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Pastrick discusses controversial procedure

May 7th, 2012 9:20 am by Staff Report

By Gregory H. Pastrick

Fat injections, or autologous fat grafting, is a procedure in which one’s own body fat is harvested though liposuction and injected back into the body in a different place to add volume to a deficient area.

The technique has been around for a long time for use as a facial wrinkle filler, lip enhancement, and buttock augmentation (the "Brazilian butt lift").

I’ve been performing fat grafting since I started practicing about 12 years ago, but it has garnered recent interest in the area of breast augmentation - despite recommendations from the American Society of Plastic Surgeons in the 1980s that it should not be performed.

The gold standard for enlarging the size of the breasts is implant surgery, but some surgeons have begun again experimenting with breast fat grafting. It has been shown to create a lasting increase in volume of the breast and I have seen some impressive results from colleagues in New York and Los Angeles.

The procedure, however, has a serious drawback.

In the April 2011 issue of "Plastic and Reconstructive Surgery," the most important scientific journal regarding plastic surgery, an article was written about breast fat grafting and concluded that it is NOT a procedure that should be recommended to patients because of the high rate of development of microcalcifications that cannot be distinguished from breast cancer on mammograms.

To clarify, the procedure itself does not lead to breast cancer, but on mammograms, it can mimic breast cancer. This will lead to unnecessary surgeries.

On the other hand, just one month earlier, an article was written in the same journal that concluded that radiographic follow-up of breasts treated with fat grafting is not problematic.

So, where does that leave us in face of two new, good scientific studies with opposite conclusions? One thing is clear and that is that the procedure is controversial and more studies need to be done to determine the best recommendation for patients.

In the meantime, surgeons, in my opinion, should not jump into performing this procedure until it can be clearly established as safe - especially while there is an excellent, time-tested alternative in breastimplantsurgery which has been the most popular cosmetic surgery performed in the United States for the past several years.

Gregory H. Pastrick, M.D., is certified by the American Board of Plastic Surgery. He practices at The Plastic Surgery Center, located at 1 Sheridan Square, Suite 200, Kingsport, Tenn. Check out all of his services at or call 423-392-4884.

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