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 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.

New fat grafting content up on our main website !

I’ve written and published some new content on our main plastic surgery practice website here. The new page outlines what fat grafting to the breast can achieve for cosmetic and reconstructive surgery patients. I’ve also got some new content on fat grafting on our breast augmentation website www.breastaugmentation-seattle.com. We are posting this content because of the growing interest in fat grafting to the breast, body and face at our Bellevue Washington clinic. Check it out !

Cosmetic Surgery Seminar in Bellevue WA- November 17 2010 6 PM

We are hosting our monthly plastic and cosmetic surgery seminar at the Naficy Rejuvenation Center here in Bellevue WA. This informal seminar is your opportunity to see a lot of before and after photos and learn about cosmetic surgical procedures. I do primarily breast and body cosmetic surgery, but any question you have about facial procedures, Botox and fillers, lasers etc. will also be answered. Topics I plan to discuss this month include post-bariatric procedures, such as body-lifts, arm lifts and thigh lifts. We will talk about fat grafting to the breast for augmentation and enhancement. We always talk about my favorite procedure- breast lifts. Other topics include Zeltiq and tummy tuck surgery. You can RSVP for this free seminar at 425-450-0880. Parking will be free. Wine and snacks are provided. November 17, 2010 @ 6 PM.

Register on-line !

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

Breast Augmentation and Reconstruction with Fat

Traditionally, breast augmentation and some types of breast reconstruction are done using breast implants. There is a revolution going on now in plastic surgery. We’re beginning to use fat with success in both cosmetic and reconstructive breast surgery.

These fat injection techniques rely on careful removal of body fat during a specialized liposuction procedure. The fat is then processed and placed into the breast. The result is a natural appearing breast augmentation with the added benefit of a comprehensive body liposuction procedure.

With the advent of the new field of fat grafting procedures for breast enhancement comes new companies eager to enter into this new market. Cytori is producing the Celution System, which is designed purify fat derived from liposuction. The system is designed to isolate the important adipose (fat) derived stem cells and prepare these stem cells fo injection into the breast.

It is debatable if this expensive piece of machinery is actually necessary to perform good quality fat injection procedures to the breast. Our clinic has been successfully using a fat grafting technique that does not rely on the expensive Cytori system. Our fat injection technique does not have the additional costs required to use an expensive disposable device like the Pure Graft system.

For women interested in breast augmentation for about one cup-size enhancement, a standard fat grafting procedure works well. For women interested in a larger breast augmentation, we recommend pre-expansion of the breast skin envelope with the BRAVA device.

For women that have undergone breast surgery for cancer, fat grafting procedures offer a new reconstructive option. Fat injections procedures can restore breast volume and shape altered by lumpectomy and radiation. A combination of BRAVA skin expansion and serial fat grafting procedures can restore an attractive breast shape to women that have had mastectomy surgery.

Check out www.breastaugmentation-surgery.com for more information about fat grafting, fat injection and lipo augmentation of the breast.