Megavolume Autologous Fat Transfer: Part II. Practice and Techniques

Summary: The authors describe the techniques that use the principles of fat grafting to allow them to successfully graft megavolumes (250-ml range) of autologous fat into breasts. The Brava external volume expansion device preoperatively increases the volume and vascularity of the recipient site. Low- pressure liposuction and minimal centrifugation are used to gently extract and purify the adipose tissue with minimal trauma. Even and diffuse reinjection of the fat increases graft-to-recipient interface and reduces interstitial fluid pressure. Postoperative Brava use protects the graft and acts as a three-dimensional immobilizing splint. By adhering to these techniques, we have been able to graft megavolumes of fat into the breasts of over 1000 patients and obtain substantial long-term volume retention.