History of Fat Transfer
Fat transfer to the breast is by no means “new”. In 1895 Dr V Czerny transferred a lipoma (a fatty tissue swelling) from the buttocks to the breasts as a way of performing a breast reconstruction. Around the same time, grafting of fat cells to the breast and other areas was reported by a number of surgeons but the first scientific studies regarding fat graft survival were not done until 1950.
At this time a number of surgeons experimented with the use of dermo-fat grafts into the breast. These are grafts of large clumps of skin and fat transferred together. Unfortunately many of these grafts underwent a process known as “fat necrosis”. This resulted in breast lumps with calcification, which made the lumps very difficult to distinguish from breast cancer. As a result of this, in 1987 the American Society of Plastic Surgeons placed a moratorium on the use of fat grafting to the breasts. Of course by this time, silicone breast implants had become available and so most breast augmentation and reconstruction procedures were based on silicone breast implants.
In 2001 Dr Sidney Coleman published a book titled “Structural Fat Grafting” detailing a technique of fat harvesting and grafting which resulted in a significant volume increase due to survival of the fat cells. This technique was mainly used around the face (such as the lips, nasolabial folds and cheeks).
As surgeons began to use small volumes of fat grafts in various locations, it was found that fat grafting was of great benefit in the treatment of scars and radiation tissue damage.
In 2008 the American Society of Plastic Surgeons reversed its 20 year moratorium on fat grafting after radiologists advised that they were able to differentiate between lumps of necrotic fatty tissue and breast cancer.
In 2009 Dr Emmanuel Delay from France reported on his personal experience with nearly 1000 fat injection procedures into the breasts performed over the previous 10 years. The long follow-up of this series proved that fat grafting to the breast was safe and effective.
Further studies have since been performed confirming the safety of fat grafting to the breast and confirming, in the reconstructive setting, that fat grafting has no effect on breast cancer recurrence.
In 2013, after over 20 years of experience with fat grafting to the face and other areas, Dr Allan Kalus at Avenue Plastic Surgery introduced moderate to large volume fat grafting to Australia. The procedure has since been refined to the point where it has become an acceptable alternative to the use of breast implants both for breast augmentation and for breast reconstruction.