Breast Augmentation by Water-Jet Assisted Autologous Fat Grafting: A Report of 300 Operations

Abstract

Autologous fat transfer for breast augmentation is gaining more acceptance as an alternative to implants because only autologous filling materials are used and because undesirable fat can be removed from other regions as an additional benefit. The advantages of breast augmentation with autologous fat include the lack of reactive inflammation, foreign body reaction, and scars as well as the natural-appearing result with more volume, an improved contour, a fuller cleavage, and natural consistency.The competence and the experience of the surgeon, the technique of the extraction and processing of the fat, as well as the fat cell injection method are critical points regarding patient safety and result. Other factors are patient selection, the efficiency of the liposuction, the tumescent anesthesia, the instruments, a minimal blood loss, a high rate of survival of the transferred fat cells, and a minimal complication rate. 1 The literature varies regarding stem cell enrichment, grow-in rate, durability of the result, complications, limitations of future preventive breast exams, and possible tumor induction. Ross et al concluded in their research of 103 publications that there is no consensus regarding the optimum technique. 2 Keywords ► breast augmentation ► fat transplantation ► autologous fat graft ► liposuction ► WAL ► lipofilling AbstractBackground The BEAULI -method (Breast Augmentation by Lipotransfer) is available for extraction and processing of large transplantable fat quantities. The aim of this work is to describe the surgical technique precisely and reproducibly and to provide an overview of the autologous fat transfer based on surgical experience. Method The author performed 300 autologous fat transplantations on 254 women between September 3, 2010, and May 13, 2015. Patients desiring moderate volume increase, fuller and firmer breasts, as well as an optimization of the silhouette, ideally with the concurrent desire of the correction of unwanted fat deposits, were selected. The fat was extracted via water-jet assisted liposuction (Body-jet, Human Med AG, Schwerin, Germany), and the fat cells were subsequently separated with the Lipocollector ® (Human Med AG, Schwerin, Germany).Results The results were assessed with a control exam and photo comparison and were based on the responses on a questionnaire. Overall, 35.9% of the patients defined the result as very good, 38.6% as good, 22.4% as satisfactory, and 3.1% as poor. Conclusion This study shows that the autologous fat cell transplantation into the female breast via water-jet assisted liposuction achieves a moderate and harmoniously appearing breast volume enlargement as well as contour improvement. Further studies with more cases and longer observation periods over several years could contribute to improving the method of the autologous fat transfer regarding the grow-in rate, efficiency, and safety.

Wasserstrahlassistierte Liposuktion zur Therapie des Lipödems

“…Im weiteren kann eine Schädi-gung des Gewebes und insbesondere der Lymphbahnen durch "aggressivere" mechanische Absaugverfahren nicht ausgeschlossen werden: Vibrationskanülen, Ultraschallgeräte oder laserassistierte Lipolyseverfahren traumatisieren das Gewebe mehr als der sanfte Wasserstrahl, welcher, der Kanülenspitze vorausgehend, einen natürlichen Weg durch das Gewebe bahnt und dadurch Gefäße, Lymphbahnen und Nerven nicht verletzt [1]. Aus diesen Gründen hat sich die WAL auch als erfolgreiche Methode zur schonenden Gewinnung intakter Fettpartikel beim autologen Fetttransfer etabliert [10,18].…”

Autologous fat grafting in breast augmentation: A systematic review highlighting the need for clinical caution

“…[6][7][8][9][10][11][12][13][14][16][17][18] The included studies' characteristics are shown in Table 1. There were 15 prospective studies, 8,[10][11][12][13][14]18,[22][23][24]28,30,31,35,39 17 retrospective studies, 6,7,9,16,17,20,21,[25][26][27][32][33][34][35][36][37]40 and three randomized controlled trials. 29,38,41,43 A total of 3757 women were included, and the mean age was 40.5 years (range, 17 to 78 years).…”

“…Complications were reported in 20 studies 6,7,10,12,14,18,[20][21][22][23][24][25]27,29,30,33,[36][37][38]42 ; the overall complication rate was 27.8% (Table 3). The most common benign findings included fat necrosis, indurations, and oil cysts.…”

Does Water-Jet Force Affect Cryopreserved Adipose-Derived Stem Cells? Evidence of Improved Cell Viability and Fat Graft Survival

“…Current liposuction methods include the water-jet–assisted liposuction, the conventional liposuction, and the ultrasound-guided liposuction 13,14 . Water-jet–assisted liposuction is a favorable procedure for lipoaspirates collection using a mild liquid spray 15,16 . It can reduce mechanical damage to fat tissue.…”

“…The water-jet–assisted liposuction could obtain more viable adipocytes and achieve better fat survival 16 . Moreover, it has significant advantages in reducing intraoperative pain and swelling, improving contouring, and postoperative recovery compared with the conventional liposuction 15,18 …”