Results of a study by a team of French researchers suggest that autologous fat grafting (AFG) may be a viable alternative to surgery for breast augmentation.
The authors undertook a systematic review of relevant literature on the topic to determine the worldwide status of fat grafting for aesthetic breast augmentation. They reviewed 42 articles and studies that were published between January 1987 and July 2014 in North America, Europe and Asia. They found that most of the studies had a low level of evidence, with only one level 2 investigation, a prospective cohort study that included 10 patients. They found that the indications were for aesthetic augmentation (92.4%) and congenital malformation (7.6%). Two cases of cancer were reported among the 2,023 patients included in the literature.
The review included all original articles concerning patients who had undergone AFG on native healthy breasts that were published during the designated time period. Reviews and studies on breast reconstruction after cancer were excluded.
The study authors note that AFG is the only potential alternative to surgical breast augmentation. As background, they point out that its use in breasts was forbidden by the American Society of Plastic Surgeons (ASPS) in 1987 due to “issues related to efficacy and safety.” Twenty years later, they explain, the ASPS Fat Graft Task Force was created to “assess the efficacy and safety of lipofilling in breast surgery and establish evidence-based recommendations in order to promote its use” and that AFG has been used on native breasts since 2009, when regulations on its use were implemented in the United States (and in France in 2011).
“AFG seems to be a major tool in this field, but we must remain cautious about its systematization for this indication,” the authors conclude. “Pre-operative patient selection is essential but under-reported. AFG appears particularly relevant in breast malformations. We believe that this method should be practiced within the scope of a national or international registry with proper follow-up of patients.”
The study appears in Aesthetic Surgery Journal.
