There has been much talk over the last few years about utilizing fat grafting or lipoinjections of fat for breast reconstruction and augmentation. Many patients given the choice would prefer to have breast tissue enhanced with their body’s own fat reserves, or something they deem natural, versus implantation, the current accepted method by the American Board of Plastic Surgeons. I have recently been spending more time watching and researching this topic to be able to share with patients the current medical findings.

The American Board of Plastic Surgery recently advised surgeons against fat injections for breast reconstruction and augmentation due to a number of factors. A primary reason for their hesitation to approve such a method is due to its lack of standardization. There has been no approved method for harvesting the fat cells to be used for augmentation – this has led the board to have greater concern for side effects like oil cysts, calcifications, and tissue scarring. There have also been more documented cases of prolonged inflammation and infection post fat injection augmentation. Most cases were resolved with antibiotic use, but the risk to the patient is greater.

Another concern from the board is fat reabsorption. In many cases, patients experienced significant loss of transferred tissue due to necrosis or reabsorption. Without initial overcorrection during surgery, change is size of breast tissue is much more common with grafting versus standard implantation. This knowledge could lead to mixed outcomes post surgery and more patient dissatisfaction at inconsistent results.

Lastly, a concern that’s of significant importance in my practice is that fat grafting could potentially interfere with breast cancer detection during mammogram screenings. I see many patients in my office for breast reconstruction and would want to be able to ensure that all my patients would not have to worry about potential obstruction to the technologies available to help with breast cancer detection.

In conclusion, these findings are not to say that breast reconstruction and augmentation through fat grafting will forever be unsafe, but I would caution patients to consider other options that have the highest level of safety and proven track record until we have more conclusive findings and standardization of this procedure. Communicate with your board certified plastic surgeon and discuss these options further as more study is given to this new alternative.

– Jeffrey W. Hall, M.D.
Hall Plastic Surgery & Rejuvenation Center