According to a new survery study published in Plastic and Reconstructive Surgery, 70% of US plastic surgeons have used fat grafting techniques for breast operations, but are more likely to use it for breast reconstruction rather than cosmetic breast surgery.
Once discouraged, fat grafting to the breast is an increasingly common technique, the study says. However, more data is needed to optimise the technique and outcomes for breast reconstruction, according to a published report from a team led by American Society of Plastic Surgeons (ASPS) Member Surgeon Dr J. Peter Rubin of University of Pittsburgh, and Russell Kling.
High rate of fat grafting for breast surgery
The researchers surveyed the ASPS membership on their use of fat grafting for breast surgery. In recent years, there has been renewed interest in techniques using the patient’s own fat for cosmetic and reconstructive breast surgery.
Four hundred fifty-six ASPS Member Surgeons responded to the survey. Overall, 70 plastic surgeons reported ever performing fat grafting to the breast, and 88% of those who currently perform fat grafting to the breast said they use it for breast reconstruction techniques, and often apply fat grafting along with implants or flap procedures. The surgeons found fat grafting particularly useful for improving the shape of the breast, including reconstruction after ‘lumpectomy’ for early-stage breast cancer.
Three quarters of surgeons performing fat grafting reported that the abdomen was their preferred site for obtaining fat for the procedure. The survey also provided information on techniques of harvesting and processing fat cells.
Potential obstacles to fat grafting techniques noted
There is a long history of debate over the use of fat grafting for plastic and reconstructive surgery of the breast. In the late 1980s, ASPS issued a strong statement against the use of this technique, citing the risk of difficulties in early diagnosis of breast cancer. However, more recent studies have reported that fat grafting to the breast provides very good results. Those studies also reported that changes seen on mammograms are easily distinguished from abnormalities related to breast cancer.
As with any surgical treatment, risks must be considered. Plastic surgeons responding to the survey viewed issues of interference with mammography and cancer screening as potential obstacles to fat grafting. Others cited problems with unpredictable results, including poor retention of the transplanted fat cells.
Despite concerns, the survey suggests that fat grafting to the breast is an increasingly popular procedure among US plastic surgeons. Almost 90% of the surgeons performing this procedure use fat grafting for breast reconstruction, with a smaller percentage also using the procedure for cosmetic breast surgery.
The study provides useful ‘benchmark’ data on the current use of breast fat grafting in the US. Dr Rubin and colleagues cite the need for further studies to establish optimal techniques for maximising fat graft retention and patient satisfaction with the results.
‘This study shows the increasing popularity of fat grafting to the breast, especially to benefit patients undergoing reconstructive procedures. As this field evolves, plastic surgeons will better understand the factors that lead to the best long-term outcomes,’ says Dr Rubin.