Fat injection (or lipofilling) has revolutionized breast reconstruction. It can be used as a complement to breast reconstruction or to perform a complete breast reconstruction solely through fat injection.
Fat is harvested through aesthetic liposuction from fat reserves (such as the saddlebag area, abdomen, and inner thighs). The fat is then centrifuged or allowed to settle, and washed with saline solution. The fat is then reinjected into the reconstructed breast.
The Brava method for breast reconstruction was developed by Dr. Khoury in Miami. In addition to fat grafting, this method involves placing a dome over the breast to be reconstructed. This dome provides constant suction, which helps to expand the tissues. The advantage of breast reconstruction using the Brava method is that it reduces the number of fat grafting sessions needed. Dr. Benjamin Sarfati has been performing breast reconstruction using the Brava method for several years.
Although breast reconstruction with fat grafting is covered by social security, the Brava device is not reimbursed by health insurance.
Fat injection techniques are quite recent. There are various methods for harvesting and “purifying” fat before injection. The quality of results depends on the quality of the patient’s fat and the recipient tissues.
The procedure is performed under general anesthesia in the operating room. The patient arrives in the morning of the surgery at the clinic and returns home the same day (outpatient surgery).
In 2014, the French National Authority for Health (Haute Autorité de Santé) convened a national committee of experts in breast surgery and fat injection (lipofilling). The objective was to establish best practice guidelines for this technique.
Dr. Benjamin Sarfati was part of this expert committee, and national recommendations were published in January 2015: “As part of reconstructive surgery following total mastectomy, contraindications for autologous adipose tissue grafting into the breast identified by the working group include:
It is necessary to wear a compression garment over the areas where fat was harvested for at least 15 days. Pain at the fat harvesting sites is very mild and can be relieved with standard painkillers.
LIPOFILLING RIGHT BREAST
Right breast reconstruction by fat injection alone (lipofilling) in 3 sessions.
LIPOFILLING RIGHT BREAST
Right breast reconstruction by fat injection alone (lipofilling) in 3 sessions.
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (side view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (three-quarter view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (front view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (front view).
Left mastectomy (breast removal)
With preservation of the areola and breast reconstruction solely through fat injections, 3 sessions were necessary to achieve satisfactory volume.
Left mastectomy (breast removal)
With preservation of the areola and breast reconstruction solely through fat injections, 3 sessions were necessary to achieve satisfactory volume.
Left mastectomy (breast removal)
With preservation of the areola and breast reconstruction solely through fat injections, 3 sessions were necessary to achieve satisfactory volume.
Breast reconstruction by fat injection
Correction of breast cancer surgery scars (tumor removal) by fat injection (2 sessions of lipofilling).
Breast reconstruction by fat injection
Correction of breast cancer surgery scars (tumor removal) by fat injection (2 sessions of lipofilling).
Breast reconstruction by fat injection
Secondary breast reconstruction with an “autologous” latissimus dorsi flap and fat injection (without implant) and a short scar on the back. Fat injection replaces the volume of the implant to achieve a natural and lasting result over time (front view).
Breast reconstruction by fat injection
Secondary breast reconstruction with an “autologous” latissimus dorsi flap and fat injection (without implant) and a short scar on the back. Fat injection replaces the volume of the implant to achieve a natural and lasting result over time (left three-quarter view).
Breast reconstruction by fat injection
Secondary breast reconstruction with an “autologous” latissimus dorsi flap and fat injection (without implant) and a short scar on the back. Fat injection replaces the volume of the implant to achieve a natural and lasting result over time (back view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (front view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (side view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (three-quarter view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (front view).
Total left breast reconstruction by fat injection (lipofilling).
Fat injection allows for a complete breast reconstruction with a very natural result, without additional scarring on the body (three-quarter view).
Breast reconstruction by fat injection
Left breast reconstruction with a latissimus dorsi flap and fat injection (without implant), this technique allows for a very natural, supple result, without foreign body and durable over time (right three-quarter view).
Reconstruction mammaire par injection de graisse
Breast reconstruction by fat injection
Breast reconstruction by fat injection
Left breast reconstruction with a latissimus dorsi flap and fat injection (without implant), this technique allows for a very natural, supple result, without foreign body and durable over time (left three-quarter view).
Breast reconstruction and fat grafting (lipofilling)
Immediate left breast reconstruction with a prepectoral implant and fat injection (lipofilling).
Breast reconstruction and fat grafting (lipofilling)
Immediate left breast reconstruction with a prepectoral implant and fat injection (lipofilling).
Breast reconstruction and fat grafting (lipofilling)
Immediate left breast reconstruction with a prepectoral implant and fat injection (lipofilling).
A portion of the grafted fat may be reabsorbed, typically between 10% and 20%, while the remainder will persist indefinitely. Final results stabilize within 2 months. Multiple sessions may be necessary to achieve the desired outcome.
DOCTOR BENJAMIN SARFATI
Specialist in breast surgery and intimate surgery
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