Lipomodelling/Fat Transfer

To naturally enhance the volume or improve irregularities anywhere in the body. It is commonly used as an adjunct to other cosmetic or reconstructive breast surgery, to enhance the cleavage and upper pole areas. In selected cases, it can also be used as the sole modality to augment breasts in a ‘vegan’, implant free approach.

Not all the fat that is transferred survives in its new position. Once the amount that is retained settles and regains a blood supply, then the results are long lasting. Taking into consideration that only about 60% of transferred fat survives, I always slightly ‘over’ graft to account for this loss. I use the Revolve system, which is designed to optimise this process and ensure the maximum amount of fat survival. Success of this procedure can adversely be affected by smoking, non-steroidal painkillers like ibuprofen and considerable excess grafting. Once the transferred fat survives, it then responds to normal weight fluctuations like any other body fat. It is therefore advisable for patients to be of a stable weight before this procedure, for more predictable and longer lasting results.

Depending on the degree of liposuction and fat transfer, the surgery takes between 2 and 2.5 hours.

There is always some discomfort associated with this procedure. It varies between individuals and depends on the volume of fat that needs to be transferred and the number of areas used for liposuction. Local anaesthetic solution is used during the surgery and oral pain killers post operatively. Overall you should not experience any sharp pain, rather a dull ache for the first few days after the operation.

Application of a compression garment to the liposuction areas, is vital for your recovery, comfort and to prevent complications. It will reduce swelling in the area, reduce pain and allow for effective skin retraction. The garment must be worn for a minimum of 6 weeks day and night. If the fat has been transferred to the breasts as a sole procedure, an additional supportive sports bra will be adequate.

Patients usually recover quickly following this procedure. You should expect to be back to normal daily activities within one week to ten days. Swelling can persist for up to 6 weeks and heavy exercise is not recommended for about a month. You are also advised to avoid hot baths for the first couple of weeks following this surgery. Please visit the liposuction page for a more detailed description.

These include some discomfort, risk of infection, risk of bleeding, degrees of asymmetry, prolonged swelling, unevenness, fat necrosis and poor fat survival. There is also a very rare risk of fat embolism, a potentially serious complication, mainly relating to Brazilian buttock lifts, which is not something I offer or recommend. Fat embolism occurs when, the fat that is injected directly enters the bloodstream and causes systemic complications. These include fat entering the lungs or brain tissue, causing a pulmonary embolism or stroke. This can happen with deep fat injections in the buttock muscles, where large blood vessels exist. This risk is minimal when fat is injected in the breasts, as there are no such large vessels in the area. Fat contains a large number of stem cells, which are undifferentiated and have the potential of becoming any tissue in the body. This is one of the advantages of fat grafting, as it can improve skin quality and even rejuvenate scarring. However, when fat is introduced into breasts, there is a theoretical risk that these stem cells could also promote or accelerate any existing breast cancer. It is therefore imperative, that your breasts are examined thoroughly for lumps, a careful family history of breast cancer is taken and special investigations are performed. For anyone over the age of 40 considering this procedure, a mammogram will be mandatory. With all procedures involving liposuction, there is always a risk of unevenness in the areas where the fat is removed. Power assisted liposuction is used, for a smoother less aggressive fat removal, leading to less bruising, swelling and increased fat graft survival. The degree to which grafted fat survives is reduced by factors such as smoking (which reduces the blood supply to all tissues in the body) and medication such as non-steroidal anti-inflammatory drugs, like ibuprofen. If fat grafting is used as the sole modality for cosmetic breast augmentation, a mild to moderate change and a natural result should be expected. There has to be available fat elsewhere (donor sites), for the procedure to be feasible and this sometimes needs to be repeated for extra volume. It is impossible to create very large breasts just with lipofilling and as a rule of thumb, 150cc of transferred fat will enhance breasts by only one cup size. In my experience if much more than 200cc are injected per side, then there is a significant risk of fat loss and fat necrosis. The unpredictability of fat survival makes this procedure unsuitable for those that require a considerable enhancement and a silicone implant might be the better choice.