When the patient is oncological clear and safe, an oncoplastic procedure performed at the time of tumor removal may not be sufficient aesthetically to restore the volume of the breast. It is true that, for example, a partial mastectomy with oncoplastic reconstruction may not leave a “gap” in the breast, but the resulting breast shape and volume will never be identical to the preoperative state. Therefore, in a second stage, fat transfer using autologous fat is performed to address any aesthetic asymmetry compared to the other breast.
Fat grafting should always be performed under specific conditions for fat harvesting, following international guidelines, to ensure that a significant percentage of the transferred fat survives and does not get absorbed after a few months. Liposculpture in general requires knowledge, experience, and the necessary tools and equipment for fat harvesting, processing, and preparation to ensure that the adipose-derived stem cells remain viable and that the volume restoration is successful without complications in an already operated breast.
Can complications arise in liposculpture?
Certainly, various complications can arise during lipotransfer if everything is not done correctly.
Immediately after the procedure, there can be an inflammatory reaction with swelling and oozing (the transplanted fat may not be accepted by the body and the body tries to expel it), accompanied by all the signs of inflammation. Immediate intervention is required, which means that the desired outcome of the lipotransfer may be lost.
Fat embolism into the pulmonary circulation can occur when the injection injures larger vessels or when the tissue conditions during lipotransfer promote the absorption of lipids into the microcirculation, leading to their migration to larger vessels and ultimately reaching the lungs. This is an extremely urgent clinical condition with a very low survival rate. This is the reason why, in the state of Florida, USA, a law was enacted in June 2022 after 32 deaths in the past 2 years due to the famous Brazilian Butt Lift (BBL). Only specialized and certified plastic surgeons from the American Society of Plastic Surgeons are now allowed to perform liposculpture procedures, including liposuction and fat transfer.
Liposculpture was performed by non-specialized doctors, in Miami and mainly in Latin American provided their services at very low costs under inappropriate conditions, without the necessary education and knowledge to perform such procedures. Clinics closed, millions of dollars were paid to the families of the deceased, but unfortunately, the young women had reached the point of no return in their lives.
Possible complications include what are called oil cysts, which may need to be surgically removed depending on their size. However, the biggest problem in an already surgically treated breast from cancer is the fact that if this wonderful material, which is autologous fat for reconstructing the deficiency in shape, is not prepared and placed correctly, it can cause distortions and hinder postoperative follow-up with ultrasound and mammography. In the case of expert radiologists, the picture is certainly different, but in countless cases, it may cause disturbance due to the recurrence of cancer. One reason why when someone undergoes a specialised surgical intervention, postoperatively they should clearly be monitored by experienced and specialised doctors.
