Autologous Fat Grafting

Grafting of “autologous” fat (bodyfat) into the breast remains controversial. Dr. Fisher radically opposes this technique because of the risk of infection and complications, but also because it cannot be effectively contoured as standard breast implants can. It may be safe in correcting minor deformities but Dr. Fisher radically opposes its use for common breast augmentation.

Surgeons experimenting with this technique argue that fat injection offers “controlled reshaping of the breast.” However, Dr. Fisher argues that from his very earliest years, as someone who stood at the cradle of breast implant surgery in the 1980s in St. Luke’s Hospital in New York, and has specialized in the field in the past more than thirty years, the “modified” injection is a minor corrective, which begs more questions than it answers.

 

The fat placement with respect to both level and quadrant of delivery cannot be thoroughly documented, as this would require ongoing supervision, if not hospitalization. Certain three-dimensional structural fat grafting approach, in which small aliquots of fat are placed diffusely, largely into the pectoral-retromammary space (the pectoralis major muscle and the retropectoral and prepectoral spaces) for augmentation, as well as more superficially into the subcutaneous space for shaping, are potentially without risk and effective, but rarely show any radical changes.

Further, in most cases, fat is not grafted into the parenchyma, but placement deep to the areola, in order to increase projection. The fat transfer is usually done through only four incision sites, although an additional site in the axilla may be used in reconstruction cases. Thus, it is of little help in “lifting” the breast or in  improving a “baggy” condition.

Since the autologous fat injection requires that cannulas of 9 cm or 15 cm in length be used, the procedure is not painless either. For further information, please visit Dr. Gregory Fisher in his office hours.

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