After PIP scandal own fat as breast augmentation

Breast surgery: autologous fat as an alternative to silicone implants

26.09.2012, updated 28.09.2012

Despite the scandal involving the breast implants of the French manufacturer PIP at the beginning of the year, breast augmentations continue to enjoy great popularity. According to the German Society for Aesthetic Plastic Surgery (DGÄPC), they are the most common surgical procedure worldwide. However, according to the experts, the patients now show an increased interest in alternatives to the previously used silicone implants.

Women who have doubts about the safety of silicone pillows due to the scandal surrounding the inferior PIP breast implants, "can also rely on autologous fat as an alternative," said DGÄPC President Sven von Saldern at a presentation of a recent patient survey of DGÄPC on Wednesday in Berlin , The survey concludes that the number of breast augmentations after the PIP scandal in Germany has declined slightly. Anyone who does not need a breast implant because of a breast cancer or surgery seems to be considering his decision more thoroughly today. This is also due to the growing demand for alternatives to conventional silicone implants.

Number of breast enlargement decreased slightly
The scandal over the inferior breast implants of the French manufacturer PIP drew wide circles at the beginning of the year. After cheap silicone graft-filled low-cost implants ruptured in multiple patients and provoked severe tissue inflammation, health authorities in several European countries recommended removal of breast implants. The resulting uncertainty among the patients is also reflected in the current patient survey of the DGÄPC. The proportion of "breast augmentations in the beauty surgery operations has dropped from 29 percent to 23 percent." In addition, more and more supposedly "safer alternatives are in demand". The "breast augmentation with autologous fat" should be mentioned as such.

Possible alternatives to silicone implants
So far, breast augmentation in the context of surgery usually silicone implants or saline-filled breast pads were used. According to the DGÄPC President, these are well-proven procedures, which assume that there are low risks. High-quality silicone implants are considered to be safe medical devices, according to Sven von Saldern. Nevertheless, there is mistrust after the scandal at the beginning of the year. For the complete renunciation of the breast augmentation, many patients are apparently not ready. They are looking for alternatives. The DGÄPC now presents the treatment with autologous fat as a possible solution. „For quite some time in the discussion is the autologous fat treatment“, Saldern explained, but acknowledged at the same time that this was by no means a standard method in plastic surgery.

Breast augmentation with autologous fat so far less explored
The breast augmentation with autologous fat is, according to the President of the German Society for Aesthetic Plastic Surgery „not yet as well researched as the enlargement with implants.“ According to Sven von Saldern, the procedure is currently used around twice a month, but sees considerable potential for expansion here. During the procedure, fat cells are taken from body parts where they are distracting and can not be eliminated by dieting. The doctor then carefully injects the autologous fat into the patient's chest. According to the expert, the injection takes place around the mammary gland or between the mammary gland and the pectoral muscle. For the fat to attach and heal well on the other cells, it is necessary that the tissue be well supplied with blood. Although will „certainly not heal everything we inject“, but the remaining fat cells survive there for as long as they would have survived in another body region, explained the DGÄPC president. The advantage is that fat remains throughout his life at the new location. The proportion of surviving fat cells was estimated at 60 to 70 percent.

Possible risks of autologous fat treatment
However, although cosmetic surgeons are already using the procedure, the expert says there are uncertainties, particularly with regard to possible disabilities in breast cancer diagnostics and possibly increased risk of cancer from the stem cells in autologous fat. The breast cancer diagnosis could be hampered in the opinion of the DGÄPC president by congestion or calcification in the chest, however „a competent radiologist will distinguish this well from suspected breast cancer changes“ could. However, there is still a lack of studies on this topic. That the stem cells in the autologous fat possibly promote the growth of tumors have confirmed animal experiments. So far, however, it is not clear to what extent the results can be transferred to humans. Whether an increased risk of cancer due to autologous fat is to be expected is still hotly debated among experts. So far, according to the DGÄPC president, only „a long-term study that ran for over ten years, but relatively small with about 150 patients“ was. The data were obtained in an Italian clinic specializing in breast reconstruction after breast cancer treatment. Here it has been shown that no increased tumor risk emanates from the autologous fat, so von Saldern on. In his view, therefore, the process is relatively harmless in this respect.

Another previously used alternative to silicone implants was until recently the injection of hyaluronic acid in the breasts. However, this method is now no longer available because the manufacturing company has withdrawn the funds, explained by Saldern. The reason for the withdrawal were, according to the doctor, the concern that possibly wrong X-ray findings in breast cancer diagnosis could occur.

In general, a breast augmentation should not be decided lightly. For example, in the case of a desire for breast augmentation for purely aesthetic reasons, the attending physicians are obliged to exclude any psychic instability during the consultation with the patient. In addition, this conversation should point out the risks that every surgical procedure entails.

Prevent connective tissue weakness on the chest
Surgeries do not always have to be performed, as non-invasive methods are also effective, for example, in the case of a hanging breast. For example, to prevent connective tissue weakness, breast-tightening exercises are suitable. Sports doctors recommend regular push-ups and chest presses. "In breast pressing, the pectoral muscle is trained," says Dr. med. Jocher Steiger. In the case of push-ups, the upper and lower pectoral muscles as well as the muscles of the upper arms and shoulders. (Fp)

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