Safety and Effectiveness of Single Session Mega Volume Fat Grafting for Breast Augmentation: A Space-Creating Concept and Clinical Experiences

BACKGROUND: The main drawback of fat transfer breast augmentation is the need for multiple sessions of fat injection. For approximately 15 years, stem cells and the Brava device for breast expansion have been discussed and extensively investigated to address relevant challenges. However, the safety and effectiveness of autologous fat transfer as a single-session primary breast augmentation technique has not yet been standardized. OBJECTIVES: The aim of this study was to achieve mega volume fat breast augmentation in a single session by developing a "space-creating" approach that emphasizes the use of highly purified fat to achieve an optimized surgical outcome with large-volume breast augmentation. METHODS: Female patients who underwent aesthetic breast augmentation (October 2013-October 2020) involving the application of this space-creating technique for mega volume autologous fat transfer were retrospectively enrolled. Inclusion criteria were patients with hypomastia, breast asymmetry, and volume replacement following implant removal with BMI ≥18.5 kg/m2. After macrospace creation, highly purified fat was injected in several rounds during the procedure. A breast massage was performed between each stage (microspace creation). Breast circumference, nipple-inframammary fold distance, and cup size were recorded during 6 months of follow-up. RESULTS: Three hundred fifty-eight patients met the inclusion criteria. Average fat injection volumes of 510.9 mL in the right breast and 490.8 mL in the left breast resulted in at least a 2 cup size increase. The significant outcome remained stable at 6 months after surgery. CONCLUSIONS: The space-creating technique and the injection of highly purified fat achieves stable cosmetic outcomes of mega volume breast augmentation in a single session.