Fat taken from where you don’t want it and then applied to the places where it is highly desired – and desirable!

The patient's fat was used for breast augmentation. The after picture, right, was taken seven years later. PHOTO: Sydney Coleman, M.D.

In the United States, fat transfer to enlarge the breasts is getting more serious attention, according  to Denver’s Dr. David Broadway who blogs that the American Society of Plastic Surgeons’ task force on fat grafting has made a positive recommendation to surgeons about “proceeding with caution.”

However, for many decades, France, Brazil, Italy, Japan and a few other nations have been going full force ahead with breast enlargement, using the patient’s own fat instead of a breast implant.

Recently, two plastic surgeons, one French (Yves Gerard Illouz) and the other Brazilian ( Aris Sterodimas), studied 820 fat transfer breast augmentation patients from 1983 to 2007.

From the get-go, the surgeons admitted the procedures shortcomings:

• Transferred fat is often reabsorbed
• Fat sometimes dies and forms cysts of calcium
• The calcium can block mammograms and hide cancer

The 820 plastic surgery patients, ages 19 to 78, were divided into three groups of:

• Breast reconstruction patients with unbalanced breasts
• Patients born with uneven breasts
• Patients who just wanted breast augmentation

The subjects all signed consent forms outlining potential complications of injecting fat into the breasts.

Following the patients after their breast surgeries for 25 years and giving them mammograms at the six-month and one year points after the surgery, the doctors found:

• 12 hematomas, pooled blood under the skin
• 5 infections
• 76 cases of black, blue and purple bruising (ecchymosis)
• 34 cases of long term unbalanced (asymmetry) breasts
• 36 cases of striae, or off-colored stretch marks

Most complications showed up at the six-month point.

The doctors caution that the treatment has to be performed in stages with small quantities of prepared fat injected into the breasts at each session.

“The way to prevent complications is make sure the patient’s final result is not the aim of a single procedure,” wrote the doctors. Three sessions usually do the trick

According to the doctors, the procedure is predictable and satisfying as long as surgeons use at least three sessions.

(Read more about breast augmentation via fat transfer.)

Medically known as breast asymmetry,  Dr. Matas cautions new patients that surgical correction sometimes offers only a 60 percent improvement.

Asymmetry may occur during the teen years  while developing or through:

• Trauma
• Infections
• Burns
• After breast feeding

Plastic surgeons say the asymmetry can be visible in several different ways, including:

• A missing breast
• Different sizes
• Various shapes

The unbalanced bust line can cause extreme worry for teens who often become withdrawn. For younger patients, buying a bra or a prom dress is a terrible experience.

Adults may be inclined to back away from intimate situations because of embarrassment. Both groups suffer a loss of self-esteem and confidence with some becoming depressed over their physiology. They also shy away from anything to do with pool or beach wear.

The American Society of Plastic Surgeons studied 35 patients who had surgical breast asymmetry procedures. After six months, the researchers found all the study subjects had “statistically significant”  improvements in:

• Vitality
• Mental health
• Self-esteem

But what does a surgeon actually do to correct the appearance of unbalanced breasts? Plastic surgeons have three surgical procedures at their disposal, including:

• Breast lift
• Breast augmentation
• Breast reduction

“Even if breasts are different by less than a half-cup size, it can be very noticeable,” said plastic surgeon Walter Erhardt, M.D.

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