Consultant Plastic & Reconstructive Surgeon, Dr Allen Rezai, introduces a new method of breast augmentation that combines implants and fat grafting.
4 April 2022| Last updated on 29 June 2022
Hybrid has become one of the buzzwords in the fields of tech and industry and is now dominating the aesthetics market with the introduction of the Hybrid Breast Augmentation.
Breast augmentation, or 'implant surgery', is by far the most popular procedure requested by women around the world.
Dr. Allen Rezai, a leading Consultant Plastic and Reconstructive Surgeon of Harley Street, London and founder of Elite Plastic & Cosmetic Surgery Group in Dubai Healthcare City shares some insight in to Hybrid Breast Augmentation, which is a combination of implant and fat transfer.
He has been performing Hybrid Breast Augmentation for years in Reconstructive and Cosmetic Breast surgeries, however it is only during the past couple of years that the term “Hybrid Breast Augmentation” has become more commonly known.
Why Hybrid Breast Augmentation?
Dr. Allen Rezai explains: “My goal with any type of breast surgery is to create a breast size and shape that complements my patient’s figure, rather than under- or overwhelms it, and this has all to do with proportion."
"When planning for breast implant augmentation, I consider the patient’s height, weight, width of shoulders and hips, breast width, breast height and the distance that exists between the nipple and breast fold, as well as patient’s preference in terms of upper and lower breast pole volume to determine the best breast implant type and size for the patient’s body, as well as the best surgical techniques to employ."
Dr Allen continues: "However, in cases where patient lacks natural breast tissue, combining fat transfer / fat grafting with implant augmentation will significantly improve the look and feel of the breast, especially in the medial, lateral and inferior parts of the breast as the upper pole will already be covered by the muscle."
"This is where the Hybrid method would benefit the patient and create a more natural look and feel to the breast," he adds.
Hybrid Technique in Breast Reconstruction & Cosmetic Breast Surgery
Fat transfer/grafting has been utilised in breast reconstruction surgeries for some time.
Alone, it is an effective method for correcting asymmetries and breast shape in individuals with breast deformities, filling breast defects following lumpectomy for breast cancer, or it may also be an option for total breast reconstruction following mastectomy; however, to achieve sufficient breast volume and reduce the need for multiple surgeries for desired outcome, hybrid augmentation may be a better solution.
In implant breast reconstructions, especially following mastectomy, the patient lacks natural breast tissue, and the transferred fat will act as a barrier between the implant and skin, cushioning the implant to create a more natural look and feel.
The hybrid augmentation technique is used for a similar purpose in cosmetic breast enhancements.
It is employed to create a natural look and feel for patients who lack natural breast tissue, or have lost natural breast tissue due to severe capsular contracture with previous implants (hardness and calcification of the tissue surrounding the implant), or simply to correct volume asymmetry or smooth out contour irregularities.
Who would benefit from Hybrid Breast Surgery?
“Regardless of type of breast augmentation, my goal is always to create breasts that are in proportion to the individual’s frame. If a patient has enough natural breast tissue without any visible asymmetries or deformities, then a natural look and feel can be achieved with implant augmentation alone, subject to correct implant selection and surgical planning. It would be unnecessary to carry out a hybrid augmentation when patient has no real indication for it.
Normally patients who lack natural breast tissue to cover the implants, those with asymmetrical breasts or those who have a wide cleavage, are ideal candidates for hybrid breast augmentation, subject to having appropriate fat to harvest.” says Dr Allen.
In traditional implant breast augmentation, following a thorough consultation and assessment, Dr. Allen normally recommends three different sizes to his patients – one that would create a “small” natural look, one that would look “completely” natural and one that would provide them with a “fuller” natural look.
In hybrid breast augmentations, whenever possible he prefers to use the implant size which would provide the “completely” natural look. This will allow for the required correction and cushioning with fat transfer without compromising the result in terms of proportion.
He says, "It would be unnecessary to carry out a hybrid augmentation when patient has no real indication for it. If a patient has enough natural breast tissue without any visible asymmetries or deformities, then a natural look and feel can be achieved with implant augmentation alone, subject to correct implant selection and surgical planning."
"Normally, patients who lack natural breast tissue to cover the implants, those with asymmetrical breasts, with a wide gap between the breasts or those who have developed capsular contracture or wrinkles and rippling of implants, are ideal candidates for hybrid breast augmentation, providing they have appropriate fat to harvest. This is usually taken from the flanks, abdomen or thighs.” explains Dr. Allen.
Hybrid Breast Augmentation – The Procedure
In hybrid breast augmentation, the implant augmentation is completed first, placing the implants in the desired pockets and closing the wound. Then, the previously agreed donor area is prepared, and an adequate amount of fat is harvested, using a blunt cannula connected to a syringe and a closed system for a careful extraction of fat cells.
The obtained fat is washed and purified using a centrifuge or special filtration process to prepare the fat cells. The prepared fat is then transferred into the desired areas of the breast using a syringe connected to a blunt cannula. The cannula is passed in and out of the areas to be augmented multiple times. Each time the cannula is withdrawn, the fat is carefully deposited in natural tissue planes.
This process is repeated until the desired correction or volume is achieved. It normally takes up to three to four months for the transferred fat cells to “take”.
The patient may lose about 30% of the transferred fat cells, however a second session of fat transfer will not be necessary as the main shape and volume of the breast is achieved with the implants; the fat cells are only there to complement the lack of natural tissue in certain areas of the breast.
Hybrid Breast Augmentation – Other Considerations
Downtime may be slightly longer than with traditional implant augmentation, as the donor site where the fat has been harvested from will be tender and swollen for a few weeks.
There is one specific side-effect that is associated with fat transfer and that is fat necrosis. This refers to the part of the transferred fat that may not receive enough nutrients and become hard.
Depending on the size of the fat necrosis, this does not have any health implications and generally does not concern patients. In many cases the fat is resorbed by the body, however sometimes it may be felt and cause discomfort, and in these instances it would need to be removed surgically. Fat necrosis may also occur on the donor site where the fat is harvested from.
The Importance of a Detailed Consultation
When considering Breast Surgery or any other type of procedure for that matter, a thorough, in-person consultation with a skilled plastic surgeon is vital. It’s during this meeting that you can discuss your goals with wanting surgery, and what your preferences are in terms of “Look”.
It is paramount that you take your time when researching plastic surgeons. One of the most important considerations a patient should have is choosing a plastic surgeon who is skilled, honest, and who will discuss all aspects of the procedure, including surgery and implant associated risks and complications, in detail and who provides realistic expectations in terms of the outcome.
As a doctor, it’s important to take the time to fully understand patients’ expectations and goals with the surgery. The Elite Plastic & Cosmetic Surgery Group believe that honest and open, two-way communication, is the key in achieving a successful outcome!
Last, But Not Least!
To conclude, we asked Dr. Allen Rezai to provide a list of what he believes to be the most important considerations to be considered when contemplating Hybrid Breast Augmentation or any other Breast Enhancement Surgery and choosing a surgeon. The following was his reply in the form of a simple but comprehensive checklist:
- Think about the change you want to see, then research and find out as much information as possible about the treatment, being precise about what you want and, above all, be open to all your wishes not being achievable.
- Find a qualified plastic surgeon experienced in Breast Surgery, making sure that he or she is board certified. Also look for “genuine” reviews and feedback from previous patients.
- Have consultations with at least 2 or 3 qualified and experienced plastic surgeons, just to have something to compare and cross-check.
- Be honest about your medical history and discuss all aspects of the surgery with the plastic surgeon. Do not be afraid to ask questions, since it is important to know the risks involved and feel comfortable with the person who will be carrying out the surgery.
- The plastic surgeon should be able to explain why they recommend a certain type of treatment option or technique, as with all cosmetic surgery, the type of technique used depends on many factors involving the patient’s indication for treatment, anatomy and lifestyle, and a treatment plan should be tailored to suit the specific needs of the patient.
- Thoroughly Research the type of breast implants offered to you. Find out information about the implant manufacturer, how long the implants have been on the market, their track record and what type of guarantees come with the implants.
- Find out what type of care is offered Before, During, and especially After the surgery as after-care can be just as important as the surgery itself. So make sure you know who to contact and how you will be looked after, especially if there are any complications or problems following your surgery.
- Find out where the surgery will be performed, as this can have major implications on safety during the operation and the occurrence of possible risks and complications.
- Last but not least, "COOL OFF" before you Commit. Cosmetic Surgery should not be taken lightly, as it is after all surgery. Take your time and reflect on all aspects of the Breast Augmentation procedure, and make sure you understand all the implications involved before you make an informed decision to proceed.