Breast augmentation remains one of the most popular cosmetic procedures we to today.  The return of silicone help increase the popularity.  But one of the latest nuances is to perform a composite augmentation.  Just what is this?  This is using a breast implant plus fat from your stomach and or your flanks to enhance their shape.  This gives the plastic surgeon another tool to use in creating a more pleasing breast shape.  So you in essence get 2 for 1 – fat taken from one part of your body where you don’t want it and transferred to another part of your body you do want it.  For sure it is a win – win.  I have always been a proponent of using your own tissues  to reconstruct or restore your body.  This is a great procedure and the results have been quite remarkable.

In the October issue of the Aesthetic Surgery Journal there was an article about fat grafting in cosmetic breast surgery.  It comes out of  Amsterdam, the Netherlands.  What these plastic surgeons have done is to review all the current literature available as it pertains to autologous fat grafting in cosmetic breast surgery.  There were 22 articles reviewed encompassing 3565 patients with follow up ranging from 12 to 136 months.  The overall complication rate was 17.2%.  Induration was the most common complication followed by persistent pain and hematoma.  The mean volume retention was 62.4% and the overall satisfaction rate is 92%.  Most patients have this done in one session depending on what size they want or what size they would like to be – several sessions may be necessary.  One of the drawbacks is some patients  want to do a composite augmentation but do not have a lot of fat so it makes it tough sometimes.  The volumes we place can be 200-300 cc’s or more.  I  had a patient In her early 60’s who had implants placed about 23 years ago.  They were hard and tender.  She just wanted them removed and not replaced but this would have been devastating to her body so I suggested liposuction to remove “excess” fat and rebuild her breasts with her own fat following removal of her implants.  She now has soft, pain free breasts and her clothes fit better.