Breast Augmentation Combining Fat Injection and Breast Implants in Patients With Atrophied Breasts

Abstract

Breast augmentation is a challenging issue in atrophied breasts related to breastfeeding. Here, we describe a modification combining breast implants and fat grafting to obtain a successful outcome without implant edge visibility and palpability.Thirty-four women with atrophied breasts underwent breast augmentation over a 6-year period. The breast implants were placed in the subglandular plane to obtain optimal filling and expansion of atrophied breast tissue. Autologous fat grafting was performed above the inframammary sulcus to prevent implant visibility and palpability due to insufficient soft tissue coverage. Rippling, implant visibility, palpability, and capsular contracture were examined in the follow-up controls.Twenty anatomical and 48 round-shaped breast implants were placed with an average size of 321 cc (range, 200-415 cc). The mean injected fat volume was 114 cc (range, 98-142 cc) per breast. The mean follow-up period was 22 months (range, 19-31 months). The implants were palpable in only 1 breast; however, there was no implant visibility or rippling. Of the 68 breasts, 2 presented with cyst formations, and 4 with Becker Grade 2 capsular contracture, but no fat necrosis was observed. Overall, patient satisfaction in terms of breast shape, size, and coverage of the breast implant was 90%.A breast implant placed in the subglandular plane with fat injection throughout the lower quadrants of the breast may provide the desired increase in size and expansion of atrophied tissue while preventing implant visibility and palpability.

Hybrid breast augmentation, double benefit or double risk? A comparative study of 932 cases

“…HBA is suitable for the following groups: (1) patients with insufficient soft tissue to cover the contour of the implant; (2) patients who want obvious cleavage and mellowing of the upper poles of the breasts; (3) patients with constricted lower pole breasts; (4) patients who are very concerned about the softness of the breast and want to reduce the proportion of implant volume while obtaining sufficient breast convexity; and (5) patients who can only accept round implants but require a natural appearance. Although there have been several reports on the surgical experience of HBA, 12–17 there is no reported comparative study on whether this operation brings higher satisfaction and additional risk. Therefore, this comparative study was designed.…”

“…Auclair and Anavekar 12 put forward the idea of using fat coverage to make circular endophytes into anatomical endophytes in 2015. Özalp and Aydinol 13 reported IBA with fat injection throughout the lower quadrants, which achieved 90% patient satisfaction. The observation of Maione et al 16 showed that the combination of high-profile round implants and fat grafting in BA could improve the aesthetic outcome and satisfaction.…”

“…10,11 Therefore, some scholars have reported a technique called hybrid/composite BA, which combines fat transfer and implants. [12][13][14][15][16][17] Fat grafting is used to mask the contour of implants and make a straightsloping upper pole (Fig. 1).…”

Application of Fat Grafting in Cosmetic Breast Surgery

“…Following implant-based breast augmentation, fat grafting can be a great addition to blend and camouflage the implant borders, thus helping to achieve a more natural transition from native tissue to the augmented breast, especially in subglandular breast augmentation and in patients with thin skin. [36][37][38][39] On the other hand, for patients desiring removal of their breast implants, fat grafting can help restore some of the volume lost (►Fig. 1).…”

Periareolar augmentation mastopexy: Finding the aesthetic level of breast lifting

“…[ 3 4 ] Breast surgery alleviates many conditions such as small size, asymmetry, hypoplasia, ptosis, and chest wall anomalies. [ 5 6 7 ] It is the most common cosmetic surgery in the United States and is growing popular around the world. [ 8 ] For a woman with both volume decrease and ptosis of the breasts, not only augmentation but also mastopexy is required.…”