Editing Breast augmentation (section)

====Fat harvesting and contouring====

The centrifugal refinement of the liposuction-harvested adipocyte tissues removes blood products and free [[lipids]] to produce autologous breast filler. The injectable filler-fat is obtained by centrifuging (spinning) the fat-filled syringes for sufficient time to allow the serum, blood, and oil (liquid fat) components to collect, by density, apart from the refined, injection-quality fat.<ref>{{cite journal|author=Asken, S.|title=Autologous Fat Transplantation: Micro and Macro Techniques|journal= American Journal of Cosmetic Surgery |year=1987|volume= 4|issue=2|pages=111–121|doi=10.1177/074880688700400205|s2cid=79451948}}</ref> To refine the fat for facial injection quality, the fat-filled syringes are centrifuged for 1.0 minute at 2,000 RPM, which separates the unnecessary solution, leaving refined filler-fat.<ref>{{Cite journal | last1 = Toledo | first1 = L. S. | title = Syringe liposculpture: A two-year experience | journal = Aesthetic Plastic Surgery | volume = 15 | issue = 4 | pages = 321–326 | year = 1991 | pmid = 1950806| doi = 10.1007/BF02273880 | s2cid = 33827789 }}</ref> Moreover, centrifugation at 10,000 RPM for 10 minutes produces a "collagen graft"; the [[Histology|histologic]] composition of which is [[Cell (biology)|cell]] residues, [[collagen]] fibres, and 5.0 percent intact fat cells. Furthermore, because the patient's body naturally absorbs some of the fat grafts, the breasts maintain their contours and volumes for 18–24 months.<ref>Uebel, C.O. (1992) "Facial Sculpture with Centrifuged fat Collagen", pp. 749–752 in Hinder, V.T. (Ed.) ''Plastic Surgery'' Vol. II. Amsterdam Excerpta Medica</ref><ref>[[#Schiffman|Schiffman]], p. 5.</ref>

[[File:20845 Dr. Placik Chicago Arlington Heights Illinois Fat Grafting Breasts.jpg|thumb|right|350px|Fat-graft breast augmentation: the pre-operative aspects (left) and the post-operative aspects (right) of a large-volume non-surgical augmentation]]

In the study ''Fat Grafting to the Breast Revisited: Safety and Efficacy'' (2007), the investigators reported that the autologous fat was harvested by liposuction, using a 10-ml syringe attached to a two-hole Coleman harvesting [[cannula]]; after centrifugation, the refined breast filler fat was transferred to 3-ml syringes. Blunt infiltration cannulas were used to emplace the fat through 2-mm incisions; the blunt cannula injection method allowed greater dispersion of small aliquots (equal measures) of fat, and reduced the possibility of intravascular fat injection; no sharp needles are used for fat-graft injection to the breasts. The 2-mm incisions were positioned to allow the infiltration (emplacement) of fat grafts from at least two directions; a 0.2&nbsp;ml fat volume was emplaced with each withdrawal of the cannula.<ref>{{Cite journal | last1 = Coleman | first1 = S. | title = Avoidance of arterial occlusion from injection of soft tissue fillers | doi = 10.1067/maj.2002.129625 | journal = Aesthetic Surgery Journal | volume = 22 | issue = 6 | pages = 555–557 | year = 2002 | pmid = 19332014 | doi-access = free }}</ref>

The breasts were contoured by layering the fat grafts into different levels within the breast, until achieving the desired breast form. The fat-graft injection technique allows the plastic surgeon precise control in accurately contouring the breast{{snd}}from the chest wall to the breast skin envelope{{snd}}with subcutaneous fat grafts to the superficial planes of the breast. This greater degree of breast sculpting is unlike the global augmentation realised with a breast implant emplaced below the breast or below the pectoralis major muscle, respectively expanding the [[retromammary space]] and the retropectoral space. The greatest proportion of the grafted fat usually is infiltrated to the pectoralis major muscle, then to the retropectoral space, and to the prepectoral space, (before and behind the pectoralis major muscle). Moreover, although fat grafting to the breast [[parenchyma]] usually is minimal, it is performed to increase the degree of projection of the [[Cleavage (breasts)|bust]].<ref name=Coleman/>