Fat grafting was featured in several sessions at the annual meeting of the American Society of Plastic Surgeons in Seattle last month. I attended a teaching course on fat grafting for breast augmentation and reconstruction. This appears to be both feasible and effective. Long-lasting results were shown with augmentations of over 300 cc’s, in one or more grafting sessions. Current investigations continue on the most reliable methods of fat grafting, the long-term safety of fat grafting for augmentation, and the possibility of lipid cysts that would be picked up on mammograms or by physical exam, leading to possible biopsies. It seems that radiologists should be able to distinguish these cysts or calcifications after fat grafting from the appearance of breast cancer calcifications.
We also saw excellent results in breast reconstruction after mastectomy or radiation therapy, even when the skin or scar is tight or damaged. The stem cells in fat seem to transform the abnormal tissue back toward normal appearance and pliability. To loosen the tissue, an external expander called the Brava device is worn for 4-6 weeks. This stretches the skin and allows space for fat to be placed. After several sessions of this, a new breast can be built out of a woman’s fat without the need for an implant or flaps. Women who have mastectomy defects from lumpectomy and radiation can have these reconstructed with fat grafts instead of muscle or abdominal flaps. Expect to hear a lot about this in the coming year.
