Fat Transfer to Breasts in Texas Clinical Cost & Safety Audit

The procedure known as fat transfer to breasts involves the surgical displacement of autologous fat from a donor site on the patient's body, in this case typically the lower body, to areas of the breast where augmentation is desired. The displaced adipose tissue is then re-implanted into the recipient site through a micro-fat transfer or traditional suction-assisted lipoplasty technique, using adipose tissue that has been centrifugally processed to maximize its fatty component and minimize the risk of adverse events.

Fat transfer to breasts offers an alternative to traditional breast augmentation using saline or silicone implants.

Anatomy

Understanding the anatomy of the breast is essential before commencing any surgical procedure aimed at augmenting its size and/or shape. The breast consists of glandular tissue, connective tissue, fatty tissue, and areolar tissue. The glandular tissue surrounds the ducts that are responsible for milk production during lactation. Connective tissue, consisting of fibrous strands, supports the glandular tissue. The main volume of the breast, however, is taken up by fatty tissue that varies in quantity among individuals. Ultimately, the appearance and shape of the breast are largely determined by factors such as fascial tension, and fat distribution within the dermal layers.

The autologous fat used in fat transfer procedures undergoes significant changes post-liposuction and before re-implantation into the recipient site, including apoptosis of dying adipocytes, followed by a secondary inflammatory response caused by trauma to the tissue at the time of liposuction. However, clinical experience suggests that when executed correctly, fat grafting procedures yield predictable, reliable results with low complication rates.

Procedure and Techniques

The fat transfer process begins with preparation of the donor site in the lower body, typically the abdomen or hips. This is followed by suction-assisted liposuction, during which an incision is made into the skin, and a cannula is inserted into the subcutaneous adipose tissue to mobilize it. Once the liposuction procedure has been completed, the autologous tissue is aspirated and centrifuged to separate out non-viable fatty and fibrotic tissue from the viable lipids in the solution. In a separate procedure, the recipient sites in the breast are prepared, usually through needle punctures in the dermal layers to create the target sites for viable lipocytes. The non-foaming fraction of the adipose tissue solution, which is typically abundant with viable lipids, is then injected through the dermal layers using a small-gauge cannula. Finally, massaging promotes equal distribution and adherence of the grafted tissue to provide increased fatty content within the recipient site.