Dermis fat grafts for bilateral augmentation mammaplasty (part 7)

The ‘take’ of the graft is also very dependent on technique. DFGs will not accept much manipulation, tugging or squeezing, and cauterizing may hinder the ‘take’. The time the grafts are left exposed to the air will damage them; once they are de-epithelialized on the patient they should be transferred immediately into the previously prepared…

Read more

Dermis fat grafts for bilateral augmentation mammaplasty (part 6)

Dermis fat grafts for bilateral augmentation mammaplasty

DISCUSSION The idea of DFGs for breast augmentation is not new. The procedure has been used by many surgeons in the past but fell out of favour because patients and/or surgeons were discouraged with the results. Furthermore, with the advent of the more reliable silicone implants, DFGs became outdated. Now the pendulum (pushed by some…

Read more

Dermis fat grafts for bilateral augmentation mammaplasty (part 5)

Dermis fat grafts for bilateral augmentation mammaplasty

CASES AND COMPLICATIONS I have operated on a total of 36 patients with this technique: 31 bilateral augmentations and five unilateral. Only one had the grafts taken from the upper buttocks, with the rest taken from the lower abdomen.Four patients, five grafts (three unilateral and one bilateral) did not take. Through a small wound dehiscence,…

Read more

Dermis fat grafts for bilateral augmentation mammaplasty (part 4)

SELECTION OF PATIENTS Obese patients, smokers, the aged and unfit make poor candidates for DFGs. The ideal patient is the young, healthy mother who has undergone a post lactational breast involution and has flaccid wrinkled abdominal wall skin. An abdominal dermolipectomy coupled with an augmentation-mastopexy greatly enhances her looks and body image. I have not…

Read more

Dermis fat grafts for bilateral augmentation mammaplasty (part 3)

Dermis fat grafts for bilateral augmentation mammaplasty

What percentage of DFGs for breast augmentation reabsorbs after one year? Verderame, in 1909, stated that the grafts reabsorb a “considerable amount” and advised the use of a larger transplant than necessary to fill the defect. Lexer contended that only one-third of the fat grafts survived and that they did not grow in proportion to…

Read more

Dermis fat grafts for bilateral augmentation mammaplasty (part 2)

Dermis fat grafts for bilateral augmentation mammaplasty

After four days there was active circulation in the small vessels of the graft, degenerative changes of some fat cells and some disintegration of the cell membranes. There was also cell infiltration of the host tissues into the graft seen as clusters of polymorphonuclear lymphocytes and plasma cells. On the 10th day it was noted…

Read more

Dermis fat grafts for bilateral augmentation mammaplasty (part 1)

Dermis fat grafts for bilateral augmentation mammaplasty

The first attempt at fat grafts found in the literature was described by Neuber in 1893. He successfully used small fat grafts in cosmetic operations about the orbit. A few years later Czerny became famous when he reported the successful transplantation of a large lipoma to replace the breast tissue removed after a subcutaneous mastectomy…

Read more