Fat Transfer to the Breast
Although the most common means of breast augmentation is the use of a silicone cohesive gel breast implant, some patients instead choose to receive a fat transfer also known in order to enhance breast size, a procedure also known as lipofilling. This operation, although not without its setbacks, has generated a lot of appeal for patients as it utilizes the body’s own fat tissue as opposed to foreign materials.
The Procedure
There has been a large amount of controversy over the procedure, which has been in practice for almost 100 years, as it has been shown to occasionally interfere with the diagnosis of breast cancer in patients. This occurs because, after the procedure, the fat can die inside of the breast causing calcification. This leads to a hardening of the tissue which can appear as a cancerous tumor in a mammogram thus leading to a positive diagnosis when the patient does not, in fact, have the disease. There has, however, been no evidence that fat transfer increases a patient’s likelihood to develop breast cancer and the surgery is generally considered to be as safe as any other breast procedure.
Despite these issues, the procedure has remained in use due, in large part, to its use of natural body materials as opposed to silicone inserts. When silicone breast implants are used, the silicone breast implants have the ability to cause a reaction in the body due to the body’s immune response to foreign materials. This complication is known as capsular contracture which occurs in approximately 2 to 8% of patients who receive breast augmentation with a silicone breast implant. Capsular contracture consists of the contracting of fibers of scar tissue around the area of the implant. This can lead to painful hardening of the breast and possibly, although rarely, deformity of the area. The use of breast implants has also been somewhat less successful in very thin skinned patients as the edges and lines of the implant are more likely to be seen externally. This can sometimes be avoided by placing the implant underneath the muscles of the chest wall as opposed to above, which is what is normally done. Also, unlike natural fat tissue, breast implants will not act as breast tissue would and the breast will typically feel harder than prior to the procedure. Because of this, the use of natural tissues are ideal but this procedure typically leads to more conspicuous scars as well as being a more complicated procedure to perform.
Lipofilling
In order to be a candidate for lipofilling, the woman must be generally healthy and must have enough body fat so that fat can be safely removed from one area of the body in order to be injected into the breast. It is also essential that a mammogram or an ultrasound be conducted prior to the surgery in order to ensure that the woman has normal mammography as, otherwise, they are immediately disqualified from receiving the procedure.
The procedure consists of two major steps, the first being the removal of the donor cells from an area of the body. The most popular donor sites are the inner thigh, the lower abdomen, and the medial area of the knee. The extraction is typically performed using a cannula which is the same instrument used in liposuction. However, to ensure that no damage is sustained by the fat cells, it is important to extract the cells carefully. If the cells are damaged, they are more likely to lead to calcification in the breast and an unsuccessful procedure. The use of a Water Assisted Harvesting and collection system promotes taking and transferring healthy fat cells.The next step is the insertion of the cells themselves into the breast which is usually done through a series of multiple tiny incisions with the use of a blunt syringe. This type of syringe is used so as to avoid damage to surrounding nerves and blood vessels. Because the transfer of fat consists of multiple steps, the procedure for breast augmentation via fat transfer is significantly longer than breast augmentation with the use of a silicone implant.
Over the years, the technique of transferring fat cells from one area of the body to the breasts have been studied and continue to be perfected with the goal being a larger and more natural looking breast. As mentioned, one of the issues which doctors have encountered is the ability of dying fat cells to mimic the appearance of cancer in a mammogram. Despite this, it has been shown that careful examination by an experienced radiologist will indicate when the area is cancerous and when it is simply a calcification of the tissue.
Pre-Surgical Mammogram and Ultrasound
Before the procedure can be performed, the American Society of Aesthetic Surgeons guidelines state that it is essential that the patient receive a pre-surgical mammogram and ultrasound to ensure that the patient does not have cancer of the breast. This exam is critical as this procedure cannot be performed on women who do not have normal mammography. Following the surgery, it will continue to be necessary for the area to be monitored through the use of regular mammograms as well as ultrasounds.
Other than the inevitable side effect of scarring, other more rare side effects are possible. This includes continued bleeding or hematoma in the donor area of the body or in the recipient site where the fat cells were injected, infection which would need to be treated with antibiotics, and temporary swelling. Also, as is the case with most operations, there is an extremely small risk of pulmonary embolism, which is a blockage of the artery in the lung. This can be caused by the release of a blood clot or fat cells into the artery. If left untreated, pulmonary embolism can prove fatal but, fortunately, this side effect is exceedingly uncommon. The recovery time for the procedure, as with most other breast procedures, is one week.
The procedure might have to be repeated to give more fullness to the breasts. This will be discussed at the initial consultation but is has to be made clear that this will involve an additional cost.
Our Practices
Mr Fourie practices at Nuffield Health Hospital, Leeds, conveniently situated in the city centre near Leeds General Infirmary and at Barnsley Medical Consulting Rooms in central Barnsley.
Cosmetic Surgery Procedures
Mr LeRoux Fourie offers a wide range of cosmetic surgery and non surgical treatments and below is a brief outline of each
Inverted Nipple Correction
Many women find their nipples to be a great cause of embarrassment as they do not project past the breast and remain inverted. Mr Fourie is able to correct this problem using a quick and reliable treatment that can be done in as little as thirty minutes
Prominent Ear Correction
Although having prominent ears typically causes no physical discomfort as such they can sometimes lead to a lack of self-confidence and be on the receiving end of cruel jokes. Sometimes just one ear is the problem but usually both will be pinned back. It is also possible to perform other types of ear surgery to the lobes depending on the complexity of the case.
Male Breast Reduction
Gynecomastia is the medical term for male breasts and can be a very humiliating condition for men and can make them very self-conscious. Because of this, some individuals decide to undergo a male breast reduction procedure in order to remove the excess tissue and, occasionally, even skin from the area of the breasts.
Liposuction / Liposculpture / Body-Jet Lipo
You can now experience the latest advancements in cosmetic surgery with the revolutionary Body-Jet Water-jet assisted liposuction procedure. The gentle water jet washes away the fat without damaging the underlying structures such as the blood vessels and nerves which means less recovery time and bruising.
Non Surgical Treatments
Antiwrinkle Injections
It is inevitable that as we age lines and wrinkles will become visible and to some this is of concern. Lines around our eyes can develop as can lines on the forehead. The prescription injection treatment we all know as BOTOX® is now formally approved for cosmetic use and is called a new name which is VISTABEL®. VISTABEL® is a treatment that is used to relax the frown lines that can trouble our forehead as well as crows feet which can develop around the eyes.
Excessive Sweating
Our body uses sweating to help control body temperature and is normal human function however some people suffer from excessive sweating which can lead to severe embarrassment and anxiety. Following a consultation if your suitable we can provide a treatment that will prevent your excessive sweating that involves BOTOX® being injection into your arm pit.
DermaRoller
Genuine Dermaroller™ Therapy™ can offer a significant improvement in appearance for those who suffer from acne scars, sun damaged skin, fine lines and wrinkles and stretch marks. The DermaRoller procedure stimulates your skin to help with the regeneration and repair of itself and is a natural and safe way to create smoother, brighter and healthy skin.
Fillers
Dermal fillers can be used for many different non surgical enhancements and anti ageing treatments. They can be used for lip enhancement to create subtly increase the volume of the lips, smoothing lines around the lips, nose and cheeks as well as many other areas of the face and body to improve the appearance of the skin.
Mole Removal
It is very common for moles, lesions or cysts and can appear in many different places on the face and body. Sometimes they can be in a prominent position which can cause frustration or self awareness. Mr Fourie is able to assist in many different types of these problems and would be happy to perform many of these in the minor theatre or treatment room if he is able.
Mr Fourie
About Mr Le Roux Fourie
Mr Le Roux Fourie is a Cosmetic and Reconstructive Plastic Surgeon based in West Yorkshire. Mr Fourie was born and raised in South Africa and underwent his medical and post graduate training in South Africa, obtaining his basic Medical Degree in 1979. Thereafter he served as a Medical Officer in the South African Defence Force Medical Corp, before starting training as a registrar in Plastic Surgery at the University of Stellenbosch in CapeTown. He qualified as a Plastic Surgeon in 1987 and was appointed a Consultant Plastic Surgeon at Number One Military Hospital in Pretoria, where he served as full-time Consultant for three years reaching the rank of a Lieutenant Colonel.
In 1991 and 1992 he was in full-time Cosmetic Surgery Practice in Pretoria.
In 1993 Mr Fourie joined the Department of Plastic Surgery and Burns at Pinderfields General Hospital as the second consultant to be appointed after the tragic murder of the two previous Plastic Surgeons. He helped establish the current Department of Plastic Surgery from two members to the current seven consultants. During his time in Pinderfields General Hospital he established a Breast Reconstructive Surgery Service, which works mostly with the Breast Surgeons in dealing with primary breast reconstructions and delayed breast reconstructions after breast cancer.
Mr Fourie has been in part-time Private Cosmetic Surgery Practice in Methley Park Hospital, Nr Leeds since 1993.
Since April 2008 Mr Fourie has been in full-time Private Cosmetic Surgery Practice in Methley Park Hospital.
Special Interests
Mr Fourie is an experienced Breast Surgeon dealing with congenital breast problems, acquired breast problems such as breast reconstructions after cancer surgery (both immediate and delayed) and cosmetic breast surgery.
He has published articles regarding nipple areola reconstruction and has developed a tattooing technique which is now used by Cosmetic Tattooists in the UK.
He has been involved with the Allergan Implant Corporation in a ten year follow-up study of the long term effects of silicone breast implants which was published in the International Journal of Plastic and Reconstructive Surgery.
Mr Fourie further specialises in Facial Aesthetic Surgery and is one of the first surgeons to use the MACS (Minimum Access Cranial Suspension) face lift technique in the UK in October 2002. His long term results using the MACS face lift were presented at the Summer Meeting of the British Association of Plastic Surgeons in Dublin in 2005.
Publications and Presentations
Mr Fourie was awarded the BAPRAS prize for the best clinical paper read at the British Association of Plastic and Reconstructive Anaesthetic Surgeons Summer Meeting in Windsor in 2005.
He was awarded the BAAPS prize for the best paper read at the 2007 Conference in London. The Hackett Prize for the best paper at the BAAPS Conference 2007 was awarded to Mr Fourie.
Mr Fourie has lectured on nipple areola reconstruction and tattooing techniques, the treatment of pressure sores, wound infections and wound problems, facial aesthetic surgery and body contour surgery.
Mr Fourie has appeared in the Discovery Channels series on cosmetic surgery. He also featured on BBC's Inside Out in October 2007.
Mr Fourie has published papers in International Peer Review Journals on topics such as Breast Reconstruction, Breast Implants, Cosmetic Breast Surgery, Nipple Reconstruction and Facial Plastic Surgery
Charity Work
Mr Fourie does voluntary charity work in Africa as part of the Facing Africa Team involved in the treatment of noma (www.facingafrica.org). This is based at Yakatit 12 Hospital in Addis Abbaba, Ethiopia where reconstructions are done on patients suffering from Noma
Qualifications
MBCHB.
FCS (SA) PLAST
FRCS
BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons)
BAAPS (British Association of Aesthetic Plastic Surgeons)
BAHNO (British Association of Head and Neck Oncologists)
GMC Specialist Register - Registered as a Specialist Plastic Surgeon on GMC full registration. The GMC registration is 3633562.
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