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May 6, 2008 (San Diego) --Transferring fat from the buttocks, hips, and thighs to augment the breasts may sound like pure fantasy to many women.
But the technique -- known as breast enhancement with fat grafts or lipoaugmentation -- is reality and shows promise, according to a panel of plastic surgeons speaking Saturday at the annual meeting of the American Society for Aesthetic Plastic Surgery in San Diego. Even so, they acknowledge that some concerns and questions remain to be resolved.
In addition to enhancing the breasts, the fat transfer technique can also help soften the edges of breast implants for more natural-looking breasts, improve the appearance of a breast reconstructed after a mastectomy, and help correct congenital breast deformities.
"It has a lot of amazing uses," says Sydney Coleman, MD, a New York City plastic surgeon with expertise in fat transfer techniques. Coleman, who was a speaker at the meeting, cautioned that the technique's success depends very much on the physician performing it.
There are other concerns about using fat grafts for augmentation, including questions about the long-term safety and effectiveness of the grafts and whether the injected fat makes breast cancer harder to detect on mammograms. When used for enhancement, the grafts typically add a cup size or less, which may not satisfy some women.
Fat cells are suctioned from one part of the body -- such as the hips or thighs -- and injected into the breasts with dozens of small injections.
"Each parcel of fat needs to be close to a blood supply" so the fat cells don't die, Coleman says.
Another option, also discussed at the meeting, involves the use of the Brava breast enhancement system followed by fat injections. A woman using the Brava system wears semi-rigid domes over the breasts for multiple hours each day for several weeks, with tension-induced growth of breast tissue the goal. Next, the fat injections are done to further increase the size.
Breast enhancement with transferred fat can cost $20,000, Coleman says. He acknowledges it's much higher than what is charged for breast augmentation with implants, but notes that it's actually two procedures.
The average surgeon's fees for breast augmentation is about $4,000 and for liposuction about $3,000 (plus facility fee and anesthesia charges), according to the American Society for Aesthetic Plastic Surgery.
How long the transferred fat will last is another unknown, he says, and will vary from one person to another. Doctors don't expect it to replace augmentation.
Even though fat grafting has been in practice for more than 20 years -- with surgeons now often using it to improve the appearance of faces and hands -- injecting the breasts for enhancement has sparked concern from some.