Lipoinfiltration, or autogenous transfer of fat from another part of the body to the breasts, is a highly controversial technique practiced by some cosmetic doctors in Asia with claims of breast enlargement using “your own natural tissue”.
Like “liposculpture” of the face, in which fat from elsewhere on the body is harvested, processed and then reinjected into the face to recreate the contours of youth, fat injections to the breasts are an attractive proposition.
However there are several problems with this technique. Firstly, the fat that is transferred can dissolve with time, leading to unequal sized breasts in which case the procedure has to be repeated; or, it could clump, forming lumps and masses.
Some of the fat cells can even die and become infected, leading to open wounds on the breasts. Worse, some of the fat may become calcified, forming little lumps which are difficult to distinguish from a breast cancer. This is particularly worrying as it complicates the interpretation of mammograms and makes it difficult for a surgeon to decide whether to operate or not.
As a result, most board-certified plastic surgeons will not perform this procedure on their patients. In Australia, fat transfer to the breasts is a no-no and the Royal Australasian College of Surgeons has advised members against the operation.
Unfortunately, there are many doctors around the world who are not bona fide plastic surgeons but who perform cosmetic procedures, including this technique. I would caution prospective breast augmentation patients to think carefully before making a decision.
Perhaps in future, the technique will become more predictable and safer.
Currently, however, the gold standard for breast enlargement is still the use of implants. The results are predictable, stable and uniformly satisfying. Even complications such as ripples, capsule formation, infection, bruises and lopsidedness are known and easily treated.
Severe complications such as implant rupture and extrusion are uncommon if the procedure has been performed by a properly-trained plastic surgeon.
The implants can be either saline or silicone filled, and can be placed behind the breast itself or behind the chest muscle. The usual access routes are via a cut in the armpit, under the breast, or around the areola – the last one mimics the irregular nature of this area and thus makes the scar unnoticeable.
Different surgeons have their preferences and it is up to the patient to discuss the options and decide.
Most plastic surgeons here will recommend silicone implants as they feel more natural, are more durable and less likely to rupture than saline implants. Some patients, however, are not comfortable with the idea after the silicone scare of the early ’90s – these implants were banned in the US for cosmetic enhancement because they were thought to cause autoimmune disorders, cancer and other health problems.
But since then, numerous scientific studies sanctioned by the US Food and Drug Administration (FDA) have shown that silicone implants are completely safe, and the FDA has once again given them the green light as of April this year.