Breast Augmentation Using Preexpansion and Autologous Fat Transplantation: A Clinical Radiographic Study

Background: Despite the increased popularity of fat grafting of the breasts, there remain unanswered questions. There is currently no standard for technique or data regarding long-term volume maintenance with this procedure. Because of the sensitive nature of breast tissue, there is a need for radiographic evaluation, focusing on volume maintenance and on tissue viability. This study was designed to quantify the long-term volume maintenance of mature adipocyte fat grafting for breast augmentation using recipient-site preexpansion. Methods: This is a prospective examination of 25 patients in 46 breasts treated with fat grafting for breast augmentation from 2007 to 2009. Indications included micromastia, postexplantation deformity, tuberous breast deformity, and Poland syndrome. Preexpansion using the BRAVA device was used in all patients. Fat was processed using low-g-force centrifugation. Patients had preoperative and 6-month postoperative three-dimensional volumetric imaging and/or magnetic resonance imaging to quantify breast volume. Results: All women had a significant increase in breast volume (range, 60 to 200 percent) at 6 months, as determined by magnetic resonance imaging (n = 12), and all had breasts that were soft and natural in appearance and feel. Magnetic resonance imaging examinations postoperatively revealed no new oil cysts or breast masses. Conclusions: Preexpansion of the breast allows for megavolume (>300 cc) grafting with reproducible, long-lasting results that can be achieved in less than 2 hours. These data can serve as a benchmark with which to evaluate the safety and efficacy of other core technology strategies in fat grafting. The authors believe preexpansion is useful for successful megavolume fat grafting to the breast. (Plast. Reconstr. Surg. 127: 2441, 2011.)