by Allison Aubrey
Morning
Edition, June 1, 2009 · Plastic surgeon Dr. David Broadway describes body
fat as "liquid gold." He is an early adopter of a controversial
technique to transfer fat from unwanted parts of the body — namely
the belly, love handles and thighs — to places where it's more
desirable — namely the breasts.
"We've been using it in combination
with liposuction," says Broadway. "And rather than simply discard
that fat, we'll inject it into the breast area."
The idea of relocating — or recycling
— fat is not new. More than 100 years ago, a German physician
grafted fat from a patient's lumbar region and used it in the
breast. And in recent years, fat transfer procedures have been
performed as part of reconstructive surgery on breast cancer
patients.
Your Mileage May Vary
But pioneers in the field of breast
augmentation have learned that transferring fat is complicated, and
things can go wrong. The process of extracting it — or sucking it
out with liposuction — can damage the fat. And once it's injected
back into the body, the fat doesn't always find the blood supply it
needs. As a result, only a portion of the fat survives.
"Usually we get 40 to 80 percent of
the fat to take," says Broadway. And that means that patients are
not entirely sure what the end result will be.
"I knew there were no guarantees,"
says Christina Stone, a mother of two from Loudoun County, Va., who
opted for a fat transfer breast augmentation surgery. She says the
idea of using her own fat was a big part of the appeal.
During her procedure, surgeons
extracted fat from her abdomen and thighs. But when she woke up
after the surgery her hopes of increasing her bust by two cup sizes
were dashed. "Immediately I looked down and saw there was no
difference — or maybe just little," Stone says. "So I was pretty
sad."
Stone had a second surgery, this time
to get silicone implants. She says she's now very happy with the
results.
Doctors Still Unsure Of Long-Term
Risks
Surgeons like Dr. Scott Spear of
Georgetown University Hospital want to know more about the
techniques used to transfer fat for breast augmentation.
"We're at the beginning of the
learning curve," he says. He has initiated a clinical trial to
answer some questions about the best way to perform the procedure
and whether there are any measurable risks. To date, there are no
published studies in the United States, so doctors are relying on
their own clinical experience.
Some critics worry that women who opt
for fat transfers to the breast may end up with calcifications —
small bits of calcium in the breast tissue — that could mask or be
confused with tumors. Over a woman's lifetime, the uncertainty may
necessitate extra mammograms and/or biopsies, and the anxiety that
comes with the screenings.
"It's not a big issue," Spear says.
Reports from France and Italy, where the procedure has been
performed for more than a decade, suggest that it does not
interfere with the detection of breast cancer, he says.
Spear says there's another question:
Can the process of injecting fat stimulate anything abnormal to
happen? "There's some research that shows in certain animal models
that injecting fat can actually stimulate tumor cells to grow more
aggressively," he says.
This has not been demonstrated in humans, but Spear says it's
an issue researchers may want to address.
The American Society of Plastic
Surgeons has issued some guiding principles to surgeons who are
performing fat transfer procedures. The society concludes that
complication rates associated with the procedure are not "unduly"
high, though reports include infection, bleeding, fat embolism and
volume loss (fat not "taking").
The group recommends that physicians
inform patients before the procedure that there is limited
scientific evidence to verify the safety and efficacy of fat
transfer procedures.
Beefing Up The 'Pecs' With
Fat
Broadway and his colleague surgeon
Dr. John Millard of Lone Tree, Colo., have pioneered a technique to
beef up men's upper torsos by injecting fat into the
muscles.
"I like to describe the augmentation
of the male pectoralis muscles this way," says Millard, "we're
taking filet mignon and turning it into Kobe beef." Millard and
Broadway are promoting the technique by teaching other surgeons how
to perform it.
According to Brad Hamilton of
Toronto, who has had the procedure, the results make him look as if
he's been working out for years. "It actually defines and enhances
your muscles."
Hamilton says he knows these
procedures are still in their infancy, and there are no guarantees
that the results will last.
But he says, at 45 years old, as
gravity pulls ... he's pushing back.
