Composite breast augmentation (implant-fat combination )

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Composite breast augmentation Korea KIES-U Plastic surgery

Hello everyone. Today, I would like to share about composite breast augmentation.
This involves using the implant for augmentation and using fat to cover up the implant to make the breasts look more natural.

If you see the internet, you would be able to find some words on if the clinics make the patients choose between “implant and fat graft”. There is a clear classification between the two therefore if it difficult to say which is better than the other. Fat graft has longer history than implants. Czerny already conducted a successful transfer of a lipoma from the buttock to the breast in mid 1800’s. Fillers were used on the breasts from early 1900’s. The silicone implants that we use today were first developed in the 1960’s.

Fat graft is good in a way that you are using your own fat but it is difficult to know the engraftment success rate therefore, there is no unity in how the result would be. Using implant can lead to expected results but it is a foreign substance therefore your body reacts to it that could end up in complications. Therefore we can apply the two together to cover up each other’s weaknesses.

We can make a pocket and put in the implant. We can inject the fat into the breast envelope (tissue cells that cover the breast). This could be done as one stage or in two stages. I would recommend two stage procedure but most patients prefer the one stage procedure.

Then, how can the composite breast augmentation be applied?

Most patients who want breast augmentation have low level of BMI. Those patients who are thin or somewhat average tend to want the breast augmentation. If an implant is used on a very thin person, then others would recognize this easily. As the ratio of implant thickness : breast envelope thickness becomes bigger and bigger, there is a higher possibility that the implant can be seen from the outside and that there would be rippling and separated breast deformity. The breast envelope is as below.



Thin person using large sized implant would have more possibility of having the problems stated above. But, if you have large original breasts or if you use small sized implants, you would not experience such problems.



There are patients who want revision surgery due to separated breast. Also, you can see on the internet that those with separated breast have less fat between the two breasts.



An implant is a foreign substance. If the gap between the implant and the breast skin is not filled with fat, then there will be more edged look on the breasts. This leads to shadows and more artificial look of the breasts.



This unnatural look can be avoided by minimizing the size of the implant. But if the implant size is too small, then the goal of breast augmentation cannot be achieved. This is why it is better to use fat and implant together. We call this composite breast augmentation.

First, we need to exactly measure how much fat to inject after inserting the implant.
The engraftment is really important in fat graft therefore, a certain amount of fat must be injected for the engraftment rate to increase to maximum possible level. Usually about 500-700cc of fat is collected. When you remove the impurities, about 100-250cc would be left to use.

Cellular fat graft method is mandatory and the surgeon must be careful in carrying out the collection properly with no damage and no pollution on the fat. There are people with less fat in the upper body compared to the lower body (lower stomach, thigh, buttocks, etc). Those who do not have much fat in both upper and lower body cannot apply this composite breast augmentation.

The fat should not enter the implant pocket, but be injected from many direction to fill the gap between the envelope and the breast all evenly.
 


The fat used not for the purpose of making the breast look larger, but to cover up the implant for more natural work therefore the fat is injected on the margin of the implant and the boundary of the breast.

The fat used can slip downwards therefore you need to use correction bra after the augmentation. The correction bra helps hold the fat from slipping downwards.

Does the composite breast augmentation have any complications?
The most common one is the Touch-up. This means that there can be follow-up surgeries. The engraftment rate of one-stage fat is not as successful therefore we would need to inject more fat into the breast boundary after a few months.

The possibility of capsular contracture is about the same as when you only use the implant. The same applies for infection/inflammation.
More complications can be followed on the fat collected spot if you take out too much fat.

Composite breast augmentation is simple and it has many advantages. It is very effective for thin person to cover up the unnatural look that can be had from using implants. If is good to apply when you are thin but want to have large sized implant. It is also good if you want to change body line in the lower body (stomach, thigh, etc).

This is very effective if you want to correct some unnatural look on the breast or if you want to fill up the volume in some spot of the breast.

Today, we shared about composite breast augmentation. I hope you find this helpful. Thank you.

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