When is it appropriate to combine a breast enlargement operation using surgical implants with fat cells?
In my view, the correct choice in most cases is a combination of breast implants and fat cells (lipofilling). Through the use of patient’s own fat cells, it is possible to achieve types of adjustments that could not be carried out using breast implants alone. This applies, for example, to the area between the breasts, to the top part of the breasts or to the filling out of the lower part of the breasts in the case of tubular breasts.
Usually it is possible, even in the case of very slender patients, to obtain at least a small amount of fat tissue to enable the space between the breasts to be shaped neatly. This process also means that the implant will be completely invisible.
Thanks to the new procedure MotivaHybrid®️, it is possible to use smaller Motiva Implants®️ with a smaller incision and a minimal scar and a potentially lower risk of complications and combine them with high-quality fat grafts made with a special fat grafting system.
Ideal patients for MotivaHybrid®:
How is the fat tissue actually obtained and how does it need to be processed before the transplant operation?
During MotivaHybrid® the harvesting of fat and fat grafting is performed using the MotivaImagine® Bulb-cannula Kit. This is a very gentle suction system, through which we not only achieve a very neat result, but also obtain fat cells of very high quality.
Fat cells harvested using this fat transfer instruments for single use can subsequently be transplanted successfully. The removal of the fat tissue is a very short procedure in this case.
The obtained fat is very efficiently and at the same time gently processed using the fat grafting system. In this way, we get pure and high-quality fat which can be used for the lipotransfer. Fat grafting keeps the tissue contained within a closed-system to maintain the highest standards of sterility.
The processed fat tissue is applied to the required regions when the breast implant pocket is ready. MotivaImagine® Bulb-cannula Kit has been designed and tested to protect the breast implant integrity during lipofilling of fat grafts.
Through this, we can also ensure that most of the fat tissue will not subsequently be resorbed by the body. Generally, it can be assumed that about 70% of the infiltrated fat tissue will remain unabsorbed. As soon as the transplanted fat tissue is established in the body of the patient, we no longer need to be concerned about its eventual absorption.
Of course, the actual breast enlargement is carried out not just with fat grafting, but also with the help of an implant. What type of implant do you use and where do you position it?
I mostly use the breast implants from Motiva®. Depending on the breast shape, I opt either for round implants or for Ergonomix® implants. In the majority of cases, I insert the implants submuscularly, as a result of which the implant is very well covered up. In the past, we have seen that textured and anatomical implants could cause certain problems. We want to prevent such problems, so we use the Motiva implants® with a special surface layer.
What does the end result of a breast enlargement achieved using implants combined with a transplantation of one’s own fat tissue look like?
Through this procedure we achieve a very stable result. The implants last in the body of the patient for many years and so it is now reasonable to assume that they will no longer need to be replaced after a specified amount of time, as was the case in the past.
As soon as the transplanted fat tissue becomes rooted in the body, we can consider the result to be permanent and do not have to be concerned that this fat tissue will be eventually reabsorbed. Generally speaking, we achieve a very stable and long-lasting result.
This operation involves three interventions – liposuction, augmentation using the breast implant and fat grafting. Is it therefore reasonable to assume that more complications could arise as a result of this?
Provided that the patient chooses an experienced plastic surgeon, then this combination of interventions is one with a relatively small number of possible complications. This means that the risk of complications associated with the combined procedure is only minimally higher than the risk associated with each of the procedures carried out separately.
Furthermore, the length of the operation, compared to a classic breast enlargement using implants only, is increased only marginally (by about 20 minutes). This small difference in the length of the operation does not result in a further increased risk.
How are your patients satisfied with the results of the operation carried out using the MotivaHybrid® procedure?
When an operation has been carried out using the MotivaHybrid® surgical system, we have noticed a greater level of satisfaction based on feedback from our patients.
Alongside an increase in breast size, the patients also achieve a reshaping of their figure through the removal of fat tissue from regions such as the hips or inner thighs. This results in a beautiful and significantly better profile in these regions.
Furthermore, the breasts are enlarged in such a way as to provide a more natural appearance, with the implant being invisible so that no one will be able to recognize that a woman has undergone breast enlargement surgery.
(1) Marcos Sforza, MD; Katarina Andjelkov, MD, PhD; Renato Zaccheddu, MD; Rodwan Husein; and Connor Atkinson: A Preliminary Assessment of the Predictability of Fat Grafting to Correct Silicone Breast Implant-Related Complications. Aesthetic Surgery Journal 2016, Vol 36(8) 886–894.