Doctors divided on using body fat for breast implants

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by Meg Farris / Eyewitness News

wwltv.com

Posted on January 26, 2011 at 12:22 PM

NEW ORLEANS -- Transferring fat from one area to another has been done for years, to plump up sunken in faces and lips and hands thinned by sun, or to round out a flat buttocks.

But transferring fat to the breasts rather than using implants has been controversial. But doctors are getting closer.

It was over two years ago when we first brought up the issue. Could women safely do liposuction on the lower body to make it smaller and use the unwanted fat in the upper body, the breasts, to make them fuller without implants?

Back in May 2008, it was controversial. Some doctors said it was a viable option. Others were concerned about the unknown. What would this procedure do to a woman's risk of getting breast cancer?

Well, in the last few years, LSU Health Sciences Center plastic surgeon Dr. Kamran Khoobehi has been performing and studying the procedure on nearly 200 patients. And he recently brought surgeons in from around the world to New Orleans to talk about the latest results.

"It's very gratifying for me to see something that I started nearly 30 years ago now to be the focus of this very important forum," said Dr. Mel Bircoll, a retired plastic surgeon from Los Angeles, who was attending the seminar.

Our patient, back in May 2008, was 62 years old. Her breast implants caused scaring and deformities. She did not want her identity revealed, but she allowed our camera in surgery to have her implants taken out and fat from her thighs transferred into her breasts.

"Twenty years ago, I had breast implants and it was just because I am so out of proportion that I wanted, but I never wanted big, but I regret that I ever did have implants. And over the last 20 years I've had four surgeries," she said, referring to all the problems of hardening she was trying to correct on her implants.

Today her breasts have kept their volume without the hardening previously caused by the implants. And today doctors have more information for interested women who are concerned about safety. The first is about cancer risk.

"The biggest group that was reported was from France, and they have more than a thousand fat graft in the breast and they haven't reported any increase risk of breast cancer in that group," said Khoobehi.

The next concern was about the fat graft causing spots from calcification on a mammogram that looked like cancer, causing a women to need a needle biopsy. And radiologists at the conference say any breast procedure or surgery, like a reduction, causes changes on a mammogram. But they say a radiologist trained to recognize the difference should have no problems.

"The question is whether radiologists have great difficulty in assessing whether those changes are related to the surgery or to breast cancer development. And for the most part, it's not a problem. There's always going to be a case where you have some questions and you end up doing a needle biopsy but that's not a disaster," said Diagnostic Radiologist Dr. Eva Rubin, who came into the conference from Montgomery, Alabama.

"The calcium pattern, calcification pattern is totally different than breast cancer calcification," Khoobehi said.

Doctors know that some of the transferred fat will not live, so they may need to over correct or you may need to have the procedure done a few times. So for now, as studies go on, doctors say fat transfer is not a good option for a women who wants to go from an A cup to a C or D cup.

But it's good for loss of volume after pregnancy, for patients having implant problems, for those who want to fill a wide space between implants to create cleavage, or to cover rippling or depressions in implants. And they says it works well for women who have had breast cancer, mastectomies, reconstruction and radiation.

But while the before and after pictures show good results, some who have been using the technique for cancer patients and reconstruction are waiting and watching the studies before using the procedure for enlargement alone.

"I don't think we're ready as a plastic surgery community to say that fat injections for cosmetic of elective breast enhancement is the way to go. There are just too many issues that have not been worked out," said Dr. John Lindsey, the chief of Plastic and Reconstructive Surgery at East Jefferson General Hospital in Metairie.

For now it's becoming more acceptable in certain patients, and doctor experience and technique for harvesting the fat and transferring it are crucial.

"I think all of the doctors that are doing this technique properly are getting excellent results," Bircoll said.

"For many years we have been trying to figure out how to get fat to last in the breast, to augment breast without implants using your own fat, and it is conceivable that this may be a very viable procedure for the future," said Dr. William Coleman, a dermatological surgeon in Metairie.

"I would say keep your eyes open; have an open mind," urged Khoobehi.

All of the women in the study had a mammogram before the surgery to make sure they didn't have any undiagnosed cancer.

Women who lost a lot of weight after the procedure, lost volume in the breast because the transplanted fat from the thighs or abdomen still reacted the same way to diet and exercise.

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