To report our clinical experience in simultaneous implant exchange with fat (SIEF) for breast augmentation and reshaping.

The medical records of 26 patients who received SIEF in our department from January 2013 to June 2019 were reviewed. All patients were female, aged (35.2±8.3) years. The prosthesis was removed through axillary approach, inframammary approach or radial incision at the junction of lateral breast and chest wall. Capsulectomy was not performed after implant removal. Fat was harvested using a blunt liposuction cannulas with the diameter of 2.5 mm and 3 side holes, with a negative pressure of -60 kPa. After washing with 4 degree physiological saline, the fat was processed with the cotton pad filtering technique, then a diameter 2.5 mm, 1-hole blunt cannula was used to place the fat. The evaluation of postoperative improvements included breast size, incidence of complications. Patient satisfaction and physician satisfaction were assessed by two independent surgeons (the full score ranged from 4 to 20).

All patients completed the study. The volume of implants in the left breast was (216.2±54.6) ml and that in the right breast was (217.9±53.1) ml. Grafted fat volume for the left breast was (256.8±55.8) ml each time and that for the right breast was (258.1±55.7) ml. The mean follow-up time was (13.5±5.7) months. Small nonpalpable nodules were detected in two patients (7.7%) by ultrasound. No other complications were documented during the study period. The average chest circumference was decreased by (1.1±0.8) cm which was less than one cup according to Chinese Industrial Standards. Patient satisfaction and physician satisfaction were (16.8±2.0) and (16.4±1.6), respectively.

SIEF is an effective and safe method to restore breast volume after implant removal.

Autografts; Adipose tissue; Breast implants; Silicone gels; Breast augmentation