Autologous fat transfer
Besides augmentation with implants, patients can choose to take fat from other parts of the body and inject the treated fat in the breast tissue, which could also achieve the results of breast size increase and shape correction. This surgery takes the required amount of fat from areas with more ample fat contents, e.g., belly, waist, buttocks, or thighs. Whole fat globules are taken from these parts using low-pressure liposuction and undergo special in vitro titration, centrifugation, or purification; then, the best quality portion is used for injection into the breast. In terms of the strictest standard, on average, only approximately one-third of the fat from liposuction can be used for breast augmentation. Using strict rules during fat preparation allows a higher quality of fat cells, which have a higher survival rate and lower absorption ratio.
In recent years, many new technologies have been developed to isolate platelet-rich plasma from the blood. There is also the more complex stromal vascular fraction (SVF) extraction to isolate stem cell-rich preadipocytes, which are mixed with normal adipocytes for injection. SVF is used to promote fat cell regeneration and activation after transfer. It significantly increases the fat survival rate. We have adopted this cell-assisted fat transfer method at Wish clinic. According to Dr. Chuang’s clinical observation and experience, this newest procedure increases the survival of autologous fat cells to 60%–70%, decreases the risk of calcification, and greatly increases the safety of augmentation using autologous fat. However, the absorption of fat cells often varies according to the patient. The long-term results still need to be confirmed through continuous follow-up.
Clinically, breast augmentation with autologous fat transfer has a wide scope of application. Whether for underdeveloped breasts, the desire for a slight upgrade in cup size, the improvement of postpartum breast atrophy, the adjustment of partial shape, the correction of breast asymmetry, mental block to implants, the removal of implants, or the correction of visible implant edges and wrinkles, autologous fat transfer can be used to improve the situation.
Comparison Between Breast Implant And Autologous Fat Transfer In Breast Augmentation
| Breast Implant Augmentation | Autologous Fat Transfer | |
|---|---|---|
| Ideal candidates | Those who would like an at least 2 cup size increase | Those who like augmentation and have enough body fat |
| Anesthesia | General anesthesia, epidural anesthesia | General anesthesia, IV sedation |
| Type of incision | Transaxillary, periareolar, inframammary, or umbilical; incisions are approximately 2–5 cm in size | 0.5-cm incision at the site of liposuction. Multiple 0.2–0.5-cm incisions in the underarms, inframammary fold, or areola. Surgery scars can completely recover |
| Duration of surgery | 2 h | 3h |
| Postoperative pain | Depends on the surgery; 3–7 points on the pain scale | Mild pain |
| Removal of stitches | 7 days | 5-7 days |
| Period of postoperative recovery | 3–5 days | 1-2days |
| Postoperative massage | Required | Not needed |
| Absorption | None | Approximately 30%–40% absorption rate with autologous fat stem cell transplantation |
| Duration of result | Long; on average, 15–20 years or longer | Depends on the degree of absorption; on average, 2–3 years |
| Texture of breast | The texture of silicone implants is similar to that of real breasts. Saline implants may have palpable edges | Same as breast tissue |
| Scar | Need at least 1 year to recover | None |
| Damage to mammary glands | None | Possible |
| Affects breastfeeding | No | No |
| Affects mammogram | No | Possible |
| Chance of repeated surgery | Low | Possible |
| Risk and complications | Capsular contracture, breast deformation, scar adhesion | Breast lumps, calcification, fat necrosis |