By Patty Kovacs, Editor-at-Large, Makemeheal.com
Want to increase your breast size and slim down your mid-section at the same time?
After years of medical research, specialty trained plastic surgeons are successfully increasing a woman’s breast size using the patient’s own fat along with fat stem cells. This revolutionary plastic surgery procedure is opening a new frontier in breast augmentation and causing interested patients to look more closely at their options.
For years, saline and silicone implants have served as the most viable method for breast augmentation patients, but inserting saline or plastic into one’s body is considered by some women as a procedure that poses health concerns. While saline or silicone implants are ‘foreign objects’ placed into the body, innumerable studies and FDA approval declare both saline and silicone implants to be safe. Breast augmentation and liposuction were front runner plastic surgery procedures for 2008, and are proving to continue to be so in 2009.
The relatively uncommon fat grafting breast augmentation procedure has women everywhere buzzing about the benefits of this seemingly more natural breast enhancement option. So what’s a woman to do? First, decisions mean options and options are a good thing. Present clinical evidence does not conclude that fat grafting is safer or better than saline or silicone implants, but the idea of taking one’s own fat and repositioning it to augment the breasts is rapidly capturing the attention of medicine, consumers, and the media. I decided to take a more careful look into this procedure as the beauty buffet of breast augmentation procedures is likely to bring a feast of pros and cons and confusion is best converted to clarity.
Autologous fat grafting, also known as fat transfer (AFT), is a procedure in which fat cells are harvested from one part of the body and injected into another. It’s gaining acclaim rapidly. Proponents of fat grafting breast augmentation say it can be very effective in enhancing the size and appearance of the breasts using one’s own tissue. The procedure can also soften the appearance of existing implants and hide visible rippling which is particularly apparent in very thin women with a bony chest wall and little skin or fat with which to work.
The process typically increases breast size by one cup size. Recovery time is argued by opponents to be less than with traditional implants, as both the breast and donor site must heal. Also, patients need to have an adequate supply of excess fat for the procedure. Opponents claim it can take up to six months or more for breast shape results to complete post surgery as opposed to implants where recovery and results appear in six to eight weeks. But the surgeons with whom I spoke expressed short recovery following the fat transfer procedure claiming their patients could return to work in only a few days.
Methods for tissue harvest and tissue injection have been refined. Fat cells are carefully removed by a specialized liposuction procedure using numerous syringes and transferred to the breast via dozens of minutely small injections. This technique results in increased survival of the fat cells. There remains debate over how much of the transferred fat remains long-term, but the doctors with whom I spoke said it could possibly last a lifetime, unlike implants which are recommended to be replaced at least every ten years.
The procedure can be very effective in enhancing in enhancing the appearance of the breast for breast reconstruction. Fat grafting breast augmentation can also soften the appearance of existing implants, particularly in very thin women who experience visible rippling with their implants.
Augmenting the breast with the body’s own fat first became popular in the 1980s; however, both ASPS and ASAPS initially cautioned its members against the technique because of side effects such as oil cysts, calcification, and tissue scarring. The calcification in particular made it difficult for mammogram readings to distinguish between calcifications associated with breast cancer and calcifications associated with fat transfer.
A renewed clinical interest in fat grafting for both reconstructive and aesthetic purposes has emerged and surgical proponents of the procedure are calling it the wave of the future in aesthetic breast enhancement procedures.
I decided to go straight to the top and speak with Dr. Mel Bircoll, retired Board Certified Plastic Surgeon and Chief of Plastic Surgery at the former Beverly Hills Medical Center, a prestigious facility which catered to the upper crust of Beverly Hills, on the site of what is now the Peninsula Hotel. Dr. Bircoll, an icon of medicine and the first doctor to perform liposuction in North America in the latter 1970’s, now resides in Bel Air and remains active on advisory boards for fat transfer procedures and stem cell research.
“My esteemed clientele were so pleased with the progressive face lift procedures I performed in the 60’s, 70’s and 80’s, they kept asking me, ‘Dr. Bircoll, can you take it from here (thighs) and place it here (breasts)?’ To accommodate their pleas I introduced the first fat transfer procedures in the United States in 1984,” Dr. Bircoll declared.
How did he come up with the first successful fat transfer procedures in North America? Dr. Bircoll explained that fat transfer procedures were going on as early as 1890, but that the procedures did not produce tissue that could be oxygenated; thus, the fat transfer tissue would die. He figured if he could inject a small enough quantity into the center of vascularized tissue, each minutely small quantity would get its oxygen supply and survive. Breathing room meant survival of the fat cells and that meant success. His procedure is the very foundation of today’s multiple micro injections procedure for successful fat transfer. Each of the micro injections receives oxygen and the procedure, when done properly, brings outstanding results, he reports. Fat is successfully removed from the patient’s own body and placed into the patient’s breast, all using the person’s own fat, creating a naturally enhanced breast with no foreign implant.
One of Dr. Mercoll’s select students is Board Certified Dr. Todd Malan of Scottsdale, AZ, now a teacher of Dr. Bircoll’s method and Founder of the signature breast augmentation procedure, the “Natural Breast Augmentation.”
Dr. Malan explained to me, “The method for harvest and injection of the patient’s tissue is a highly refined approach. But we’ve achieved success unlike any other fat transfer breast augmentation procedures. Procedures previously performed in the 1980s provided only 50 per cent of fat cells surviving. The procedure we perform today maximizes fat stem cells to provide an 85-90 percent survival of the cell. We implement a method of harvesting the fat cells that places little to no trauma on the harvested fat and allows the aesthetic enhancement to last (potentially) a lifetime. Fat cells are carefully removed by liposuction using syringes and transferred to the breast via dozens of micro injections. The ‘Natural Breast Augmentation’ technique results in greatly increased survival of the fat cells, and though there remains debate over how much of the transferred fat remains long term, we see no reason to believe it is not for life.”
Dr. Malan has trained only six surgeons in the United States due to the precision and surgical expertise required to perform the procedure correctly. One of his elite students, Dr. August Accetta, of Huntington Beach, CA (www.accettamd.com) told me he is amazed regarding patient satisfaction and success with the procedure.
“Finally my patients who have long desired breast enhancement but did not wish to have implants due to their not wanting a foreign substance in their body nor on their breast wall, comment that the procedure has offered them a wonderful, full, all natural, utterly beautiful breast enhancement and they’re elated. It’s a tedious procedure requiring meticulous attention to every detail and should only be performed by a highly trained specialist, but the end results can be astonishingly natural and beautiful,” acclaims Dr. Accetta.
He says there are four primary reasons for patients to request Natural Breast Augmentation: First, general augmentation. Second, restoration to pre- pregnancy breast size, shape, and appearance. Natural Breast Augmentation is also performed to correct embarrassing size discrepancies, and, lastly, restoration following surgical lumpectomy procedures.
“As long as the fat is injected in the correct way, the patient will be overjoyed that her breasts look and feel 100% natural,” said Dr. Accetta. “This is the very first procedure to allow doctors to use everything nature gave us to help a woman obtain that perfect hourglass figure… naturally!”
In 2007, the highly respected medical association, American Society for Plastic Surgery (ASPS) , formed a Fat Graft Task Force to conduct an assessment regarding the safety and efficacy of autologous fat grafting (AFT). I spoke to Dr. Karol A. Gutowski, Chair for the ASPS review, about the results of the study.
“We looked at studies from around the world and concluded that while there are a lot of concerns, there’s much evidence showing positive results from this procedure. We actually couldn’t find strong evidence showing why not to perform this procedure for breast augmentation, but we also didn’t conclude this is the best technology there is for achieving certain specific goals, say for breast reconstruction. The standard now for breast augmentation is implants which has its pros and cons; same is true for fat grafting. Unfortunately, we have no formal studies comparing the two. Maybe in the near future as we could use more information and studies on this.”
While there is one registered prospective clinical trial (BRAVA, clinicaltrials.gov ID:NCT00466765) and other non-registered prospective trials involving fat grafting to the breast, no randomized controlled trials were identified during the literature search.
As the procedure continues to grow in demand, numerous surgeons are creating their own ‘signature’ or trademark procedure of the fat transfer breast augmentation. In reply to safety, proponents argue that sophisticated radiology and modern digital mammography equipment of today can better distinguish cancer cells from benign ones when examining dense breast tissue. Advocates state that fat grafting breast augmentation does not compromise accurate mammography readings any more than implants, and, in fact, most of them feel the procedure means far less mammographical compromise than implants. Opponents suggest more research is needed before concluding that the procedure’s benefits outweigh risks.
The process typically increases breast size by one cup size. Recovery time may be less than with traditional implants, as both the breast and donor site must heal. Patients need to have an adequate supply of excess fat for the procedure.
Opponents claim it can take longer for results to take shape after the procedure as opposed to implant procedures. There remains debate over how much of the transferred fat remains long term. Formal clinical trial evidence does not exist to suggest that fat grafting is safer or better than saline or silicone implants.
The American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) urge consumers to proceed carefully with any breast enhancement procedure.
As with all aesthetic surgical procedures, research the facts, I want to emphasize how important it is to consult only with a Board Certified Plastic Surgeon, compare the stratum of fat transfer breast augmentation procedures, and examine carefully all before and after procedure results.
Patty Kovacs, Editor-At-Large at Makemeheal.com, is a published author and beauty expert. Patty is the Executive Producer/Host of The Health and Beauty Revolution Show on wsRadio. Her 800+ interviews include over 450 New York Times best-selling authors. Patty
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