The first ever Composite Breast Workshop was held this past April just before the annual Aesthetic Meeting for the American Society for Aesthetic Plastic Surgery (ASAPS). The focus of the workshop for myself and some of the leading plastic surgeons from around the world was the combination of fat grafting and breast implants. Our main goal for the one-day workshop was to discuss the future of this treatment as it relates to breast augmentation, breast revision surgery, and breast reconstruction, and the needed shift in philosophy from a fat versus implants advantages versus disadvantages type of thought process, to the benefits of including some variation of fat and implants with each procedure.
The workshop was a very exciting and educational event, and represents the first time plastic surgeons have put together a full-day session to not only talk about fat transfers or breast implants, but the use of the two together. The realization many of us have come to is that we now have the ability to completely customize breast surgery to each patient, and the workshop was designed to help us better utilize fat to enhance the shape of the breast in conjunction with the use of an implant.
Breast Revision Presentation from Dr. Bucky
I presented on the role of fat grafting in repairing or improving aesthetic results, particularly with breast revision surgery. I discussed my experience with using large volume fat transfers to improve results or replace the need for an implant. Instead of having a patient with an implant problem and replacing the implants expecting an improved result, which is what we’ve done for years, we now have other modalities to create a better cosmetic outcome.
The particular benefit is apparent as we use fat to improve a patient’s soft tissues. In other words, not just exchanging the implants, but changing the environment where the implants are placed by using fat to create a pocket specifically shaped for the implant to suit the patient’s cosmetic goals. This is a whole new paradigm for breast surgery, a complete game changer for my patients, and anyone considering a breast enhancement procedure.
Traditionally, we’ve looked at patients who are very thin or who don’t have enough breast tissue, and approached the procedure with two choices: either go with a small implant to match their frame, or use a bigger implant and run the risk of the patient developing problems such as rippling or capsular contracture. What we discussed at the workshop was how to best add soft tissue around the implant to make that patient a better candidate for a larger implant to help them reach their goals.
We also discussed how to use fat transfers to shape the area to create a more natural looking result. With the addition of fat, we are able to modify the patient’s natural chest to go from an average candidate to a very good candidate for breast surgery. We can shape cleavage and create a more natural, tapered, softer feeling breast that’s not just skin and muscle over the implant.
Comprehensive Breast Procedures Are Here to Stay
While this procedure represents only roughly 5% of total breast surgeries at my Philadelphia plastic surgery practice right now, the number of procedures is increasing monthly. As this approach continues to gain acceptance and play a bigger role in successful outcomes, the technique will continue to gain in popularity.
Additionally, as BRAVA® continues to gain momentum, we’ll hear more and more about natural breast augmentation. This is an exciting technology, and an exciting time for someone like myself who is very interested in the latest plastic surgery technology and the role it can potentially play in safe, effective cosmetic enhancement for my patients.