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Fat Transfer to replace Implants-Sydney

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I had a mastectomy back in 2010 and had implants (Silimed, polyurethanes) which I now need out. Don't want to go down the implant path again yet don't want a flat chest. Can  anyone suggest a plastic surgeon in Sydney that specializes in this? My original surgeon reckons she can do it but I read a poor review of her work in this field online which doesn't inspire confidence. I'd really appreciate hearing from anyone who has gone down this path.

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LMM I am interested in this as well. I have the PU Silimeds and I’m looking to explant ASAP. 

It’s hard to find Aussie doctors that are skilled in fat transfer. Most say you need multiple sessions and that you can lose some/a lot of the transferred fat...

 

 

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10 hours ago, JenJen said:

LMM I am interested in this as well. I have the PU Silimeds and I’m looking to explant ASAP. 

It’s hard to find Aussie doctors that are skilled in fat transfer. Most say you need multiple sessions and that you can lose some/a lot of the transferred fat...

 

 

Jen jen this is true, it will not be a one off surgery as they can'not transfer a large amount of fat at one time, the most I'm lead to believe is about 250 cc and with any type of transplant/transfer your body stands to reject some or all of what is transfered . 

When they lipo/ harvest the fat it is treated first cleaned & washed then put into a centrifuge to seperate the plasma from the fat before it can be implanted which is why up to 50 % of the volume transferred is lost as the fat cells die off. Dr Tavakoli and Dr Mark Magnusson do fat transfer to the breast. 

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22 hours ago, Nomoreboobs said:

Does any know if there is any surgeon do it ( Fat transfer) in Perth? 

My surgeon has just started doing it,  i was going to ask him about it at my next appointment as i have a little asymmetry that i would like evened out. 

DR Sam Cunneen in West Perth 

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I have researched this extensively because I am deciding between implants or fat transfer.  

In Australia, surgeons are not great at fat transfer.  They haven't been doing it for very long, and will tell you that it's best for patients who have a fair amount of fat to be liposuctioned away, and that they can't inject much fat into the breast, and that you may need to have multiple procedures.  If you want someone in Sydney, Dr Rastogi or Dr Wessels are good options.  Rastogi does lovely liposculpture and he has before and after FT photos on his website.  Another option is Dr Chin in Brisbane but he posts no before and after photos online and I haven't seen any of his pics.  Make sure you get someone who is good at lipo, not just the breast fat transfer.

In the US, surgeons have been doing fat transfer for longer.  They transfer much larger volumes of fat.  There is a surgeon called Dr Bednar in North Carolina and he is the most experienced.  He has been doing this for 10 years and does 300 patients a year. I know some Australian women fly over to see him.  He transfers large volumes - I'm talking 500cc of fat per breast (20-30% of that cc amount includes tumescent fluid from the lipo).  Other US surgeons are Dr Burns, Dr Coleman and Dr Khouri.

The benefits of FT are that it uses your own tissue so there is no risk of "breast implant illness" or ALCL, or capsular contracture or any of those issues to do with a foreign object in the body. Once the fat has connected to a blood supply, it stays there permanently and behaves like normal fat.  If you gain weight in future, it will go to those fat cells, that are now in the breasts.  It looks very natural.

The disadvantages of FT are that it is soft so you need a lot more fat than implant to get the same volume, and because the fat is soft, you don't get a lifting effect like you do with an implant.  It is almost impossible for them to fill the upper pole because of the way gravity affects the fat in the breasts so you cannot get that full upper pole look that you can get with implants.  Once established, the FT breasts will age and sag like breasts which are naturally large.  Another disadvantage is that how much fat will survive is unpredictable.  They can inject a lot of fat but after a year once it has all settled, your breasts may not look much fuller than they do pre-surgery.  

You have to take into account the risks of liposuction - the donor sites can end up with lumps and bumps and adhesions, and cellulite on your legs can look worse.

My main concerns about FT are health-related.  Because not all the fat that they inject survives, the fat that dies can form lumps in the breasts. There are 3 different types of lumps that can develop.  They can look and feel strange.  They calcify and can obscure breast cancer during mammograms and ultrasounds (I have confirmed this with my mammogram sonographer, and my friend who is a sonographer).  So there is no known increase of breast cancer, but there is a risk that they could miss a breast cancer, because the calcified fat obscures it.  If you develop lumps, they can try to aspirate them or liposuction them out, but that can leave deformities on the breast.  They have done studies showing that women who have had FT have long-term inflammation in the breasts.  There is an article about it here: https://journals.lww.com/prsgo/FullText/2017/12000/Ultrasound_Diagnosis_and_Treatment_of_Breast_Lumps.8.aspx?fbclid=IwAR06h5ZTQKJ97BMgwXNkBQckCm2Sb4irlC57VPnSZUnDZlMisyO11b1DhkQ

My main concern is that this technology has only been around for 10 years.  Not many women have had this procedure - far less women than have had implants.  The long-term risks of cancerous changes to the breasts are unknown.

I hope this helps - I have consulted numerous surgeons about this and done lots of online research and read medical journal articles about it, and I'm in some facebook groups about fat transfer, which is how I know so much about it! I love the idea of it but ultimately it suits some people and not others, and it has some risks, just like any procedure. 

 

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13 hours ago, MissS said:

I have researched this extensively because I am deciding between implants or fat transfer.  

In Australia, surgeons are not great at fat transfer.  They haven't been doing it for very long, and will tell you that it's best for patients who have a fair amount of fat to be liposuctioned away, and that they can't inject much fat into the breast, and that you may need to have multiple procedures.  If you want someone in Sydney, Dr Rastogi or Dr Wessels are good options.  Rastogi does lovely liposculpture and he has before and after FT photos on his website.  Another option is Dr Chin in Brisbane but he posts no before and after photos online and I haven't seen any of his pics.  Make sure you get someone who is good at lipo, not just the breast fat transfer.

In the US, surgeons have been doing fat transfer for longer.  They transfer much larger volumes of fat.  There is a surgeon called Dr Bednar in North Carolina and he is the most experienced.  He has been doing this for 10 years and does 300 patients a year. I know some Australian women fly over to see him.  He transfers large volumes - I'm talking 500cc of fat per breast (20-30% of that cc amount includes tumescent fluid from the lipo).  Other US surgeons are Dr Burns, Dr Coleman and Dr Khouri.

The benefits of FT are that it uses your own tissue so there is no risk of "breast implant illness" or ALCL, or capsular contracture or any of those issues to do with a foreign object in the body. Once the fat has connected to a blood supply, it stays there permanently and behaves like normal fat.  If you gain weight in future, it will go to those fat cells, that are now in the breasts.  It looks very natural.

The disadvantages of FT are that it is soft so you need a lot more fat than implant to get the same volume, and because the fat is soft, you don't get a lifting effect like you do with an implant.  It is almost impossible for them to fill the upper pole because of the way gravity affects the fat in the breasts so you cannot get that full upper pole look that you can get with implants.  Once established, the FT breasts will age and sag like breasts which are naturally large.  Another disadvantage is that how much fat will survive is unpredictable.  They can inject a lot of fat but after a year once it has all settled, your breasts may not look much fuller than they do pre-surgery.  

You have to take into account the risks of liposuction - the donor sites can end up with lumps and bumps and adhesions, and cellulite on your legs can look worse.

My main concerns about FT are health-related.  Because not all the fat that they inject survives, the fat that dies can form lumps in the breasts. There are 3 different types of lumps that can develop.  They can look and feel strange.  They calcify and can obscure breast cancer during mammograms and ultrasounds (I have confirmed this with my mammogram sonographer, and my friend who is a sonographer).  So there is no known increase of breast cancer, but there is a risk that they could miss a breast cancer, because the calcified fat obscures it.  If you develop lumps, they can try to aspirate them or liposuction them out, but that can leave deformities on the breast.  They have done studies showing that women who have had FT have long-term inflammation in the breasts.  There is an article about it here: https://journals.lww.com/prsgo/FullText/2017/12000/Ultrasound_Diagnosis_and_Treatment_of_Breast_Lumps.8.aspx?fbclid=IwAR06h5ZTQKJ97BMgwXNkBQckCm2Sb4irlC57VPnSZUnDZlMisyO11b1DhkQ

My main concern is that this technology has only been around for 10 years.  Not many women have had this procedure - far less women than have had implants.  The long-term risks of cancerous changes to the breasts are unknown.

I hope this helps - I have consulted numerous surgeons about this and done lots of online research and read medical journal articles about it, and I'm in some facebook groups about fat transfer, which is how I know so much about it! I love the idea of it but ultimately it suits some people and not others, and it has some risks, just like any procedure. 

 

Thank you so much for your reply. I can now totally rule FT out. x

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