Augmentation using lipofilling
Because breast tissues are made of a mammary gland and fat, lipofilling increases breast volume. The procedure consists in harvesting fat tissue from the flanks or the abdomen, centrifuging and purifying the fat tissue in order to graft it into the chest area. The injected fat cells react as a fat tissue graft and the result is permanent.
The procedure is recommended with the following previsions:
- Patient under 35 years old
- No personal or family history of breast cancer.
- Normal preoperative examinations (mammography, ultrasound and MRI).
- Necessary quantity of adipose tissue available: in order to add one cup size to both breasts, at least 300 cc of adipose tissue are required for each breast. This means that at least 1 liter of fat must be harvested in order to obtain 600 cc of purified fat cells.
In the case of implants situated in front of the pectoral muscle, lipofilling of the cleavage may be necessary in order to hide the upper part of the implant. It usually requires less than 150 cc of adipose tissue and can be performed on a thin patient.
Preoperative preparation
The preoperative preparation implies 2 mandatory consultations, a radiological check-up with mammography, ultrasound and MRI.
Smoking must be avoided because it reduces the vascularization of the tissues and does not favor a good engraftment.
The procedure
The surgery is performed under general anesthesia, and takes between 2 and 3 hours. It is carried out in a day-hospital surgical facility, and the patient is dismissed on the same day.
The incisions for liposuction are very discrete. As the fat which has been suctioned is filtered, centrifuged and purified before being injected through very thin cannulas, the procedure leaves no marks on the chest.
After the procedure
In order to secure the donor sites, a pressure garment is placed after the surgery and must be worn for a period of 1 month. A compressive dressing will secure the breasts during the first 4 days and will be replaced by a soft medical bra which will be worn day and night for a period of 1 month.
Please be aware that major edema will appear in the treated areas but it will disappear within a period of 2 months following the surgery. It is important that patients maintain a stable body weight, since the adipose tissue grafted into the breast will be sensitive to weight fluctuations. The definitive volume and skin retraction will become stable within 6 months after treatment.
The first shower is permitted the day after the surgery, but baths should be avoided during the first month. The scars need to be protected from the sun during the first year after the surgery in each and every case!
Frequently Asked Questions
How many cup sizes does it increase?
A single breast lipofilling procedure ranges from simply reshaping the breast to an increase of one cup size. Immediately after the procedure, the chest will show edema (swelling) due to the operation. This edema will dissipate and disappear completely within three to six months. That’s why we can’t assess the final result until then.
Do I have to do several sessions?
It depends on the result you want and the amount of fat available in other areas of the body.
If you want an augmentation in volume of one cup size or more, several sessions may be required (generally two), scheduled at least six months apart.
But sometimes thin patients, with little fat available, cannot have a second lipofilling procedure because no more fatty tissue is left to use. Patients in this case are informed of the maximum possible result.
How much does a breast lipofilling cost? Is it reimbursed by health insurance?
The price depends on the amount of fat to be taken, because the liposuction is what actually takes a lot of time. To avoid damaging the skin and protect the fat to be injected, liposuction must be performed gently with a very fine cannula (a sort of tube used to suction the fat). That takes time, and the more areas there are to suction and fat to be removed, the longer the liposuction takes. So the price can vary a lot from one case to another (between €6,000 and €8,000). An exact amount can only be determined after a consultation.
As with breast implants, lipofilling can sometimes be partially covered by insurance in cases of breast reconstruction after cancer or breast deformities (tuberous breasts or Poland syndrome).
What are the advantages and disadvantages of lipofilling?
The main advantage of lipofilling is that it doesn’t involve an implant, so no foreign body. There is no risk of infection or capsular contracture. The result is final (excluding cases of significant weight loss). There is no need for a follow-up procedure to change the implant, because there isn’t one. Lipofilling is a totally natural procedure.
Plus, by taking fat from areas where it is in excess and injecting it in areas where there isn’t enough, lipofilling contributes to balancing out body shape, which optimizes the results.
The disadvantages of lipofilling are mainly that you may need a second procedure to achieve the result you want, and that augmentation may be limited due to the amount of fat that can be removed.
Can I still breastfeed after a breast lipofilling?
Of course, because the milk ducts needed for breastfeeding remain perfectly intact. Breast tissue is exactly the same but with more volume.
What are the potential complications after lipofilling?
Potential complications with lipofilling primarily concern the liposuction. General complications are rare but possible (phlebitis, pulmonary embolism). The main issue is potential imperfections in the appearance of areas where fat is removed, resulting in a “lumpy” effect. That’s why it is essential to use a very fine cannula and to suction gently.
The main complication in the chest area is cytosteatonecrosis, or death of fat cells injected. A sort of hardened ball forms in the breast, and the fat cells that don’t survive can become infected. To keep that from happening, fat injection procedures must be followed perfectly. And in that case, post-operative recovery is simple. Antibiotics are always prescribed for a few days after surgery to prevent infection.
