Fat grafting to breast for reconstruction found to be safe in controlled clinical trial

An academic paper was published recently in the medical journal Annals of Oncology documenting an important safety factor for the fat grafting procedure. The full journal article can be read here…

[1] “Locoregional recurrence risk after lipofilling in breast cancer patients”.
Annals of Oncology doi:10.1093/annonc/mdr158

One criticism of fat grafting (referred to as ‘lipofilling’ in the paper) to the breast for both reconstructive and cosmetic purposes has been the behavior of the transplanted fat derived stem cells. There has been concern that stem cells transplanted into the breast might ‘turn on’ cellular signals that make otherwise normal breast tissue turn into cancer. This concern was raised many years ago, and is part of the basis for the American Society of Plastic Surgery’s hesitancy to support the procedure (until very recently). However, clinical papers published within the past two years that have looked at large numbers of patients that have had fat grafting to the breast have not supported these, and other concerns about fat grafting to the breast.

This recent paper, out of the European Institute of Oncology, fails to show an increase in breast cancer recurrence amongst women that have had breast cancer procedures such as lumpectomy, quadrentectomy and mastectomy and also had breast reconstruction using fat grafting techniques.  This case-control clinical study compared the fat grafting group to a large cohort of breast cancer patients that received breast cancer surgery without a fat grafting reconstructive procedure.

The natural history of invasive breast cancer treated with all type of breast cancer surgery is a local recurrence rate of about 5%. This study fails to show an increase in local recurrence rates of invasive breast cancer amongst women who, on average, were 56 months (4.6 years) post-op from cancer surgery and 26 months (2.1 years) post-op from fat grafting. This is encouraging news !!

Of course, longer term follow-up studies are needed (5 years, 10 years, 15 years). At least for the short and medium terms, fat grafting to the breast does not appear to result in increased local recurrence rates for invasive breast cancer who undergo fat grafting as part of their breast reconstruction procedure.

We offer fat grafting to the breast for cosmetic and reconstructive purposes, and will continue to do so, based on encouraging clinical results such as this one.

Cosmetic Surgery Seminar with Dr. Scott Sattler in Bellevue WA, Feb 23 @ 6 PM

Wednesday, February 23, 2011 – 6-7 PM

You are invited to attend a cosmetic surgery seminar on Wednesday February 23 at 6 PM, with Dr. Scott Sattler – a double board certified plastic surgeon practicing in Bellevue WA. Join us for this free event at the Naficy Rejuvenation Center. Dr. Sattler will be speaking on a broad array of topics, including breast augmentation surgery, fat transfer procedures, laser liposuction, abdominoplasty, Zeltiq and injectable fillers and Botox.

These monthly seminars are a great way to meet our staff and review a lot of before and after photos of procedures that you are interested in. The seminar is designed to be an open forum, so bring your plastic surgery questions.

Light snacks and drinks are provided. Parking is free.

A free cosmetic consultation in our clinic is offered to each seminar attendee at a later date – bring your calendars – we will be scheduling these appointments after the seminar.

RSVP by calling 425-450-0880 and reserve your spot in this educational seminar.

Breast implant sizing is important for a natural augmentation result

Here in the Pacific Northwest, women considering breast augmentation surgery are looking for a ‘natural’ result. We hear this all the time from our breast augmentation patients. ‘I want to look natural’. What does this mean?  There is nothing natural about a breast augmentation using a silicone or saline implant. (We can augment the breast with natural fat, but that’s a different topic…) So for patients interested in restoring breast volume, or enhancing their current breast shape with an implant, we can deliver a ‘natural’ result with some careful pre-operative planning.

What are factors that are important for a  natural breast augmentation appearance? Let’s look at an example.

Before breast augmentation

After augmentation with 300 cc saline implant

Implant selection for this patient was based on the width of the breast’s existing footprint (the base width of the breast). Volume of the implant was determined by the patient’s desire to look natural, and the amount of breast tissue ‘stretch’ the patient exhibited. In the operating room, the implant was placed through an incision along the bottom of the areola. The fold beneath the breast was surgically lowered to give the breast a more ideal shape. The nipple position remained exactly the same.  It was not moved. The bottom of the breast was lowered to center the nipple over the implant’s foot print.

The post-op photo was taken 15 months after surgery. You can barely see the surgical scar at the edge of the areola.

After breast augmentation

In the photo the the left, you’ll notice the very gentle transition from the upper chest wall onto the breast itself. This smooth transition is another hallmark of a very natural, attractive breast augmentation result. It is achieved by paying attention to the diameter and projection of the implant. Larger implants tend to create a very rounded upper pole, which has a ‘fake’ appearance. Typically, I use implants on the ‘smaller’ side. I think, long-term, smaller implants in the submuscular or dual-plane position will look better and more natural. I prefer silicone implants in most patients, but as you can see, beautiful results can be achieved with saline breast implants.

 

 

 

 

If you’ve read this blog post to this point, you are likely to be interested in how a similar breast augmentation result can be achieved in your case. Give our clinic a call at 425-450-0880 or www.breastaugmentation-seattle.com and schedule a consult with me and our cosmetic breast-care team.

New Seattle Breast Lift website goes live

Dr. Sattler’s new Seattle Breast Lift website goes live  !!

Our Bellevue breast lift practice has grown considerably over the past couple of years. We now see several patients per week interested in breast lift procedures. I’ve condensed what I have learned from these patients, and my growing experience in breast lift (mastopexy) surgery into a new website. The Seattle breast lift website reviews important information about breast lift surgery. Read new content about mastopexy-augmentation, vertical breast lifting, fat grafting and auto-augmentation techniques. Lots of before and after photos too. Check it out !

www.Breastlift-seattle.com

Breast Lift and Augmentation Surgery – the combo can be ideal

The combination of breast lift (mastopexy) surgery with breast augmentation can be tricky to plan and execute effectively for patients. The two operations do separate, but opposite things to the breast- the breast lift tightens and lifts the breast while the breast implant adds volume. Getting the procedure right the first time takes surgical judgement and experience.

For women, a combined breast lift and augmentation can be the ideal solution to their cosmetic breast issues. It’s a one-stop solution to both sagging and volume.

As surgeons, we know that this combination breast surgery can be challenging. It has a fairly high revision rate. There are complications that can occur at a higher rate than if each procedure was done separately.

Based on my experience with breast augmentation and lift combination surgery, I’ve made the following observations that I can pass along to patients.

1. A smaller breast implant is recommended, as the implant is only going to contribute upper pole volume to the breast.

2. Commit to the set of breast scars that are going to produce the most reliable lift of the nipple. A ‘short scar’ breast lift is sometimes the wrong lift for a patient.

3. Consider eliminating the artificial implant altogether and do fat grafting. This technique uses your own fat (from liposuction) for breast augmentation. A breast lift with fat grafting is called a LipoPexy- more information can be found about breast fat grafting here.

4. If you have enough breast tissue in the lower pole of the breast, that tissue can be moved into the upper pole of the breast as an auto-augmentation flap- which improves breast shaping and contributes a little to upper pole volume.

An example….

Before mastopexy augmentation

After mastopexy augmentation

 

This woman had a simultaneous breast augmentation with a 300 cc  submuscular silicone implant, a peri-areolar breast lift and areolar reduction. The scar is limited to around the areola. Her ‘after’ photo is taken 3 months after surgery. She’s very happy with the result.

We can deliver these types of result to you as well.

Call our clinic at 425-450-0880 to schedule a consultation.

Tissue engineering for the Breast- in November 2010 Wired Magazine

As a follow-up to my post on fat grafting to the breast for cosmetic enhancement and reconstruction I’m posting the link to Wired magazine’s article on Cytori and the strides its making to bring a adipose (fat) derived stem cell transfer technology to the US market.

Check out an excerpt of the article here

The term ‘disruptive innovation’ was used in the article- this is a particularly apt description for what fat grafting techniques are poised to do in cosmetic and reconstructive breast surgery. We have all been doing breast procedures for so long that we have focussed time and creative energy into producing a better silicone breast implant. Its time to rethink the paradigm and apply principles of tissue engineering to the breast.

Whether or not ‘stem cells’ are truly an important part of the process is still debatable. But clearly, the transfer of a viable graft a fat to the breast as a living volume filler is a reality.

Harvesting and processing techniques are important.
Tissue pre-expansion is important.
Stem cells are probably participants in this process.

Fat grafting will shortly become an absolute game-changer in the realm of cosmetic and reconstructive breast surgery.

I’m pleased to be working on refining the fat grafting techniques that we offer to breast enhancement and reconstruction patients. Stay tuned for more about this exciting niche of plastic surgery.

www.breastaugmentation-seattle.com

All Natural Augmentation : Fat Grafting to the Breast for Augmentation and Enhancement

Our clinic is now offering fat grafting to the breast for augmentation and enhancement. This procedure is coupled with a comprehensive body liposuction procedure. No implant is required for this new breast augmentation technique.

Dr. Sattler is one of the few surgeons in the Pacific Northwest to offer the Lipo Augmentation procedure. The technique requires technical expertise in fat injection to the breast and special preparation of the fat prior to injection.

The fat grafting technique can be used to perform a primary breast augmentation, or to enhance an existing breast augmentation, as seen in the photographs shown below.

The results we’ve seen in our patients have been very natural and beautiful.

Call our clinic or check out the website for more information on all-natural Breat Augmentation with fat grafting.

www.breastaugmentation-seattle.com
425-450-0880

Before fat grafting to the breast

After fat grafting to the breast

Seattle Summer Liposuction Specials with Dr. Scott Sattler in Bellevue WA

Summer is here – its time to get ready!

I’m offering some great package pricing on Liposuction Procedures for the rest of the summer.

All prices are include anesthesia and facility fees- no hidden costs!

Body Contouring Packages

Full Abdomen (upper & lower)                      $3375

Full Abdomen and Love-Handles                 $4950

Thighs (circumferential)                                   $4950

Arms                                                                                  $4950

Male Liposuction (full abdomen, pecs and LH) $5500

These regions can also be combined with other procedures such as  breast augmentation, tummy tuck, fat grafting to the breast,  and facial procedures.

Prices Include:

• Surgical and Facility Fees
• Anesthesia Fees
• Compression Garment
• All Follow-up Visits with Dr. Sattler

Liposuction is a surgical procedure. Patient safety during your liposuction procedure is our highest priority.

Our patients are cared for in our on-site Medicare and WA State certified Ambulatory Surgery Center. For maximum patient comfort, your liposuction procedure is done under ‘twilight anesthesia’ under the direction of a certified anesthesia provider. Your surgical procedure is performed by Scott Sattler MD FACS, a double-board certified plastic surgeon from Bellevue WA, licensed in WA state.

Call 425-450-0880 to book a consultation.

Visit our new liposuction website www.necklipo.com to schedule a consultation and view before and after photos of liposuction patients.

Timing Tips for Summer Time Cosmetic Surgery

We all want to feel beach and boat-ready for the summer.

Based on my experience with cosmetic surgery recovery times, here are some tips about when to schedule that breast lift, breast augmentation, liposuction or mommy-makeover surgery you’ve been thinking about- and be ready for summer bikini weather!

Breast Augmentation- it takes a few weeks for the implants to ‘drop’ into position. Schedule surgery now, and you will be bikini ready in 3 weeks. Early July if you scheduled in early to mid June.

Breast Lift: Recovery is quick if no implant is used. You’ll be bikini ready by late June if you scheduled now.

Tummy Tuck: a full tummy tuck has a 2 week recovery. Sometimes longer. If you are fit and motivated, plan on being bikini-ready (with a very low and well concealed scar) one month after surgery. If you scheduled in June, you could hit the beach feeling great by early August.

Liposuction: Recovery is very quick, but I ask patients to wear a compressive garment (kind of like Spanx) for two weeks. You could hit the beach two weeks after the procedure. Liposuction results progressively improve over several months as the skin retracts.

Before Breast Augmentation

Four weeks after breast augmentation surgery

May 19 6 PM :: Plastic Surgery Seminar :: Naficy Center in Bellevue

We’re holding our next monthly seminar on cosmetic surgery on May 19th at 6 PM at the Naficy Plastic Surgery Center in Bellevue WA. This is a free informational seminar – we discuss what’s new and innovative in cosmetic surgery. Bring your questions and prepare for a fun hour discussing my favorite topic : Cosmetic Surgery !! RSVP at 425-450-0880 or go online www.seattleface,com to register for the seminar. Topics for next month’s seminar include breast augmentation with fat (lipo augmentation), body contouring after massive weight loss,, Zeltiq cryolipolysis, and innovative breast lift (mastopexy) techniques.