There have been numerous major innovations in breast reconstruction over the last quarter century that have paved the way for dramatic improvements in the final results. Starting with tissue expanders that are designed to stretch out the chest wall tissues in order to accommodate breast implants, to a multitude of microsurgical tissue transfers options (taking tissue from other areas of the body to use to reconstruct the breast) and even tissue transplantations (ADM’s or acellular dermal matrices) that allow for support, finesse and greater predictability of the breast reconstruction endeavor.
We can now add one more major breast reconstruction advancement to these: fat grafting.
There has been a prudent hesitancy for years in the plastic surgery community regarding the usage of fat grafting in the breasts – and for good reason. The first concern was that injecting fat grafts into the breasts could cause pathological changes that might make it difficult discerning between benign and cancerous findings on mammograms. This could then lead either to missed diagnoses of breast cancers or unnecessary breast biopsies in order to determine the nature of the mammographic findings – benign or malignant.
The second major concern was the possibility that some of the injected fat cells could increase the risk of the development or recurrence of breast cancer. There was some previous non-human research that had suggested this possibility.
Fortunately, extensive research and clinical studies have shown that these two areas of concern are, in fact, non-issues. Non factors.
Radiologists can discern whether specific changes in the breasts on mammogram are of a benign or malignant nature. As for stimulating new breast cancers, there is no evidence in humans that fat grafting will lead to an increase risk of breast cancer or its recurrence.
So what will fat grafting in breast reconstruction accomplish?
Fat grafting adds volume which can be used to further reshape a reconstructed breast to a more refined, desirable one. It can allow for creation of a more conical result as compared to the fairly common flat shaped ones that usually eventuate from many reconstructive approaches. Fat injections can also add some strategic increase in breast projection as well as fill in contour irregularities following reconstruction. They can also allow for more natural, smoother transitions with the surrounding tissues. Finally, fat grafts have also been shown to increase the quality of the overlying skin which can be a major positive benefit in those who have undergone radiation treatment.
So, with fat injections to the breasts we have even better, more natural reconstructed breasts AND liposuction of one or more areas to harvest the fat.
It’s a real win-win situation for those women who could use a little more luck, happiness and improvement of self-esteem in their lives.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona