Breast surgery: autologous fat as an alternative to silicone implants
09/26/2012, updated 09/28/2012
Despite the scandal surrounding breast implants by the French manufacturer PIP earlier this year, breast enlargement continues to be very popular. According to the German Society for Aesthetic Plastic Surgery (DGÄPC), they are the most common cosmetic surgery worldwide. However, according to the experts, the patients are now showing an increased interest in alternatives to the silicone implants previously used.
Women who have doubts about the safety of silicone pillows due to the scandal surrounding the inferior PIP breast implants "can also use autologous fat as an alternative," said DGÄPC President Sven von Saldern when presenting a current patient survey by DGÄPC on Wednesday in Berlin . The survey comes to the conclusion that the number of breast enlargements has decreased slightly in Germany after the PIP scandal. Those who do not need a breast implant due to breast cancer or surgery seem to be considering their decision more closely today. This also results from the growing demand for alternatives to conventional silicone implants.
Number of breast enlargements slightly reduced The scandal surrounding the inferior breast implants of the French manufacturer PIP reached wide circles at the beginning of the year. After the cheap implants filled with industrial silicone gel were torn in several patients and triggered severe inflammation in the tissues, the health authorities in several European countries recommended removal of the breast implants. The resulting uncertainty among the patients is also evident in the current DGÄPC patient survey. The proportion "of breast enlargement in cosmetic surgery has decreased from 29 percent to 23 percent". In addition, supposedly "less dangerous alternatives" are increasingly being requested. The "breast enlargement with autologous fat" should be mentioned as such.
Possible alternatives to silicone implants Up to now, silicone implants or breast pads filled with saline have mostly been used for breast augmentation during surgery. According to the DGÄPC President, these are well-tried procedures that are expected to pose little risk. High-quality silicone implants are considered safe medical devices, Sven von Saldern continues. Nevertheless, there is mistrust after the scandal at the beginning of the year. However, many patients are apparently not ready to forego breast augmentation entirely. They are looking for alternatives. DGÄPC is now presenting treatment with autologous fat as a possible solution. "Autologous fat treatment has been under discussion for some time," von Saldern explained, but at the same time admitted that this should in no way be regarded as the standard method in plastic surgery.
Breast augmentation using autologous fat has so far been less researched According to the President of the German Society for Aesthetic Plastic Surgery, breast augmentation using autologous fat has "not yet been researched as well as enlargement using implants." Sven von Saldern currently says that he uses the procedure around twice a month , sees significant expansion potential here. During the procedure, fat cells are removed from parts of the body where they are perceived as annoying and cannot be removed by a diet. The doctor then carefully injects the autologous fat into the patient's breast. According to the expert, the injection is carried out around the mammary gland or between the mammary gland and the pectoral muscle. In order for the fat to adhere well to the other cells and heal, it is necessary that the tissue is well supplied with blood. The DGÄPC president explained that "certainly not everything that we inject will heal," but the remaining fat cells survive as long as they would have survived in another part of the body. The advantage is that fat stays in the new place for life. Von Saldern estimated the percentage of surviving fat cells at 60 to 70 percent.
Possible risks of autologous fat treatment Although cosmetic surgeons are already using the procedure, the expert says that uncertainties remain, particularly with regard to possible disabilities in breast cancer diagnostics and with regard to a possibly increased risk of cancer from stem cells in autologous fat. The DGÄPC President believes that breast cancer diagnosis could be made more difficult by thickening or calcification in the breast, although "a competent radiologist could differentiate this from changes suspected of being cancerous". So far, however, there has been a lack of studies on this topic. Animal experiments have confirmed that the stem cells in autologous fat may promote the growth of tumors. However, it is not yet clear to what extent the results can be transferred to people. Experts are still hotly debating whether an increased risk of cancer due to autologous fat can actually be expected. So far, according to the DGÄPC President, there is only "a long-term study that ran over ten years but was relatively small with around 150 patients". The data were obtained in an Italian clinic specializing in breast reconstruction after breast cancer treatment. Here it has been shown that there is no increased tumor risk from autologous fat, according to Saldern. In his view, the procedure is therefore relatively harmless in this regard.
Until recently, another alternative to silicone implants was the injection of hyaluronic acid into the breast. However, this method is no longer available because the manufacturer has withdrawn the funds, von Saldern explained. According to the medical doctor, the reason for the withdrawal was the concern that false X-ray findings could occur in the diagnosis of breast cancer.
In general, breast augmentation should not be taken lightly. When treating breast augmentation for purely aesthetic reasons, the treating physicians are obliged to exclude any psychological instabilities during the consultation with the patients. In addition, the discussion should point out the risks associated with any surgical intervention.
Prevent chest weakness
Surgeries do not always have to be carried out, since, for example, non-invasive methods are also effective for a sagging breast. For example, to prevent connective tissue weakness, breast lifting exercises are suitable. Sports doctors recommend doing pushups and chest presses on a regular basis. "The chest muscle is trained during chest pressing," says Dr. Jocher Steiger. With the pushups, the upper and lower chest muscles as well as the muscles on the upper arms and shoulders. (fp)
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