

Dr. Roger Khouri, a plastic and reconstructive surgeon who manages the Miami Breast Center, is one of the few physicians who have performed many breast augmentations via fat transfer. He tracked 50 women for an average post-procedure period of three and a half years and noted that 85 percent of the transplanted fat survived, meaning that most of his patients had no extra trouble with mammograms following their procedure.

But Dr. Khouri echoes what many surgeons say about fat transfer: technique is everything. He says that fat injected by an inexperienced or unskilled physician may produce results that look good at first, but a few months down the road result in “oil cysts, masses, nodules and scarring.”

As another plastic surgeon explains, fat is delicate tissue. It must live through the removal process and the transfer procedure, then gain a new blood supply and survive over the long term. Not an easy proposition.

Even the president of the American Society of Plastic Surgeons, the group that recently declared fat transfer to be a safe method of breast augmentation, cautions, “How you take the fat, how you process it, how you inject it are all factors in how successful fat survival is going to be.”

If you’re one of the women who are enthusiastic about trying fat transfer, it’s understandable. There’s definite appeal to moving some of your own cells from one part of the body to another rather than using implants for enhancement. But think twice about fat transfer and research the unknowns and drawbacks.

Perhaps you’ll conclude you’re willing to put yourself in the position of “early adopter,” or even “guinea pig.” If so, the most important thing you can do is choose a plastic surgeon with significant experience in successful fat transfer. Experience should not be confused with enthusiasm – there’s plenty of that to go around these days. That’s bona fide experience with fat transfer. Someone who can explain with firsthand knowledge how to harvest, prepare and inject the fat so it has the best chance of survival.

Ask questions, many questions. Especially with a procedure like this, it’s your right and your responsibility.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.