Mega-Volume Fat Transplantation to the Breast and Buttocks: A New Surgical Technique That Brings New Anesthetic Challenges

Abstract

Objective: Autologous fat-grafting for the purpose of breast augmentation has gained widespread acceptance as a viable and safe alternative to classical breast implant procedures and has recently been successfully applied to buttock augmentation. Due to the numerous patient re-positionings and widely variable OR time, these procedures present unique challenges for anesthesiologists. Our goal is to discuss the current surgical methods, anesthetic methods, risks and benefits of this procedure. Methods: This is a retrospective cohort study in the setting of the operating room. Twenty-nine consecutive cases of mega-volume fat transplantation, defined as >300 cc to an individual site, performed by one surgeon, were reviewed. Age, Body Mass Index, total fat injected, total operating room time, maximum intraoperative temperature, minimum intraoperative and temperature were measured. RESULTS: Our procedure has enjoyed a 100% patient satisfaction rate. Analysis reveals high variability in age (21-57), total fat injected (200 cc-1990 cc), patient Body Mass Index (18.8-42.2) and total operating room time (1:23:00-6:14:00) for our procedures. There were no instances of major complications in this cohort. Conclusions: Autologous fat transplantation for the purposes of breast and buttock augmentation is an emerging technique that shows great promise and high patient satisfaction, but providing unique challenges for anesthesiologists and surgeons.

Physical, Biochemical, and Biologic Properties of Fat Graft Processed via Different Methods

“…Autologous fat grafting is a widely used technique for soft-tissue filling and augmentation in reconstructive and aesthetic applications, including in the face, 1 buttocks, and breasts. 2 , 3 However, optimization is needed to increase engraftment efficiency and achieve more predictable clinical outcomes, particularly improvement of long-term graft volume retention. Reports of volume loss range from 20% to 90% over the first few months, 4 – 8 far from the desirable clinical outcome.…”