IMCAS Annual World Congress 2013 / Program


Name : KHOURI Roger K
Specialty : Plastic Surgeon
Country : United States


Congress IMCAS Annual World Congress 2013
Title session 26 (View)
SubTitle lipofilling: video & livemarking -> breast & buttocks


Title mega-volume autologous fat grafting to the breast: 10 years experience with over 1000 cases • 10min video and 5min q&a
Number 3805
Date February 1, 2013 11:32 AM


Getting mega volumes of fat, in excess of 200 ml, to survive in the hypoplastic breast or in the mastectomy defect in one single grafting session has remained a challenge. The limit to how much fat graft a tissue can accept depends upon two factors:

1- The meticulous grafting technique that can evenly distribute the micro-graft droplets inside the recipient to avoid localized collections larger than a 2-3 millimeters across and preserve graft to recipient interface.
2- The mechanical compliance of the recipient breast and its size so that the added graft volume does not tightly fill the tissue to increase the interstitial pressure above physiologic levels that will choke the budding microcirculation.

This presentation describes our experience with over 500 cases of breast augmentation and breast reconstruction with fat graft where we were able to maximize the above factors by utilizing the Lipografter to harvest and distribute the graft and the Brava external breast expander to increase the size of the recipient and its mechanical compliance.

Average volume of the breast augmentation achieved in one grafting session is in excess of 235 ml/breast and the better the preoperative expansion, the larger the final augmentation. Using similar techniques, we were able to regenerate a normal looking and near normally sensate B-C cup breast following at total mastectomy with an average of 2.8 grafting sessions.

In addition to fat grafting, we developed a number of surgical techniques required for optimal result in shaping and regenerating a breast. These include the Rigottomy mesh release of the scars, the Percutaneous Aponeurotomy and Lipo-Filling (PALF) procedure, that allows for tissue regeneration as opposed to the classic FLAP tissue transfer. And the Reverse Abdominoplasty Fat Transfer (RAFT) technique to salvage previous failed reconstructions.

Conflict of interest disclosures

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this work was not supported by any direct or non direct funding. it is under the author's own responsibility