Specifics about Fat Transfer Breast Augmentation/Reconstruction 

Performing breast augmentation to give you both the volume and contour using an external tissue expansion (EVE) followed by fat grafting is a safe and minimally invasive procedure, where all of our patients are extremely satisfied.

Breast augmentation without the use of implants is the superior way!  Its a unique technique and not many people around the world do it.  Our technique is a minimally invasive way with NO SCARS, to provide you with natural looking and feeling breasts without the complications of implants.  In addition since I will have to perform liposuction to obtain the fat graft, you will benefit from the secondary benefits of body sculpting, which are amazing. 

About the Patient

The ideal patient has moderate fat deposits to harvest grafts, would be a non-smoker, and would tolerate a trial of the external tissue expansion EVE (photos of the expansion machine increasing the skin size.

Exclusion criteria include smoking, bleeding disorders, skin conditions that lead to deepithialization (epidermolysis bullosa, and pemphigus to name a few), active skin infection in your breasts.

Even patients with low body mass index (BMI) are good candidates for the procedure. However, due to the small amounts of fat deposits, procedure will require significantly more effort, time and expertise. My typical patients are around 110 lbs, and are a 32-34A cup, and wish to go as high as a full C or even a low D cup.  I have about a 90% volume relation rate, which is very high compared to what you read out there.  In my hands I get my patients from an A cup to a full C cup with one procedure, and if they wish to be bigger I offer them a small touch-up down the road to get them to a small D or a full D cup.  You and I will determine the last scenario within 3 months of your surgery.  Almost all my patients are satisfied with their results and do not require a touch-up.

What to Expect at Your Consultation

You need to come for an evaluation prior to surgery.  At your initial evaluation, we will go over everything in detail.  You will need to have a breast MRI to make sure there is nothing to worry about, and we use the MRI to figure out your initial breast volume.

We will also have you fitted for the external tissue expander EVE (if you need it), and you will be instructed on how to use it prior to surgery. If you are traveling from out of town, this appointment can be a day in Miami only, meaning fly in the morning, and fly back in the evening.  Then we can program your surgery for whenever it is convenient for you.

You will need to have a medical clearance letter for surgery from your physician, and will need to get basic labs such as a complete blood count, electrolytes, and coagulation profile.

If you are from out of town, most of my patients fly into Miami on Monday, a day or two prior to the surgery.  We will spend some time together the day of surgery, at this point I will mark you and decide on the areas of liposuction.  On Tuesday or Wednesday you will have the procedure, and I will see you on follow-up on Monday of the following week (spend the week in Miami).  If everything looks fine, then you might fly home that same evening.

External Tissue Expansion

            Not all patients will require external tissue expansion (EVE), this necessary step will be determined at your initial consultation. If EVE is required, the prescribed dose of expansion is 200 hours over 15 days of cycling pressures of 0 to 60 mmHg for 3 min on and 1 min off for 10 hours per day starting typically 3 weeks prior to your surgery.

The mechanical forces of EVE to enlarge the biological scaffold (your breasts), stimulates genesis of new stromal and vascular elements that allow the survival of higher volumes of fat grafts. Therefore, it is safer, and the results of fat transfer breast augmentation or reconstruction will be amplified if EVE is performed prior to surgery.

 

 

 

 

 

 

 

Preparation for Fat Transfer

Patients are ready for fat transfer if their breasts are at least 2 or 3 times greater than their pre-expansion size. Some blistering and skin breakdown around the expansion cups is expected, and is a clinical signs that there was excellent tissue expansion. The more the breasts are expanded, the higher the amount of fat that can be transferred and ultimately will survive, which translates to having better results. (photos of fully expanded patient for augmentation and reconstruction)

In The Face of Radiation

In radiated breasts after cancer (Lumpectomies or Mastectomies), poor tissue compliance due to radiation fibrosis will limit expansion of your breasts. Therefore we are restricted in the amount of fat that can be safely grafted during the operation. On these difficult cases EVE is critical and very important to maximize the results. By expansing the fibrotic breast skin, we increase the ability to transfer more fat safely and guarantee a higher survival percentage.