Expert Doctor

Unwanted Fat Tissue Used to Enhance or Reconstruct Breasts

Posted January 31, 2017

Joel Aronowitz, MD

Los Angeles, CA

Unwanted Fat Tissue Used to Enhance or Reconstruct Breasts

Fat tissue is really unappreciated. We deride it as an unhealthy, even ugly and unnecessary, part of the body and many of us spend herculean efforts to get rid of it. Of course, fat can be unhealthy, and too much of it definitely is not pretty, but fat (or the more technical term 'adipose tissue') contains a lot more than just the extra calories we haven’t been able to burn off. Fat tissue is composed of cells just like all living things. In addition to calorie-storing fat cells, it’s been known for many years that the fat that makes our jeans tight and skin loose contains large numbers of small, starburst-shaped cells with very special properties. These “stem cells” have the potential to grow into many types of the tissue and play a central role in healing and regeneration. Recently, doctors have been able to apply these exciting laboratory findings to help patients in clinical practices. An IRB-approved study currently underway by doctors at the Breast Preservation Foundation and the University Stem Cell Center in Los Angeles exemplifies this new trend in clinical use of Adipose Derived Stem Cells. 

Women in the study are offered use of their own adipose or fat stem cells to regrow their breast after damage by prior surgery or radiation to treat breast cancer. The treatment of breast cancer usually involves removal of the tumor itself along with all or part of the surrounding normal breast to ensure that a complete removal is accomplished. After the surgery the breast is frequently treated with radiation, which further shrinks the breast and turns the soft breast tissue to a hard, woody texture. For years the only options available to reconstruct the breast were highly invasive flap procedures such as the lat dorsi or TRAM flaps or an implant. The flaps require a donor site scar and extended healing and implants are associated with the problems of any large foreign body. They are especially problematic after radiation treatment

Women who have breasts damaged by cancer treatments, especially lumpectomy and radiation, are generally good candidates for this treatment. The study requires a waiting period after cancer treatment but doctors feel that soon the treatment will be offered in conjunction with cancer treatment, as there is no evidence that normal fat derived stem cells interfere with treatment.

Stem cell treatment has the advantage of producing a natural regrowth of fat tissue within the breast giving a soft, natural appearance and feel using the woman own fat stored in the abdomen, hips and thighs. 

Another university stem cell center study currently underway uses fat harvested with liposuction from the hip, abdomen or thighs to enlarge breasts as an alternative to implants. The fat, usually 400 to 600 cc’s, is treated in a special biologic laboratory right in the operating room to isolate the tiny stem cells from the larger mature adipocyte or fat cells and other components in the lipoaspirate—the fat produced by liposuction. The whole process takes about 90 minutes. The tedious process involves a complex series of washings and high-speed centrifugations, but no additional chemicals or growth factors are added to change the biology or genetics of the cells. Almost a million cells on average are isolated from each 1 cc drop of liposuction fat. The stem cells are then added to additional lipoaspirate to inject into the disfigured breast. The stem cell-enhanced fat grafts are placed with a blunt, hollow needle in small aliquots to prevent surgical scarring. Postoperative healing is usually limited to swelling and bruising both in the breast and the liposuction harvest area. Patients usually complain of more discomfort in the liposuction areas than the treated breast. The postsurgical difference in breast size is immediately apparent, but the improved skin quality and regeneration or regrowth of fat takes about three to six months as the larger fat cells are replaced by new tissue. 

Women seeking an alternative to breast enlargement with implants will be happy to know that this option is available to them as well. Stem cell-enhanced fat grafting can produce one to two cup sizes of enlargement on average and can be repeated every three to four months (so long as sufficient donor fat is available).

Cell-enhanced fat grafting is an emerging, natural option for both cosmetic breast enlargement and breast reconstruction. If you want an alternative to implants or invasive muscle flap surgery, you might want to look into this option. 


Article written by Dr. Joel Aronowitz in Los Angeles, CA.

Article Last Updated on January 31, 2017