Breast augmentation using your own fat tissue

Are you dissatisfied with the volume of your breast, or would you like a larger size? You can come to us for breast augmentation that uses your own fat, also known as lipofilling.

With the evolution of lipofilling, it is now possible to enlarge breasts with your own fat tissue (autologous breast augmentation). Through liposuction, the surgeon removes excess fat tissue from the patient’s abdomen or thighs and reuses it to enlarge the breasts. The major advantages of this technique are the absence of scars and the permanent result (no implants that would need to be replaced). The drawback is that the desired increase in breast volume is often not achieved in a single surgery, as the surgeon can only gradually build up the volume of the breast (otherwise, a large portion of the transplanted fat may die). Multiple procedures are often necessary to achieve the desired breast enlargement (typically three fat lipofilling sessions to gain two cup sizes).

• You are dissatisfied with the volume of your breasts. Your breasts are not very small, and you desire a modest increase or slightly fuller breasts.
• You have some excess fat in your abdomen or thighs that can be used for a breast augmentation.
• You were born with a noticeable breast asymmetry where only one of the breasts is irregular and needs to be enlarged. Since the unilateral placement of a prosthesis is also an option, this will often lead to asymmetry over time. Correction with your own fat tissue provides a more natural, lasting, and symmetrical solution.
• You have had breast implants for years but need to have them removed for whatever reason. You prefer not to use silicone implants anymore, but you are concerned that the remaining breast without an implant will appear too ‘empty’. In that case, lipofilling can be applied immediately after the removal of the implant to refill the breast.

The procedure is performed under general anaesthesia and takes about 2.5 hours (bilateral augmentation). The physician uses the BEAULI method for this procedure. First, atraumatic liposuction is performed using Waterjet-Assisted Liposuction (WAL). By loosening fat cells with a fine jet of water, fewer fat cells are damaged and the survival rate of fat cells is higher (50-80%). The fat is purified and injected into the breasts through several small (2 mm) incisions in the breast fold. The liposuction and lipofilling incisions are closed. An elastic compression bandage is applied to the liposuction area (e.g. an abdominal band or lipo tights). You may leave the hospital the same day (day hospital admission).

The pressure garment for the abdomen or thigh should be worn for 6 weeks (day and night for three weeks, then during the day for three weeks). No pressure should be applied to the breasts. In which case, you should not wear a bra for four weeks. You may shower after the procedure. Around the liposuction area, the skin will be swollen, show bruising and feel numb. The breasts are larger immediately after the surgery than the final result will be (partly due to swelling, and partly because some of the injected fat tissue will die off). During the first week, the operated areas feel painful (like muscle pain) and it is advisable to take painkillers. Light work is possible after one week. Intense exercise using the pectoral muscles is not recommended for six weeks. Follow-up consultations are scheduled to take place at 1 week, 6 weeks, and 3-6 months and 1 year. The final result of breast enlargement with the patient’s own fat tissue is visible after three months. A subsequent lipofilling session can be performed after 3-6 months.

• Post-operative bleeding. Rarely, a second operation may be needed to remove a haematoma (post-operative bleeding). Wearing the elastic compression garment and following the post-operative instructions significantly reduces the risk of bleeding.
• Infection of the surgical wound is rare, except in smokers and diabetics. Stopping smoking a few weeks before and after surgery is definitely recommended. Good glycaemic controls in diabetics are also indispensable. High fever and chest redness after the procedure may indicate an infection and should be reported to your attending surgeon immediately. Infections are treated with antibiotics.
• Fat necrosis: The loss of some of the injected fat cells is inherent to the procedure, as the fat lacks its own blood supply. Smoking reduces blood supply and decreases the survival rate of the fat. Sometimes, the death of a certain amount of fat can lead to the formation of a fat necrosis cyst. These cysts sometimes appear after several months but are harmless. If a cyst is somewhat larger and also palpable, it can be punctured and aspirated during the consult. Sometimes, fat cell death can lead to the formation of small calcifications. These calcifications are also harmless but are visible on a mammogram and can sometimes cause concern, as certain breast tumours can also show calcifications on a mammogram. Fortunately, an experienced radiologist can distinguish these calcifications from those caused by malignant breast tumours.

Bilateral breast augmentation with the patient’s own fat tissue is an aesthetic procedure that is not reimbursed by health insurance.

Only in selected cases of breast asymmetry due to unilateral reduced breast development can a portion of the costs be reimbursed, provided that prior approval from the health insurance fund is obtained.

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Latest publication date: 13/08/2024
Supervising author: Dr Vertriest Rudolf