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    Fat grafting for the breast

    Various fat grafting techniques for breast surgery have been proposed, but some have their critics.

    One viable alternative to standard liposuction is tissue liquefaction technology (TLT), as embodied in the HydraSolve Lipoplasty System (Andrew Technologies LLC; Irvine, Calif.).

    Dr. Myckatyn"By removing the fat with HydraSolve, the operating surgeon may be able to minimize the intermediate step of processing the fat for reinjection by effectively washing and separating the fat cells at the time of harvest,” says Terence M. Myckatyn, M.D., a professor of plastic and reconstruction surgery at Washington University School of Medicine in St. Louis, Mo.

    Unlike competing technologies that rely on heat or a water jet to process fat, HydraSolve synergizes water with heat to efficaciously separate the fat cells with minimal trauma, according to Dr. Myckatyn.

    After processing, “the fat is very clean, in tiny parcels, and ready for reinjection,” Dr. Myckatyn tells Cosmetic Surgery Times. “The actual clumps of fat are smaller than with other forms of liposuction and fat grafting. This translates into a smoother, easier reinjection back into the patient.”

    In 2012, HydraSolve became the first FDA-approved liposuction device for fat grafting.

    Dr. Myckatyn is co-author of a retrospective chart review in Aesthetic Plastic Surgery that involved 136 consecutive breast reconstruction patients, nearly all for either cancer or prophylaxis for cancer prevention, who underwent fat harvest with HydraSolve, for a total of 237 procedures (mostly bilateral).

    The abdomen was the donor site for 50% of the cases, with the remaining two sites being the flanks and the thighs.

    The overall complication rate for the study was 29%, with roughly 75% of adverse events due to fat necrosis at the recipient site.

    “I believe our results are on par with standard liposuction,” says Dr. Myckatyn, whose practice group since 2014 has used HydraSolve on about 350 patients, the vast majority for breast reconstruction.

    NEXT: Beyond Breast Reconstruction

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