Once discouraged, fat grafting to the breast – especially for reconstructive procedures – is now embraced by about 70% of US plastic surgeons, according to a survey study in the July issue of Plastic and Reconstructive Surgery®.

Researchers led by J. Peter Rubin, MD, of University of Pittsburgh surveyed American Society of Plastic Surgeons (ASPS) members about their use of fat grafting for breast surgery. Overall, 456 member surgeons responded to the survey, with 70% reporting that they had performed fat grafting to the breast.

Fat Falls Back in Favor 

Eighty-eight percent of plastic surgeons who currently perform fat grafting to the breast said they use fat grafting for breast reconstruction, and often do so along with implants or flap procedures. The surgeons found fat grafting particularly useful for improving the shape of the breast, including reconstruction after lumpectomy for early-stage breast cancer. Three-fourths of surgeons performing fat grafting reported that the abdomen was their preferred site for obtaining fat for the procedure.

In the late 1980s, ASPS issued a strong statement arguing against the use of fat grafting, citing the risk of difficulties in early diagnosis of breast cancer. However, more recent studies have reported that fat grafting to the breast provides very good results, and that any changes seen on mammograms are easily distinguished from abnormalities related to breast cancer.

Still, respondents viewed issues of interference with mammography and cancer screening as potential obstacles to fat grafting of the breast. Others cited problems with unpredictable results, including poor retention of the transplanted fat cells.

“This study shows the increasing popularity of fat grafting to the breast, especially to benefit patients undergoing reconstructive procedures. As this field evolves, plastic surgeons will better understand the factors that lead to the best long-term outcomes,” Rubin says in a press release.