Breast lipomodelling, or breast lipofilling, or breast lipostructure or fat transfer in the breast, or adipose tissue graft, represents a major breakthrough in Plastic, Reconstructive and Aesthetic Surgery of the breast, and is a result of our experience, and the great progress of the past 20 years. This technique currently provides unmatched results in terms of quality, consistency and naturalness +++. The natural breast being made mainly of fat, common sense could have made it possible to foresee or anticipate these results, but it was necessary to fight against many ideas received and “politically correct” imposed by certain “guardians of the temple”, and finally, after long and difficult scientific studies, to admit that fat transfers represent, when possible, the best possible alternative in Plastic and Aesthetic Surgery of the breast when a volume contribution is necessary.
The results in terms of quality are unparalleled and lipomodeling has significantly improved the quality of results in Aesthetic Surgery or Reconstructive Surgery. If the concept of the intervention is simple, the technical realization is much more difficult with a learning curve ++++ of at least 100 cases to obtain constant and predictable results (learning curve of the technique, of natural history, and indications). In order to limit the learning curve of our fellow surgeons, we have organized numerous courses and conferences on this subject to be able to share this important experience and spread this knowledge acquired after an intense and creative surgical practice. The main purpose of this site is also to share this experience +++ and knowledge resulting from our work and experience since 1998.
In Autologous Breast Reconstruction, lipomodelling is the ideal complement for autologous dorsal flap reconstruction; the musculo-subcutaneous flap of Latissimus Dorsi then behaving like an ideal recipient site of adipose tissue grafts (recipient matrix for grafting fat tissue). The combination of lipomodelling with Latissimus dorsi flap allows for autologous reconstruction in a vast majority of cases. Only the rare cases of patients with no steatomeria, from where to withdraw the fat, can not benefit from this technique. And in these cases, we need to combine an implant as a Composite Breast Reconstruction.
By analogy, lipomodeling can be applied to breast reconstructions by implants, and the best indication is when considering implant changing. The lipomodelling then makes it possible to improve the quality of the reconstruction, to improve the neckline, and decreases the tendency to the periprosthetic capsular contracture which penalized the breast reconstructions by implant in the long term. Lipomodelling can also contribute to reconstructions after TRAM Flap, or after DIEP; and this is particularly valuable in secondary cases, in patients disappointed by the insufficient results of prior surgery; it then makes it possible, at the price of a procedure with acceptable constraints, to perfect the reconstruction from the point of view of form, consistency and naturalness of breast, especially at the neckline. In these different situations, the lipomodelling is for us a technique of daily use, which completely reset our practice, finally allowing us to obtain breasts of natural consistency and appearance.
Breast reconstruction exclusively by lipomodeling is a technique that we have developed since 2001, but which is currently experiencing significant development, especially in combination with the use of BRAVA (developed by Roger Khouri from Miami). This technique has the disadvantage of requiring several surgeries, and can only be applied for patients with a limited breast volume and significant adipose deposits allowing several fat withdraws . This technique can be very interesting in precise and limited indications, wobfimed during the medical consultation process.
The application of lipomodelling to thoraco-mammary malformations is a field in full development. In the framework of the Poland syndrome, this technique brings a major breakthrough, and will probably revolutionize the treatment of severe cases of Poland’s syndrome, allowing reconstruction of unequaled quality, at the cost of simple follow-up interventions, with insignificant scars. The lipomodelling also makes it possible to correct the thoraco-mammary repercussion of certain pectus excavatum, and to provide a complement to the custom-made prostheses in the context of the major median pectus excavatum which can not be treated solely by fat transfer. Finally, Lipomodeling represents a new therapeutic alternative for the treatment of the tuberous breasts +++ and also allows to obtain amazing results, unequaled in terms of quality, flexibility and naturalness without placing prostheses in these young patients. The non-prosthetic correction of mammary asymmetries resulted from unilateral mammary hypotrophy is also an ideal indication to obtain remarkable results with almost perfect symmetry, with a natural look ++++, without the worry of a prosthesis that would require repeated interventions, because the two breasts will never evolve symmetrically over time if case of unilateral implant insertion.
In Aesthetic Breast Surgery, lipomodeling has also allowed obtaining excellent results. It is very interesting in the minimal asymmetries where it gives very good results. In bilateral breast augmentation by lipomodeling also called Lipoaugmentation, or Natural Breast Augmentation, Lipomodeling allows to obtain very natural results with a moderate increase but a natural character of the breast +++, imperceptible even for a trained hand. The demand must however be well specified during the initial consultation: if the patient wishes a significant augmentation Lipomodeling is not the solution, and it is better then to use the conventional prosthetic solution, or more readily the Composite Breast Augmentation +++, which combines the advantages of both techniques, and gives superb aesthetic results. Finally, lipomodeling is very helpful based on our experience in cases of sequelae of cosmetic breast surgery. In these cases, which are entrusted to us secondarily for repair following a complication, the Lipomodeling makes it possible to get out of a therapeutic impasse; it makes possible to give back the patient’s smile; it makes possible to remove a thorn from the foot to the surgeon who initially operated the patient, and who is often traumatized by the occurrence of a serious complication not originally planned, which has reset completely the management and gave a disappointing result to the patient and the previous surgeon.