Breast Augmentation, No Implants Needed?

breast implant

Staria Peterson loves her breasts.

"My breasts are beautiful," said Peterson, 75, of Miami, Fla. "They are not great, big breasts, but to me they seem huge."

Peterson's enthusiasm over her bust may seem unusual to those unfamiliar with her story. But for women like her who have undergone double mastectomy -- the removal of both breasts – after breast cancer, her reaction is completely natural.

Her breasts, too, are completely natural. Peterson refused artificial breast implants after her surgeries, fearing they would obscure evidence of her cancer if it recurred. That was 35 years ago. For more than three decades, Peterson lived without breasts.

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"I went 30 years with nothing," she said. "I was flat-chested, with scars on my chest. It was not pleasant."

That was until 2007, when Peterson opted to undergo a novel procedure that injected her own fat, harvested from her waist and buttocks, into her chest. It is an approach that has been attempted for decades, but with limited success. Now, a doctor behind a new technique to inject fat into the breasts says that this time it is different.

"Fat tissue grafting to the breast has been frowned upon for a very long time," said plastic and reconstructive surgeon Dr. Roger Khouri of the Miami Breast Center in Miami, Fla. However, he said his new approach, which incorporates a vacuum pressure device to expand the breasts before and after injection, leads to better results than in the past.

"It is feasible, and the results are very good," he said. "We've refined the technique to really make it work."

One of the technique's supporters is plastic and reconstructive surgeon Dr. Thomas Biggs. "We've been injecting fat for a long time, but never as successfully as we have recently," said Biggs, who is also the protégé of Dr. Thomas Cronin, one of the inventors of the first artificial breast implant.

Other plastic surgeons agreed the technique is an intriguing one with great potential, particularly for mastectomy patients. However, some plastic surgery experts said that it would be a while yet before this technique would enter the mainstream of the lucrative cosmetic surgery market. One of these experts is president of the American Society of Plastic Surgeons (ASPS), Dr. Michael McGuire.

"Ideally this is a great solution," McGuire said. "I can't tell you how many patients have told me, 'I have too much fat here, and my breasts are too small – can you take this out and put it there?'

"Unfortunately, there are still a large number of issues that remain."

Fat Transfer and Safety Concerns

The most prominent of these issues has been that historically, not all of the fat transferred into a breast will survive. The first surgeons who attempted to move fat from other parts of the body learned that the fat that died off led to loss of volume and, in some cases, a lumpy appearance. Worse, this dying fat formed calcifications in the breast, which could obscure the presence of breast cancer during subsequent mammograms.

Dr. Julius Few, director of the Few Institute for Aesthetic Plastic Surgery in Chicago, said that these concerns may still linger. "If someone is considered at higher risk for breast cancer, due to family history or other factors, it is vital they discuss this with their primary doctor," he said.

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