The increase in breast volume by lipofilling consists of injecting one's own adipose tissue into the breast to correct a volume deemed insufficient.
The intervention can be proposed when the breasts have not developed sufficiently or when the breast volume has decreased following weight loss or pregnancy.
It can also be associated with the correction of the fall of the breast.
However, this surgery cannot be performed on thin, fat-free patients. It is sometimes necessary to practice a second intervention to perfect the result.
Lipofilling: a transfer of fat to the breast
This fat transfer technique is a very well codified procedure that has been used for many years in plastic surgery. Called by various authors lipostructure, liposculpture, lipomodeling or lipofilling of the breast, it consists of removing fat from a donor area (usually the stomach, hips or thighs) by liposuction and then reinjecting it with fine cannulas after purification. Spontaneous resorption of approximately 40% of the injected mass occurs, explaining the need for over-correction. The result obtained around the 6th month is final.
Currently no scientific argument suggests that the transfer of fat can promote the appearance of breast cancer. However, it is important not to perform this surgery on a patient with a latent tumor. This is why it is requested to carry out an imaging assessment (mammography and ultrasound) preoperatively and to carry out monitoring at one year and then at two years. During this monitoring, calcifications may be discovered. If in doubt, a biopsy will be performed. It is therefore advisable to reserve this type of surgery for a woman with a minimal family cancer risk.
Fat transfer is not indicated for all breast augmentations. It is reserved for women who want a moderate increase and have sufficient fat. This surgery can be performed alone, in addition to an augmentation by prosthesis or associated with a cure for ptosis (breast lift).
How is breast augmentation by lipofilling performed?
The purpose of the operation is to perform an injection of fat into the breast after removing it from where it is in excess.
The fatty tissue is removed by liposuction in a gentle and atraumatic way. After purification, the cellular part of the fat removed is reinjected as a topping using small cannulas through punctiform skin incisions.
The procedure is usually performed under general anesthesia. A short hospital stay of one day or one night is sufficient.
How does lipofilling take place?
The initial consultation
During the initial consultation, you will be offered the different surgical methods that may be suitable for you. A quote will be given to you. This cosmetic surgery cannot be covered by health insurance.
Before the intervention
The anesthesiologist will be consulted less than a month before the intervention.
The radiological assessment (mammography and ultrasound) is carried out by a radiologist specialized in breast imaging. This same radiologist will, if possible, carry out follow-up examinations after surgery.
No medication containing aspirin should be taken within 15 days prior to the operation.
It is imperative to stop smoking at least two months before the surgery, tobacco being a factor in the failure of the adipocyte graft.
It is imperative to remain on an empty stomach (do not eat or drink anything) during the 6 hours preceding the operation.
Before the surgical act and the two preceding days, an antiseptic soap will be used for the shower.
After the procedure
The postoperative course is generally painless. Edema at the donor site and the recipient site is often significant and generally takes between 15 and 20 days to disappear. Any bruises are visible for one to three weeks. Sun exposure is contraindicated during this period.
After significant liposuction, a marked feeling of fatigue can be felt over a period of 10 to 15 days. The resumption of a professional activity is possible after one week and of a sports activity after 4 weeks.
There is a slow resorption of fat which stabilizes around the 6th month. It is on this date that the final result can be assessed. A 2nd breast lipofilling session can then be considered in order to optimize the result (in shape or volume). The costs incurred are identical to the first session.
The fatty tissue graft is definitive and the grafted volume follows the variations in volume linked to changes in weight. In case of weight loss, the volume of the breasts will decrease and in case of weight gain, the volume will increase.
The final result of liposuction is also appreciated from the 6th month.
A follow-up consultation will be necessary at 3 months, 6 months and one year. A radiological assessment identical to the initial assessment will be carried out at 1 year and then at 2 years.
What are the risks associated with breast augmentation by lipofilling?
Any surgical procedure, even carried out with competence in conditions of maximum security, carries a risk of complication. There are risks of reaction to anesthesia. You should know that the anesthetic techniques, the products used and the monitoring methods have made immense progress. They offer optimal safety, especially when the intervention is performed outside of the emergency room and on a healthy person, but they nevertheless carry the risk of serious complications.
An infection of the injected fat can occur exceptionally. Antibiotic treatment may be used. In case of collection, a surgical evacuation can be carried out resulting in a scar of one or two centimeters.
A pneumothorax can occur even more exceptionally, possibly requiring surgical drainage.
Oily cysts may appear in the breast during the procedure. The technical term is a cytosteatonecrosis nodule. Totally benign, it can be confirmed by an ultrasound and evacuated by a simple puncture.
Imperfections of results can be observed (asymmetry, irregularities). They can be corrected by another intervention from the 6th month.
As far as liposuction is concerned, the procedure usually presents very little risk. The risk increases with the volume of fat removed and the number of areas treated during the same operation.
The most important complication is the migration into the bloodstream of a clot from a vein in the lower limb (phlebitis) to the lungs (pulmonary embolism). This complication can, when it is massive, lead to death. Wearing stockings with varicose veins, getting up early and possible anticoagulant treatment can prevent this risk. Hematomas and infections are rare.
The scars are small in size and usually hidden in the natural folds. Imperfections in results are not absent after liposuction. The result may show asymmetries. Sometimes an additional intervention may be necessary.