Any surgery, be it plastic surgery or general surgery, is subject to side effects and complications. The same goes for the side effects and complications of surgery. By choosing a good surgeon, the chances of side effect hazards and complications can be reduced to very low.
The principle of autologous fat breast augmentation
The breast, mainly consists of breast gland, fat tissue and milk duct. Among them, the amount of fat tissue directly determines the size of the breast.
When we become adults, our body development is basically mature, and the size of our breasts is almost fixed. At this time, if we want to change the size of our breasts, we can only do so by filling them with foreign substances. Fat grafting, because it is taken from our own body and because the breast itself is made of fatty tissue, has become the focus of doctors’ research.
The principle of fat transfer is that excess fat from other parts of the body (such as thighs, waist and abdomen) is suctioned out, separated, purified and then injected and transplanted into the breasts for the purpose of filling the breasts and increasing their cup size.
Since the source of fat is yourself, it has no rejection reaction, and after injecting into the breast, it feels natural and is no different from the real breast. However, there is still the problem of survival rate, which is a problem that plastic surgeons are trying to solve.
The procedure of autologous fat breast augmentation
- Pre-operative preparation
Diagnosis: accurate diagnosis of the patient before surgery, to understand the physical condition and purpose.
Previous medical history collection: medical history collection in addition to general medical history items, for patients with chronic diseases such as hypertension, diabetes, heart disease, infectious diseases, need to decide whether to do under stable conditions depending on the situation. Patients with mental illness, allergies, bleeding disorders, and women during menstruation should generally not be done.
Pre-operative talk: The doctor will usually reconfirm the preliminary surgical plan with you before surgery, and then will tell you the risks and complications of the procedure.
- Vital signs before surgery side measure body temperature, blood pressure, pulse rate, heart rate and other vital characteristics, and their values should be in the normal range. The physical condition should meet the requirements of anesthesia.
- The whole body and local examination check the whole body fat distribution and local deformity to clarify the site of aspiration, aspiration plant and various deformities on the skin surface.
- Medical and technical examinations
- Laboratory examination: including blood routine, blood type, suspected blood mechanism, urine routine, etc. Select the laboratory examination items according to the patient’s condition.
- Electrocardiogram: older patients should have an electrocardiogram to exclude heart disorders.
- Other examinations: other medical examinations should be done for large-volume fat aspiration, such as chest X-ray examination, blood glucose measurement, pulmonary function examination, etc.
Pre-operative photo shoot: In order to compare the post-operative results, as well as the accumulation of cases. Doctors will often ask you to take preoperative photos.
Pre-operative design: Based on the photos you take, the doctor will tell you some potential problems that
Signature confirmation: Nowadays, in order to avoid unnecessary disputes, the doctor will also sign a pre-operative agreement with you before the surgery. It includes risk notification, purpose and time of surgery, doctor’s opinion, etc.
- Design: Before the surgery, the doctor will mark the area of liposuction and the range of breast filling. Generally, the doctor will choose the fatty places like waist, abdomen and thighs. So while breast augmentation, you can also slim down your belly and legs by the way.
- Anesthesia: Anesthesia is general anesthesia with tracheal intubation, because liposuction surgery is extensive and often performed in several parts, thus often accompanied by a large amount of tissue fluid loss, the use of general anesthesia is convenient for the doctor’s surgical operation and the anesthesiologist to control vital signs.
- Sterilization: Routine disinfection of laying towels, strict disinfection of the surgical site, and the doctor must strictly follow the surgical aseptic operation procedure in the surgical operation room.
- Extraction of fat cells.
Advantages of Autologous Fat Breast Augmentation
- Small trauma
Breast implants are “implantable”, that is, allogeneic materials are transplanted to the inner side of the chest through open incision to improve the breast shape, so there will be scars no matter your incision choice is under the armpit, areola, lower wrinkle wall or belly button. But autologous fat breast augmentation is a “filler” method, the fat is injected in, so the wound is the same as the liposuction wound, it is just the size of a needle eye.
- Little pain
The pain of breast augmentation comes from two aspects, one is the pain of the incision and the other is the pain of foreign body swelling after implantation, and the most painful time is relieved by medicine. Although autologous fat filling will also have a certain amount of pain, but compared with the prosthesis can be completely negligible. Because after the fat filling, it is not so obvious foreign body feeling, fat can be much softer than the prosthesis, and will not feel diaphragm, and the degree of trauma and damage to the body is also much smaller, so those who are afraid of pain can consider the autologous fat breast augmentation.
- Fast recovery
After breast implant augmentation, you usually have to stay in hospital for 2 to 3 days for observation to see if there is any discomfort and other surgical conditions, and the overall recovery time is almost half a month before you can slowly return to work, which takes a long time. The overall recovery time is about a week, and if the recovery is good, it will take less than a week to go to work normally.
- More natural
The softness of autologous fat is much better than silicone, the breast shape is more “firm” after filling with prosthesis, while fat is liquid, so in the feel, there is no prosthesis that “texture”, more close to the real. Many people to judge each other breast augmentation did not, will also use a way is to let each other lie down. If the chest shape does not change when lying down or is still so upright, then most likely the breast implants have been done. If the breast augmentation is done with autologous fat, the fat will be more or less fluid and will not be as obvious as the implants.
Complications and after-effects of surgery
It is caused by the lack of strict disinfection during surgery, contamination during liposuction, fat flushing or fat injection, or local chronic inflammatory diseases in the affected area such as breast. Infection usually appears after 5-7 days, with local redness, swelling, heat and pain, and in serious cases, local skin flushing and bruising or the needle opening does not heal. Therefore, the sterilization must be strict, each link must be strictly aseptic technology, skilled operation, injection of fat should be evenly dispersed, do not gather into a block to cause ischemic necrosis in the middle area and become a hidden problem. Once the infection occurs, it must be treated with antibiotics, including local needle mouth change, generally 3-5 days after the symptoms can be significantly eliminated, in serious cases, the affected area should be incised and flushed with antibiotics, remove necrotic tissue, leave negative pressure drainage, there is a cavity need to add pressure bandage, generally after active treatment can be cured.
- Hemorrhage and hematoma
It is caused by the injury to blood vessels when aspirating fat in the donor area or injecting fat in the recipient area, or by the disorder of blood suspicion mechanism of the recipient and improper postoperative pressure bandaging. Therefore, when aspiration is performed, a fan-shaped tunnel aspiration technique is used, and one hand is placed flat on the surface of the skin to sense and grasp the direction and depth of aspiration, and uneven depths of aspiration should be avoided. The injection should be done gently, with appropriate force, avoiding violent operations, mastering the levels, avoiding large vascular areas as much as possible, and using blunt-tipped side holes for the injection needle. If a hematoma appears, use a needle to puncture and aspirate the area after local pressure bandaging, intramuscular injection or intravenous drip anti-inflammatory and hemostatic drugs.
Due to uneven injection of granular fat or too much injection in the same area resulting in the agglomeration of granular fat into a lump, the fat injected in the affected area gathers towards the center, causing the loose fat tissue to decrease in volume and be wrapped into a sphere by the surrounding fibrous tissue; or there is no proper massage and shaping after surgery to disperse the gathered fat. Therefore, when injecting, the granular fat should be evenly dispersed and injected at as many points as possible, and after surgery, massage and pressure must be applied to disperse the gathered fat. The hard nodes in the breast usually have no uncomfortable symptoms and can be left to absorb on their own without any special treatment other than appropriate local massage and hot compress.
- Fatty cystic-like changes
Due to long-term fat necrosis, liquefaction, coupled with fat degeneration, fibrosis, calcification into a complete play wall, so that the play wall gradually secrete a lot of liquid, resulting in the enlargement of the lump, feasible surgical removal, postoperative pressure bandage. Calcified granular fat and fibrous tissue can gradually form caseous changes, treatment can choose surgical removal.
- Fat liquefaction
The incidence of fat liquefaction is proportional to the amount of granular fat injected. Due to excessive injection of inactivated fat cells, or uneven injection of fat, or excessive injection of fat at the same level and in the same area, the granular fat fails to contact the graft bed extensively and gathers into a block by itself, while the surrounding tissues may become alive and the central area gradually becomes necrotic and liquefied. Or the fat in the graft bed is severely damaged, with hematoma and infection, which affects the survival of the injected fat and causes necrosis and liquefaction of the fat. When fat liquefaction occurs and symptoms such as redness, swelling, heat and pain occur, in addition to giving antibiotics, if necessary, a needle can be inserted at the edge of the liquefied area or a hidden place nearby, punctured to extract the fluid, flushed with antibiotics, and then bandaged with pressure. If the liquefied area is large, suction is needed to draw out the flow. Therefore, fat injection should be strictly controlled, and should be injected as evenly as possible to avoid over-injection in the same area, and to make the injected fat fully contact with the graft bed in order to receive the maximum possible nutrition provided by the graft bed and become viable. In addition, the fat should be flushed and screened gently and carefully so that the injected fat is pure and viable granular fat.
Because the injected granular fat aggregates into a mass, it stimulates the host cells to transform and proliferate into a lipoma. Therefore, the injected granular fat should be evenly distributed and the aggregated masses should be massaged away after surgery. If it has become tumor-like hyperplasia, the only way is to cut open the tissue to flatten or remove the hyperplasia.
- Fat embolism
If the tissue damage is serious with blood vessel rupture, the large presentation of fat into the blood may lead to fat embolism and fat embolism syndrome. Fat embolism syndrome should be prevented by maintaining effective circulation and avoiding low blood volume batch shock. Treatment should then be respiratory support, large doses of twisted glucocorticoids, etc.
- Skin unevenness
Uneven skin in the donor area after six months indicates that the fat aspiration is not uniform, and second aspiration repair or granular fat injection grafting should be performed. The uneven skin in the recipient area is mostly due to uneven injection of granular fat. When transplanting, we should grasp the injection halo, do not inject too much, and massage moderately until the skin is smooth immediately after surgery.
- Pigmentation and dullness of sensation
Pigmentation at the incision or injection site and dullness of sensation in the operated area are often temporary and can be gradually recovered within six months.
To sum up, the advantages of autologous fat augmentation are that it makes full use of autologous tissues without foreign body rejection, the operation is simple and less invasive, and the material is widely and cheaply taken. The disadvantage is that the transplanted fat is not fully viable, which may lead to complications such as fat liquefaction, cystic lesions, caseous necrosis, calcification of necrotic fat and infection.
Finally, the biggest problem with fat grafting is the survival rate. Doctors who tell you that 100% of the fat will survive must be exaggerating, because there is no means to do so. On the contrary, the most skilled doctors claim that the fat survival rate is only around 60-80%.
Therefore, if you want to achieve the ideal breast augmentation results, you often need to do multiple injections to do so. As always, try to choose a good doctor before the surgery to minimize the risk of after-effects and complications.