The Department of Health is currently conducting a consultation survey regarding Autologous Fat Grafting to the breast specifically for the treatment of defects arising from breast surgery from the treatment and prevention of breast cancer and for congenital breast deformity. Mr Allan Kalus, acting on behalf of Avenue Plastic Surgery and Fat Transfer Australia has provided a submission based on several hundred cases performed over the last 5-6 years.
The application for the provision for an item number for this procedure in the Medicare Benefits Schedule highlighted the safety and efficacy of Autologous Fat Transfer – especially after breast cancer. Recent major clinical studies have shown that autologous fat grafting does not result in an increased rate of local recurrence in patients with breast cancer. One researcher in France, Doctor Delay, and his colleagues found in a series of 880 fat transfer procedures over 10 years that there was no increased risk of recurrence of breast cancer.
There was some concern that fat necrosis following fat transfer could make follow-up imaging of the tumour site difficult. However fewer cysts and calcifications were seen on radiological imaging than for other types of breast surgery. With experience, it is rare for cysts to form in the breast and in fact the total complication rate following fat transfer is much less than with other procedures.
Fat grafting to the breast is achieving wide spread recognition and a study of 2584 plastic surgeons in the USA revealed that 62% were using fat transfer for reconstructive breast surgery.
At Avenue Plastic Surgery we use Autologous Fat Transfer to correct both congenital and acquired breast deformities. These deformities can result from mastectomy as part of the treatment or prophylaxis of breast cancer. Breast deformities can also result from breast implants. The longer implants are in place, the greater the effect on surrounding breast tissues. Due to the questions about long-term safety of breast implants, many women are electing to have their breast implants removed and their breasts reconstructed with their own fat.
Of course many women suffer from conditions such as Breast Asymmetry or Breast Hypoplasia – inadequate growth of the breasts. These can both be correct by Autologous Fat Transfer. In skilled hands, the results are usually far superior to those obtained with breast implants.
The following 3 cases were included in our submission to the Department of Health as being indicative of the types of results that can be achieved with Autologous Fat Transfer.
A case of breast asymmetry corrected by 140cc of fat graft to right breast
A case of breast deformity created by breast implants. Corrected by removal of implants and autologous fat transfer (one session)
A case of left breast deformity following subcutaneous, nipple sparing mastectomy with implant reconstruction. Corrected by autologous fat transfer and implant replacement.