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Breast Reshaping with Fat

Dr Kourosh Tavakoli is Australia's Super Specialised Breast Surgeon
Dr Kourosh Tavakoli is Australia's Super Specialised Breast Surgeon
Dr Kourosh Tavakoli Member Of Australian Society Of Plastic Surgeons, International Society of Aesthetic Plastic Surgery, Australasian Society of Aesthetic Plastic Surgery, UNSW Australia, Fellow of the Royal Australasian College of Surgeons

Dr Tavakoli’s Principles in Fat Grafting in Breast Cosmetic and Reconstruction

Fat Grafting (Lipofilling) Technique has been around since the 1980s but has become far more refined in recent times.

In women with a small amount of breast tissue and body fat, Breast implants can become palpable at the edges and in some cases the implant edge can become visible in the cleavage area and lower pole of the breasts. In these cases, breast fat grafting is mostly used by Dr Tavakoli to treat women with extremely bony cleavages. It can also be used to avoid implant rippling and implant visibility; as such, it is a common and very popular procedure.

Dr Tavakoli also uses fat grafting in a second category of women who are not suitable candidates for breast implants. In this instance, the breast is reshaped with a combination of mastopexy and/or breast reduction followed by lipofilling to the upper pole of the breast. This creates upper pole fullness, avoiding the need for a breast implant. *It is important to note that in these cases, lipo-augmentation should be understood as a reshaping of the breast rather than increasing the size.

Indications

Fat Grafting Breast Augmentation Surgical ImageFat Grafting Breast Augmentation Surgical Image

  1. Fat grafting is used to correct slight breast asymmetry during Breast augmentation using implants. This is usually preferred to the use of  different size implants where possible, as the fat can be accurately targeted  & injected into the breast areas of uneven tissue thickness.
  2. Camouflage technique to cover up boney prominences over the sternum and pronounced ribs.
  3. Camouflage technique to provide coverage over rippling and wrinkling breast implants in thin patients with low upper body fat.
  4. Tuberous correction almost invariably utilises the Fat Grafting technique to bring symmetry and lower pole curvature.
  5. Create upper pole fullness in breast lift/reduction patients who wish to avoid an implant.

Lipoaugmentation During Breast Lift/Reduction

Technique: The fat is removed from the patients abdomen or thighs using gentle liposuction. The harvested fat is cleaned and processed through closed system and re-injected into the upper pole of the breast to remodel the shape and create upper pole fullness without the use of an implant.

Post-op Care: The area of liposuction is generally tender for up to 3 weeks. The fat grafted area is swollen and little tender and may get bruised.

Result: Up to 70% of the fat injected will "take" and gets incorporated into the body. This figure is much lower in smokers. The fat that is not incorporated is safely excreted by the kidneys with no harm.

Case Study 1: Breast Reduction with fat grafting to upper pole.
Total fat graft: 50mls (L) 30mls (R)

 Breast reduction with fat graft to upper pole Total fat: 125mls (L) 125mls (R)

Case Study 2: Breast reduction with fat graft to upper pole.
Total fat: 125mls (L) 125mls (R)



Fat Grafting During Breast Augmentation
Fat grafting during breast augmentation is a technique often utilised by Dr Tavakoli to camouflage a bony chest, provide implant coverage, correct asymmetry or to create shape and fullness in the lower pole of the breast in tuberous patients. In some cases, Dr Tavakoli is able to correct tuberous breasts with the use of a breast implant and fat grafting alone.

Technique: The fat is removed from the patient’s tummy, inner or outer thigh regions using very fine liposuction cannulas. The fat then gets prepared meticulously on a side table during surgery. The fat is loaded into 10ml syringes for injection into area of hollowness or rippling or asymmetry; the fat provides a fantastic coverage to the concerned area and disguises rippling and implant visibility. This procedure can be done during breast augmentation or at a later date.

  • Fat graft for breast surgery procedure - step 1
  • Fat graft for breast surgery procedure - step 2
  • Fat graft for breast surgery procedure - step 3
  • Fat graft for breast surgery procedure - step 4

Post-op Care: The area of liposuction is generally tender for up to 3 weeks. The fat grafted area is swollen and a little tender and may get bruised.

Result: Up to 70% of the fat injected will "take" and gets incorporated into the body. This figure is much lower in smokers. The fat that is not incorporated is safely excreted by the kidneys with no harm.

Thin breast augmentation needing external fat graft 30ml.Thin breast augmentation needing external fat graft 30ml.Case study 3: 30mls of fat grafting to camouflage hollow chest.

Case study 4: 26 yo female with bony cleavage. 395cc moderate plus anatomical textured gel implants placed in a dual plane plane pocket. 48 mls of fat transferred to the cleavage and sternum.

Case study 5: 25 yo female with bony cleavage and minimal body fat. 330cc high projecting anatomical textured gel implants placed in a dual plane pocket. 50 mls of fat transferred to the right breast.

Fat graft for breast contouring before
Case study 6:
Bony cleavage and hollow chest appearance, corrected with fat graft. Video filmed at 5 weeks post-op.


Case study 7:
Fat grafting to the lower pole for tuberous breast correction.