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News Americas

With the new technology, the insertion of implants would be unnecessary. (Photo: Thomas Hlavacek/Shutterstock)
Jul 2, 2012 | News Americas

Researchers find a way to enhance nonsurgical breast augmentation

by Surgical Tribune

MIAMI, Fla., USA: Preoperative expansion of the breast followed by injection of the patient's own fat provides a safe and effective alternative to implant surgery for breast augmentation, researchers from Florida have found. The technique, which entails using a special suction pump bra device for a few weeks before surgery to pre-expand the breasts, provides greater augmentation than fat transfer alone.

The technique is an adaptation of the increasingly popular autologous fat transplantation technique. In this approach, fat obtained by liposuction from one part of the body, such as the thighs, is transferred for use in breast augmentation and reshaping.

The patient first undergoes several weeks of pre-expansion treatment using BRAVA, a bra-like device that uses gentle negative pressure (a vacuum) to expand the breast gradually. BRAVA was invented by Roger K. Khouri, surgeon at the medical department of Florida International University and Miami Breast Center, and lead author of the study.

BRAVA pre-expansion provides extra room in the breast, along with a fibrovascular scaffold that the transplanted fat cells can occupy. The patient also wears the BRAVA for a week or so after fat cell injection.

In the study, researchers tested the new technique on 81 women who desired breast augmentation but did not want implants. Seventy-one used BRAVA as instructed before the fat transfer procedure.

One year after surgery, breast volume had increased by an average of approximately 230 cc (about eight fluid ounces) in women undergoing the BRAVA procedure. This is significantly greater than the 130 cc average reported by previous studies using fat transplantation without pre-expansion.

The researchers explained the difference as being due to increased survival of transplanted fat cells after pre-expansion: about 80 percent, as measured by MRI scans before and after surgery. This was compared with about 55 percent fat cell survival without pre-expansion.

There were no major complications. Sixteen percent of the women had areas of fat cell necrosis (cell death), which was harmless and easily detected on mammograms.

While the idea of breast fat transfer is not new, it has seen a resurgence in recent years, with several groups of plastic surgery researchers reporting successful results. However, relatively low survival of the transplanted fat cells has been a limiting factor. Without pre-expansion, there is simply not enough room within the breast for the transplanted fat cells to survive and thrive.

Using BRAVA before and after fat transplantation provides better conditions for successful fat transfer, Khouri and his colleagues assert.

"With recommended use of the BRAVA device before fat transfer, at least some women can expect to double their original breast size in a single, outpatient procedure with no incision," according to Khouri and co-authors. While further research and experience are needed, the researchers believe their study "establishes a benchmark and a platform for further potential improvements."

The study was published in the May issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.

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