Breast augmentation, what's on offer?

Implants remain THE main breast augmentation procedure. However, women want more natural results these days. To satisfy this demand, two new techniques are now on offer: lipofilling and hyaluronic acid injections.

During the IMCAS congress, several techniques were shown to offer a more natural result under lighter surgical conditions. Plastic surgeon Olivier Gerbault gives Doctissimo an update on the three latest procedures.

Breast augmentation: lipofilling

To meet their desire for natural beauty, more and more women are turning to lipofilling. This recent technique involves reinjecting the patient's own fat into the breasts. Dr Olivier Gerbault explains that we have two years of experience in this technique that enables an increase of "maximum one to two cup sizes".

Injecting the patient's own fat into breasts has the advantage of producing a more natural result and evolves depending on the patient's own evolution (weight gain or loss). By definition, this technique is not for slim women who do not have sufficient available fat reserves.

Lipofilling is the first breast augmentation procedure that doesn't involve foreign bodies or agents. But this technique is not very widespread because of potential risks. "The stem cells used could increase cancer risks and it is very difficult for the time being to say that there is no correlation between breast cancer and these injections," explains Dr Gerbault. What is more, lipofilling is quite restrictive: you may need several sessions and each injection requires hospitalisation (the procedure takes place in the operating block under general anaesthetic).

It is also quite expensive (between £3,500 and £4,000 per session and two to three sessions are often necessary). Patients also need to be aware that the breasts remain swollen for 3 to 4 weeks after the operation. Despite all these reservations, Dr Gerbault does believe that lipofilling "will develop in the future, once everyone is in agreement and the health authorities have given their blessings. The cost should also be more affordable in the near future". Given the reservations issued by professionals and the very little experience concerning this technique, you should perhaps wait further results before going for this.

Breast augmentation: hyaluronic acid injections

We may have little experience with lipofilling, but we have even less with breast augmentation by hyaluronic acid injections. This procedure has been in use for a year and a half and we already know that the results are not permanent. This technique seems to be quite restrictive as the patient, who can hope to gain a single cup size, will require follow-up injections every year, considerably increasing the cost (about £3,500 per session). "Hyaluronic acid injections are generally less used by women as they are very costly. But they can be useful for patients to correct a fault in their breast implants," explains Dr Gerbault.

Injections do not require hospitalisation, and are given under local anaesthetic. The technique offers a natural result given the supple nature of the gel injected. As for risks, according to Dr Gerbault, these are "probably nil". "For the time being, there is no proof of carcinogenic risk for hyaluronic acid," he adds. However, this procedure could hinder breast cancer screening. "The gel is opaque and could mask early cancers on X-rays," explains Dr Gerbault. "This technique is therefore not to be recommended to women with breast cancer risk factors."

Breast augmentation: implants

Breast implants still remain a sure fire method, "representing around 99.9% of all breast augmentation procedures," concludes Dr Gerbault. We have enough experience these days in this technique (the first implants go back to the 1950s) to know that there are no major disadvantages. Today's technology offers implants that look increasingly more natural. In the past, you had to regularly change the implants (every 10 years), "these days, implants do not require changing so frequently and are usually only replaced in the event of a problem," says Dr Gerbault. Nowadays, women receive implants that are less visible and less deforming.

Breast augmentation methods are therefore evolving. For women who do not want to introduce foreign agents into their bodies, techniques (like lipofilling or hyaluronic acid injections) can be used. But experience is still lacking in these new procedures.

Remember that only consultation with your doctor who has a "veritable medical and pre-operative analysis approach" can help you to make the right choice. Dr Gerbault advises women who want to have breast implants to "not hesitate to consult several different doctors". The relationship and dialogue created with the doctor will dictate how successful the operation is. He also warns against fantasies of large breasts.

"Patients need to be careful about large breast augmentations and should think about future pregnancies and changes to the body. They need to be properly informed about the risks and limits which should be respected so that breast augmentation does not have negative consequences in the long term".

Source: IMCAS (International Master Course on Aging Skin) congress press conference, interview with Dr Olivier Gerbault

Jessica Xavier

Copyright © 2010 Doctissimo

Posted 30.06.2010

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