Objectives: To learn about anatomical regions that can benefit from fat grafting during composite breast augmentation
Introduction: Composite breast augmentation has been becoming a more common practise around the world. Regardless of implant choose, type, size or dissection plane fat grafting has beneficial effect on breast augmentation. However, regarding the placement areas fat there is no algorithmic or anatomical approach.
Materials / method: In both primary and secondary augmentation cases of breast augmentation fat graft has been used to increase the clinical outcome of the procedure and potentially decrease the complications. Four anatomical areas are defined for fat grafting. Depending on the need of the patient and initial assessment the fat was placed in those areas. The outcome and fat graft survival have been followed by 3D volumetric analysis by a computerised system.
Results: Four anatomical areas are defined and 30ml to 60ml fat graft has been used per side in primary cases. In secondary cases the amount raised to 80ml to 140ml. Fat grafted regions revealed more swelling and bruising than the rest of the surgical field. Fat grafting has not any detrimental effect on recovery period. No infection has been observed and there were 2 cases of hematoma which one of them required reoperation. Follow-up studies revealed an average of %65 fat graft volume preservation at 6 months.
Conclusion: Fat graft is a valuable part of a breast augmentation procedure. It has multiple benefits as it will increase the tissue thickness especially at the superior and medial areas, increases the lower pole elasticity whenever it is constricted, helps to match volume asymmetries among right and left side. Composite breast augmentation can also be helpful for rippling deformity as well. For proper assessment and surgery an area definition has been proposed both to decide on need as well as fat grafting.
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