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Fat Grafting to the Breast Revisited: Safety and Efficacy

Coleman, Sydney R. M.D.; Saboeiro, Alesia P. M.D.

Plastic and Reconstructive Surgery: March 2007 - Volume 119 - Issue 3 - p 775-785
doi: 10.1097/01.prs.0000252001.59162.c9

Background: A 1987 American Society of Plastic and Reconstructive Surgeons position paper predicted that fat grafting would compromise breast cancer detection and should therefore be prohibited. However, there is no evidence that fat grafting to breasts is less safe than any other form of breast surgery. As discussions of fat grafting to the breast are surfacing all over the world, it is time to reexamine the opinions of the 1987 American Society of Plastic and Reconstructive Surgeons position paper.

Methods: This is a retrospective examination of 17 breast procedures performed using fat grafting from 1995 to 2000. Indications included micromastia, postaugmentation deformity, tuberous breast deformity, Poland's syndrome, and postmastectomy reconstruction deformities. The technique used was the Coleman method of fat grafting, which attempts to minimize trauma and place grafted fat in small aliquots at many levels.

Results: All women had a significant improvement in their breast size and/or shape postoperatively and all had breasts that were soft and natural in appearance and feel. Postoperative mammograms identified changes one would expect after any breast procedure.

Conclusions: Given these results and reports of other plastic surgeons, free fat grafting should be considered as an alternative or adjunct to breast augmentation and reconstruction procedures. It is time to end the discrimination created by the 1987 position paper and judge fat grafting to the breast with the same caution and enthusiasm as any other useful breast procedure.

New York, N.Y.

From the New York University School of Medicine.

Received for publication February 21, 2006; accepted July 18, 2006.

Presented at the American Association of Plastic Surgeons meeting, in Hilton Head, South Carolina, on May 9, 2006.

Sydney R. Coleman, M.D.; New York University School of Medicine; 44 Hudson Street; New York, N.Y. 10013;

©2007American Society of Plastic Surgeons