In the upcoming issue of Plastic and Reconstructive Surgery, Dr. Roger Khouri and associates give us an update on their experience with fat transfer to the breast for the purposes of breast augmentation. The bottom line: as long as you use the Brava system for several weeks beforehand, fat transfer works pretty well.
In the study, 81 patients used the Brava for 4 weeks before surgery, then had their own fat transferred with liposuction harvesting to the breast. They then wore the Brava post-op for at least a week. An average of 277 ml per breast was used - which, compared to typical breast implants, is a pretty conservative volume. The patients were followed for an average of 3.7 years postoperatively.
Based on MRI data, they found about 82% graft survival, which was much better than earlier studies in which the Brava system was not used, where the average fat graft survival was 55%. Also, the better the pre-expansion was with Brava prior to surgery, the better the results. There were no suspicious breast masses or nodules during the follow-up period.
These results are pretty much the same as what Drs. Khouri and delVecchio presented at last year's breast surgery conference in Boston. But now the data has gone through the formal peer review process.
I'm a fan of this technique. As a plastic surgeon, it's exciting to build something out of nothing - or in this case, build a breast out of otherwise unwanted fat. Plus, the patient gets the benefit of the contouring from the liposuction at the fat donor site. We're still working on methods to streamline and standardize the operation, but it does work. Wearing the Brava really does help the fat to survive, and our early experience with this method has been very promising.
But wearing the Brava system isn't easy or comfortable - it certainly does require a solid commitment from the patient, to wear it 10 hours a day, every day for the required time - so it's not for everybody. The surgery is more expensive than an implant surgery. Also, if you want more than a cup size increase, or the high-profile implant look, implants are currently still the better choice. With fat grafting, however, there's no worries about implant deflation or capsular contractures - and that can be pretty appealing for the right patient.
