Best of both

Mr Allen Rezai introduces a new method of breast augmentation that combines implants and fat grafting.

MR ALLEN REZAI


Mr Allen Rezai is an aesthetic, plastic and reconstructive surgeon with over 20 years’ experience. His particular specialisms are in breast and facial surgery, including “free flap” breast reconstruction and head and neck reconstruction, the natural SMAS facelift, tuberous/ tubular breast correction, short scar breast uplift and reductions; and natural-looking breast enlargements.


My goal with any type of breast surgery is to create a breast size and shape that complements my patient’s figure, rather than one which under or overwhelms it, and this has everything 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 the 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.


COMBINED APPROACH


However, in cases where a patient lacks natural breast tissue, combining fat transfer with implant augmentation in the hybrid method 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.


Fat transfer has been used 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.


In traditional implant breast augmentations, I normally recommend three different sizes to my 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 my hybrid breast augmentations, whenever possible I prefer to use the implant size which would provide the “completely” natural look. This will allow for the required correction and cushioning without compromising the result in terms of proportion.


“IN CASES WHERE A PATIENT LACKS NATURAL BREAST TISSUE, COMBINING FAT TRANSFER WITH IMPLANT AUGMENTATION WILL SIGNIFICANTLY IMPROVE THE LOOK AND FEEL OF THE BREAST”


THE HYBRID PROCESS


It would be unnecessary to carry out a hybrid augmentation when patient has no