-One Happy Buford Patient
Denver, Colorado

And so it is not surprising that fat grafting would eventually make its way to breast enhancement. Since many of us have a little extra fat here and there, surgeons put two and two together and realized that breasts could potentially be volumized simply by taking fat from another place and injecting it into a woman’s breasts. And so the media caught on and results were shown of beautiful breasts made more beautiful simply by adding fat. But its’ not that simple.

The American Society of Plastic Surgeons (ASPS) banned the use of fat grafting for cosmetic augmentation in 1987 but recently revisited its use by conducting a study to evaluate just how safe it actually is to use fat for breast augmentation. The concerns range from slight imperfections (due to local fat necrosis) to severe infections and potentially induction of breast cancer. Although plastic surgeons have used fat to reconstruct breasts after mastectomy, in this case all breast tissue is removed before the fat is actually added. And so fat, which excretes estrogen (a hormone that stimulates breast cell growth) has very little risk of stimulating breast cancer cells. But in the case of cosmetic augmentation, breast tissue obviously still remains and so there is a theoretical risk, albeit small, of increasing the risk of breast cancer. The current study, although not large (50 patients) to date has not shown an increased risk but nevertheless the risk potentially still remains.

And so the question is asked, will fat transfer ultimately replace the need for breast implants and is it a safer alternative to the saline or silicone gel implants currently being used. To best answer this, keep in mind some potential advantages and disadvantages.

Fat Is Readily Available

• Advantage: there is no implant cost
• Disadvantage: fat can be unpredictable and the procedure may need to be repeated to achieve long-lasting durable results whereas with an implant the volume is known

Fat Is Your Own Tissue

• Advantage: there is no chance for rejection
• Disadvantage: numerous studies have documented the safety of breast implants and their results are predictable

Cost

• Advantage: liposuction is performed at the same time and so you are getting two procedures at the same time
• Disadvantage: most surgeons currently performing AFG for breast augmentation are charging significantly more for this procedure than for a conventional implant breast augmentation (many times the cost may run upwards of $10,000 or more!)

The Technology For Fat Grafting is Becoming More Refined

• Advantage: better fat survival is being seen and the results are potentially more predictable than they were previously
• Disadvantages: aside from a few highly trained specialists, many plastic surgeons are not actually trained to use fat for breast augmentation and so the risk for complications can be very high. A recent study in the Journal of Plastic & Reconstructive Surgery documented just how dramatic these complications may be and warned of these dangers.

And so what is the consensus? Most plastic surgeons are still very wary to fully embrace fat grafting for breast augmentation until the process is more adequately refined and until the question of breast cancer stimulation is satisfactorily answered.

If you have any questions about this interesting topic, please do not hesitate to call me or my staff at 303.708.8234. We look forward to your input.

I was frustrated to find that no exercise or padded bra could replace the loss of fullness my former breasts had or give me the same feeling of womanly sexiness I possessed with my pre-baby breasts. I never fully appreciated how having firmer, fuller and sexier breasts was such a part of my sense of self and womanliness until they were gone. Finding clothes, swimsuits and cocktail dresses was a challenge and there were so many things I just couldn’t wear without a particular bra, let alone go braless, and it was starting to affect my self confidence.

I began noticing other moms and found that many of them had fuller breasts than I did. Did they just have better genetics or was it possible they had managed to find the ultimate bra that I had somehow overlooked? Eventually I brought up the subject to one of my close friends, who happened to be a mom of two and filled out her tops amazingly well. She let me in on her secret; breast implants. I was shocked. I thought only models and Hollywood types got breast implants, not suburban moms. Once I knew the secret I realized how oblivious I had been to how common breast augmentation is among suburban moms. There are a lot of great-looking moms thanks to breast augmentations and I wanted to join the club.

So I began asking around. I got several names of reputable Board Certified Plastic Surgeons and I learned all about the procedure, options, recovery and possible risks. For me it was a no-brainer; I was going to have full and sexy breasts again.

After narrowing my list to three Plastic Surgeons, I interviewed each of them and decided on mine based on his years of experience, technique, reputation, expense, his staff, and finally his personality. My decision to have a breast augmentation was quickly becoming a uniquely intimate experience so I made sure I had a doctor that was not only very capable of successfully performing this transformation, but one I felt secure and comfortable with. Saying a breast augmentation is an intimate experience may sound strange, but this was my breasts/womanhood that a Plastic Surgeon was going to give back to me, and make them better than before! It’s very easy to start seeing your surgeon as a hero because what he can do for you and your self confidence is extraordinary.

After a few pre-surgery consultations with my Plastic Surgeon, I had picked out the size of implants I was going to use by “trying them on”. I placed several recommended sizes in my bra until I found the size I liked and suited my proportions. I didn’t want to go too big or look too obvious, but wanted to replace the volume I had lost by having children. I had followed my doctor’s advice and started wearing two extra-padded bras a few weeks before my surgery to get used to how I would look afterward. This is also a great way to make a sudden transformation less obvious among your friends, family and coworkers. As it turned out, many people thought I had lost weight after my breast augmentation because my fuller breasts accentuated my waistline.

The day of my breast augmentation I was taken to the outpatient surgery center at my hospital. My doctor greeted me with a smile and soon began marking my chest with a black sharpie in preparation for my surgery. I wasn’t at all nervous and was more than ready to receive my new breasts. The procedure itself lasted a couple hours and went very well. I was placed under general anesthesia while my surgeon performed this miracle and woke up with the sore breasts I anticipated tightly wrapped in a very supportive surgical bra topped with bandages to keep the new “ladies” secure. After resting for a couple hours post-operative, I was sent home to continue my recovery.

My doctor had given me some medication for the pain, but having given birth to three children I thought the pain was completely bearable and it lasted only a few days. In the weeks that followed I learned how often I actually use my pectoral muscles, as every jar of jelly I opened to make PBJ’s reminded me. There was discomfort for a few weeks afterward but the recovery process was not so bad considering the gift I had been given. Yes, I did pay for my breast augmentation but it seems like a gift since feeling like a sexy woman again instead of a deflated and self-conscious soccer mom is priceless. Having a breast augmentation is like the birth of children; you forget all about the discomfort of the process because the reward is so great.

Several years later I am still immensely happy with my decision to have a breast augmentation. I’ve had another child since then and was able to nurse her like I did my other children and my breasts still look great. I can go braless and wear what I like and I feel more attractive and sexy than I ever did before my surgery.

In my practice, clients come from all walks of life but they all want the same thing…a natural and proportionate look. Many of these women have had children and find that their breast volume was dramatically reduced following pregnancy or breast feeding. And while some are simply looking to restore the shape that they once had, others have always dreamed of larger, shapelier breasts and now feel empowered to achieve this.

Whatever the motivation, breast augmentation has changed dramatically over the last few years largely due to improvements in the breast implant itself. In particular, silicone gel implants are now more durable and more lifelike than in previous years. I am personally seeing more and more women educated about and coming in asking for the new cohesive implants. Some have seen their friend’s results and were impressed with the very natural look and feel while others are simply looking for a more natural alternative to saline-filled breast implants. In the past few years, more and more of my clients are gravitating towards this choice to the extent that cohesive gel implants have become my predominant choice for breast augmentation. And I continually receive positive feedback from my clients regarding these implants; many often comment that they cannot even feel them because of their ability to blend in with their own natural breast tissue.

The shift to silicone gel breast augmentation is simply a reflection of a trend towards more natural results in Plastic Surgery overall. While many clients want to look better, they still want to look like themselves and want options that allow them to do just that. Young moms are realizing that pregnancy is a new beginning on several fronts and that the body changes incurred can be addressed with a minimal downtime procedure yielding very natural results.

-Gregory A. Buford, MD FACS

• Board Certified Plastic Surgeon
• Fellowship Trained Cosmetic Surgeon
• Founder & Medical Director, BEAUTY by BUFORD

I chose BEAUTY by BUFORD and elected to work with Dr. Buford after researching surgeons in the Denver area and found that this surgery center was growing in popularity and had a great reputation.

I was very pleased with the overall experience of both before and after surgery. Everyone on staff is very friendly and knowledgeable and the office is very efficient and organized. Each of the staff that I worked with insured that all of my questions were answered and that I understood and was comfortable with the decisions that I had made. I was given all of my post surgery instructions and was told what to expect, prior to the operation. Recovery time was very fast after surgery and I am very happy with the results. I would absolutely do the surgery again and will probably look into that a few years down the road. I have already told my friends about BEAUTY by BUFORD and my experience there and they are planning to schedule soon.

-Actual Patient Testimonial (Breast Augmentation)

To address the first concern, most patients are concerned about side-effects related to narcotic pain medications.  They simply don’t have the time nor the patience to be senseless, nauseated, and lose their appetite simply to achieve effect pain control.  Thankfully, times have changed.  Today’s Plastic Surgeon is armed with more options including non-narcotic pain relievers, localized nerve blocks, and topical devices aimed at reducing their post-operative discomfort.  In my practice, all patients begin on a loading dose of Celebrex, a non-narcotic pain reliever, the night before surgery.  Following their surgery, they continue with a lower dose of this medication and supplement with a narcotic pain reliever as needed.  In addition, to help reduce the need for any pain medication following surgery, I not only inject their breasts with numbing medication during the procedure, I also wash out the implant pocket with antibiotic solution and additional numbing medicine. Most importantly, I also perform an Intercostal Nerve Block immediately before the procedure which I feel is extremely effective in reducing immediate post-operative discomfort.  As a result, a majority of my patients are able to greatly decrease their reliance on narcotics and transition to non-narcotic pain medications within 24-48 hours following surgery and continually remark to both myself and my staff that their recovery was much easier than anticipated.

As far as activity restrictions, I recommend that they not lift anything heavier than 6-8 pounds (including their children) for one week after surgery and that they hold off on any aggressive physical activities for the first few weeks during their recovery.  They are encouraged to return to light exercise one week after surgery as long as it doesn’t involve the use of their shoulders or chest muscles.  From here, they can usually return to aerobic activities, running, Yoga, and Pilates within 4-6 weeks.

A majority of my patients return to work as early as 3 days after their surgery as long as their profession does not require extension lifting or use of their chest muscles.  As compared to years past, Breast Augmentation is now a more finely tuned procedure in both what we do during and after the actual procedure.  The result is a more comfortable and more rapid recovery and an overall very happy patient population.