Breast augmentation by lipofilling

The purpose of breast augmentation is to obtain a new shape that improves the harmony between the breasts and the rest of the body, while maintaining the most natural appearance and feel possible.

Breast augmentation by injecting your own fatty tissue (Lipofilling) is very rewarding because it leaves no scar and helps to trim the shape of the lower body at the same time.

The operation is intended for women whose breasts are poorly developed or have undergone volume variations and sagged. These patients will also have localised areas of fat on the lower body. So, the figure can be brought into balance by using adipose tissue extracted by liposuction from the lower body to increase breast volume by re-injecting it.

This new harmony is a factor of well-being and self-confidence, whether the body is naked or clothed.

The operation is ideally used for people who have a disharmony between the upper and lower body, with breasts that are low in volume or empty, especially after one or more pregnancies or after significant weight loss. They will also have an excess of fat on the lower body (stomach, hips, buttocks, thighs...).

If the patient also has a sagging stomach, abdominoplasty can be performed and the fat removed on the abdomen will be re-injected into the breasts.

On the other hand, if the patient has little reserves of fatty tissue on the lower body and she wants a significant increase in volume, it would be better to opt for an increase by using prostheses if necessary, with liposuction on the lower body to perfect the figure.

Each person arrives with a request for correction of a particular defect that is particularly troublesome to them. The objective of the operation will be to correct this defect as a priority by assessing whether it may be appropriate to correct other associated defects to have a well-balanced, natural result that meets expectations.

So, depending on the insights gained during the first consultation, the operation could possibly be combined with another intervention, such as an abdominoplasty, a breast lift aimed at breast enhancement for empty and sagging breasts, correcting inverted nipples or an areola reduction. These can be performed at the same time or on another occasion.

During the first consultation, it is essential that you openly express what bothers you and what you would like to improve. Do not be afraid to ask any questions, including expressing your fears and expectations. Everyone has a different body shape, psychology and expectations. These are not the same and there is no standard to apply.

After you have explained your motivations, I will examine you and offer one or more solutions, taking into account your expectations, your anatomy, respecting your identity and the natural aspect of your appearance.

At the first consultation, I will evaluate the increase in volume and the best technique to use.

So you can visualise the desired result, I will show you photos of surgical results from cases similar to yours to help you understand the objective of the intervention.

It is essential that you and I have a good understanding when deciding to operate and to determine the technique to use from among those I can offer.

I will then give you all the information on the techniques proposed along with the information sheets from the Société Française de Chirurgie Plastique Reconstructrice et Esthétique (French Society of Plastic, Reconstructive and Cosmetic Surgery) as well as a detailed estimate of the costs for the options chosen. You will then be able to move your project forward and get ready for a second consultation when you will be able to ask any additional questions to help you make a decision and prepare for the operation.

Pre-operative examinations are required as follows:

• Breast ultrasound and/or mammography to check breast health. These will allow any anomalies to be diagnosed and be treated during the operation or may lead to other pre-operative examinations.

• A blood test, if necessary, depending on the type of anaesthetic (local or general).

If you have a general anaesthetic, you will need a consultation with the anaesthetist in the weeks preceding the operation and at least 48 hours beforehand.

You will be prescribed a bra specifically designed for post-operative support and will have to buy this and bring it on the day of the operation so it can be worn at the end of the operation.

No medications containing aspirin or anti-inflammatories can be taken within 10 days of the procedure.

For a general anaesthetic, you will have to fast strictly for 6 hours before the operation (do not eat anything, chew gum, eat sweets or smoke).

Tobacco consumption should be stopped or reduced as much as possible during the month before and month after the procedure. Tobacco can cause scarring problems

Your stay in hospital is usually limited to one day in a day clinic.

The duration of the operation varies according to the number of locations where liposuction is to be performed. The minimum duration of the procedure is about 45 minutes; then you can go home after a few hours of monitoring following the procedure.

Local, deep local (neuroleptanalgesia) or general according to your preferences.

Before you go to the operating theatre, in your room, I will go over the precise goals with you as we agreed during the consultations. You can then always make recommendations and ask any questions. I will then draw the lines and marks on your skin to guide the operation and the lines of the incisions.

The fatty tissue to be re-injected is removed from the fatty areas during liposuction. With Lipofilling, a portion of the transplanted fatty tissue will be absorbed back and a portion will be maintained and become re-vascularised as normal local fatty tissue. The percentage of this fatty tissue taken varies in each case and is between 30-80% of the volume of fatty tissue injected. It is, therefore, necessary to take a larger volume of fatty tissue to overcorrect the area to be filled by at least 30% (a total overcorrection of 130%).

Re-injection is performed using a 2mm micro cannula and in small strokes so as not to allow the graft to accumulate in a single place but to distribute it evenly over the entire breast.

There are no scars because the micro-cannulas are introduced through needle puncture holes that leave no marks.

At the end of the operation, a support bra is put in place to maintain the volume of the injected adipose tissue in the desired position, as well as a compression panty to support the liposuction areas.

During the night and days following the operation, there may be a painful sensation of tension in the area that was operated on, including aches and pains, which may impede your mobility. These pains are moderate in a resting position and may require analgesics that are given through a drip during hospitalisation or are taken as tablets at home. These post-operative pains will diminish and disappear within a few days of the operation.

The stitches used to close the 3mm micro incisions from the liposuction are absorbable and do not need to be removed.

Swelling (oedema) and bruising in the thoracic area are usually very moderate and it takes about ten days for these to disappear almost completely.

You will need to take about 2 to 3 days off work in the majority of cases.

The support bra and panty should be worn day and night for 15 days, then only during the day for a further week.

You will need to arrange a follow-up visit 4 days after the procedure, then after 15 days, 1 month, 3 months, 6 months, and 1 year.

• You may think about resuming sporting activities 1 month after the operation while wearing the support bra and limiting yourself to painless movements. However, intensive weight training using the chest area is strongly discouraged.

• The recommended rest position is lying on your back, slightly raised if possible. You may also lie on your side but you must not lie on your front

• Exposure to the sun: no direct exposure before 1 month and then exposure is allowed using a sun protection cream with a maximum sun protection factor. No exposure to the sun while you have bruises.

• Pregnancy and breastfeeding: Breastfeeding is possible. However, it is advisable to wait for 6 months before considering a pregnancy so that the breast has settled into its final form.

The new shape of the breasts is immediately visible and perceptible to the touch, despite any swelling. Even if the shape is initially a little hard, it will soften in the weeks following the operation.

It takes 1 to 3 months for the tissues to heal, for the breast to become supple and natural and for the increase in volume to stabilise.

In the long term, the result will be stable and sustainable. However, if you want a larger volume increase, lipofilling can be carried out again.

In addition to an aesthetic improvement, this operation has a beneficial impact on the patient's personal well-being and development.

Read the information from the French Society of Plastic, Reconstructive and Cosmetic Surgery.

The cost of the operation will depend on the procedure to be carried out, the duration of the operation, the type of anaesthetic and any hospital charges.

If the reason for the operation is purely cosmetic, you cannot get any reimbursement through a Social Security claim. On the other hand, if it is for reconstructive purposes, you may be covered by Social Security and, if necessary, by your mutual insurance company.

A detailed estimate is given to you during the first consultation according to the options you have chosen. You then have a minimum legal period of 15 days to consider your options and move your project forward.

The first consultation costs €50. The follow-up consultations before and after the operation are free.