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Composite breast augmentation –the supercharged alternative to plain breast augmentation

Recent media reports on the supercharged breast augmentation or composite breast augmentation have created a lot of interest. Dr. Mohan Rangaswamy, consultant plastic surgeon in Dubai elaborates more about this new surgery.

What is it?

It is a relatively new procedure but one that is finding increasing acceptance. It is a two-in-one technique where the breast core is augmented by an implant [as usual]and then patient’s own fat harvested from other areas is grafted all around to give added volume and address the issues of implant coverage and shape.

What are the advantages?

  • More natural shape
  • More customizable, not constrained by available implant sizes
  • Can improve difficult areas like upper pole, cleavage
  • Reduces the need to go below the muscle even in thin individuals. Now the fat graft can give extra tissue to cover the implant and therefore one can use the subglandular plane.
  • Allows one to use a smaller implant for the ‘core’ and use fat graft for the added volume requirement.
  • By not using a larger implant and depending of fat to give the desired extra volume, pain and risk of nerve damage are both reduced.
  • The ‘bonus’ of improvement in the donor area from which the fat is taken
  • Ability to correct areas that cannot be addressed by an implant: such as bony upper chest, very thin skin on breast bone, super thin sun damaged skin on the décolletage etc.

Who can benefit from this type of enhancement?

  • Almost every woman considering breast augmentation can be a candidate for the super-charged surgery. But it is especially good for the woman with small breasts & thin tissues and who has unwanted fat on her hips, tummy or elsewhere.
  • Revision cases of dissatisfaction from previous augmentation
  • Women with rippling of skin, palpable implant [where the fingers can feel the implant beneath]
  • Breast asymmetry
  • Women with deficiency of volume on the upper part and cleavage areas
  • Women with widely spaced breast [with implants]

Is there additional expense?

There is additional cost due to additional operative time, physician time and consumables involved. However, the improvement in the ‘donor’ area is a free bonus! By establishing a work-flow of harvesting, processing and re-injecting the fat without too much delay, the fat survival is better and the surgery time can be reasonable.

How long is the experience with this procedure and are there any added risks?

The procedure has been practiced by individual surgeons for past decade but this has really taken off since 2009. Dr. Mohan has been performing this since 2009. A review of 197 patients treated by this way was published in Plastic and Reconstructive Surgery journal in 2013 * where it was found that 57% of the injected fat volume survived and that the combination did not have any significant downsides while enhancing the shape and coverage for the implant.

Surprisingly the procedure is well tolerated, several studies have shown very low incidence of added complications provided correct technique is used. Many surgeons also feel that the risk of capsule contraction is decreased by simultaneous fat grafting but this needs more study. No added risk for cancer formation is documented. No interference with future breast feeding ability. There are no additional scars due to fat graft.

Can fat grafting be done later after conventional breast augmentation?

It can be performed any time later as a stand-alone procedure to enhance the shape further and to make the breasts look more ‘naturally full’. However actual results vary somewhat and candidates considering this must have reasonable expectations.