Can Fat Transfer be used to Reconstruct a Woman's Breast after cancer safely?

Very interesting article that I recently came across. Fat transfers, taking fat from one area and placing it in another for augmentation or reconstruction, is becoming a very hot field. Lots of debate on both sides, those for and those against. I personally believe that fat transfers to the breast are a very safe and effective procedures and can have incredible results and I use them both cosmetically and for recosntruction. I believe the following research supports this

Fat Stem Cells: Safe for Breast Reconstruction?

Fat-derived stem cells can be safely used to aid reconstruction of breast tissue after mastectomy as long as there is no evidence of active cancer, according to researchers at the University of Pittsburgh School of Medicine. Their findings are available in Tissue Engineering Part A.

Plastic surgeons have long moved fat from one part of the body into the breasts for reconstruction, but with some complications and a varying success rate, explained senior author Vera S. Donnenberg, PhD, assistant professor of surgery, Pitt School of Medicine. More recently, they have considered adding stem cells derived from adipose, or fat, tissue (ADSC) or the bone marrow to the transferred fat with the aim of supporting graft integration by enhancing new blood vessel formation.

"But it has not been clear whether these stem cells are safe for breast cancer patients because they could send growth signals that promote tumor reactivation or provide new blood vessels for the tumor," Donnenberg says. "Our research suggests that this risk is real if the patient still has active tumor cells, but is safe when the cells are inactive or resting."

For the study, the researchers collected adipose tissue that would have been discarded during "tummy tuck" procedures performed by study co-author J. Peter Rubin, MD, associate professor of surgery, Pitt School of Medicine, whose team has several federally funded projects underway to develop fat grafting and stem cell therapies for reconstruction of a variety of tissues.

Plastic Surgery Worldwide

Came across an interesting article. The United States is still the leader in cosmetic surgery and innovation when it comes to cosmetic surgical procedures. There are some suprising countries that are quickly becoming centers of cosmetic surgery innovation. China is one of them.
New York — The United States continues to dominate the plastic surgery field, but some countries not always associated with such procedures are emerging as leaders, according to a global survey released by the International Society of Aesthetic Plastic Surgery (ISAPS).

The “ISAPS Biennial Global Survey” of plastic surgeons and procedures is a first in terms of independent statisticians collecting and analyzing reliable international plastic surgery data, PRNewswire-USNewswire reports.

The society says the survey represents 75 percent of all cosmetic surgery procedures performed in 2009. Among many trends analyzed, the survey reveals what it calls “a new hierarchy of countries with the most surgical and nonsurgical cosmetic procedures.”

Among the top 25 countries are China (No. 2), India (No. 4), South Korea (No. 7), Turkey (No. 9), Colombia (No. 18), Thailand (No. 20) and Saudi Arabia (No. 23).

The survey also notes that liposuction is the leading aesthetic surgical procedure, comprising 18.8 percent of all such procedures worldwide. Breast augmentation follows, at 17 percent, along with blepharoplasty (13.5 percent), rhinoplasty (9.4 percent) and abdominoplasty (7.3 percent).

Nonsurgical procedures outnumbered surgeries, according to the survey. The top five were toxin or neuromodulator injections (32.7 percent), hyaluronic acid injections (20.1 percent), laser hair removal (13.1 percent), autologous fat injections (5.9 percent) and intense pulsed light laser treatment (4.4 percent).

The ISAPS Global Survey also estimates the total number of board-certified (or national equivalent) plastic surgeons practicing today to be 30,817, the total number of surgical procedures to be 8.54 million, and the number of nonsurgical procedures to be 8.76 million.

Full details of the ISAPS Biennial Global Survey are available at www.isaps.org.
A very interesting article. Reflects the globalization of cosmetic surgery.

Breast Cancer "Rights"

One of the biggest issues facing all patients these days is access to treatment. I have found that most women are not aware that Breast Reconstruction after a cancer procedure is available to all women, in fact it is a law. Unfortunately many women are not given the opportunity to even consider reconstruction as they are not even made aware that reconstruction can be done at the same time as their Mastectomy or Breast Cancer Procedure. New York has gone one step further,  the act of informing patients of what their options are concerning breast reconstruction must be discussed by law. I think that this is a wonderful idea and allows a woman to make the choice of whether or not to reconstruct their Breast. I offer all the latest Breast Reconstruction techniques here on the North Shore and I am always available to discuss reconstructive options no matter where a woman is in her treatment.

New Law Requires Hospitals to Inform Breast Cancer Patients of Reconstruction Options

While breast reconstruction after a mastectomy is covered by insurers in New York, many poor, minority, and less educated women do not seek out the procedure. Now, New York Governor David A. Paterson has signed into law a bill that is aimed at reversing this trend.

"A disproportionate number of women who are at a socioeconomic disadvantage do not get breast reconstruction surgery after a mastectomy for one of several reasons. Either they are unaware of it as an option, they do not know it is covered by Medicaid and Medicare insurance programs, they do not know where to gain access to the procedures, or it is never mentioned to them by their other doctors," said Evan Garfein, MD, the plastic and reconstructive surgeon at Montefiore Medical Center who authored the Bill.

He hopes that the new law (A10094B/S6993-B/Information and Access to Breast Reconstruction Surgery) will correct this disparity. It requires hospitals in New York to inform breast cancer patients about the availability of, and insurance coverage for, breast reconstruction before they undergo "mastectomy surgery, lymph node dissection or a lumpectomy."

While Congress passed the Women's Health and Cancer Rights Act in 1998, which guaranteed universal coverage for reconstruction after surgery, and New York soon passed comparable provisions into its laws, disparities in access remain.

"Breast reconstruction has been repeatedly shown to improve the quality of life and overall well-being of women who have been treated for breast cancer," Garfein says. "This new law will ensure that breast cancer patients from all socioeconomic groups are informed about their options regarding breast reconstruction and about where to get the procedure."