Hybrid Breast Augmentation Using Subglandular Implants and Intraoperative Contour-Guided Fat Grafting in a Slender Patient: A Case Report
This case report demonstrates that combining subglandular breast implants with intraoperative contour-guided autologous fat grafting effectively addresses soft-tissue deficiencies and refines breast contours in slender patients, resulting in satisfactory aesthetic outcomes without significant complications.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
For many women, the goal of breast augmentation is to achieve a fuller shape that still looks and feels natural. Traditional surgery often relies on silicone implants to add volume, but in very slender individuals, the skin and muscle covering the chest are often too thin to fully hide the edges of the implant. This can result in a visible line where the device meets the body or a shape that feels too rigid. To solve this, surgeons have developed a method that combines the reliable volume of an implant with the soft, natural texture of a patient's own fat. By harvesting fat from another part of the body and injecting it around the implant, the surgeon can smooth out sharp transitions and add a layer of soft tissue exactly where it is needed. This hybrid approach aims to give the best of both worlds: the predictable size of a device and the gentle contour of natural tissue.
A recent case report from a clinic in Tokyo describes how this technique was applied to a twenty-one-year-old woman who was notably slender, standing one hundred and fifty centimeters tall and weighing thirty-seven kilograms. She wanted larger breasts but was concerned about the look of the transition between her chest and the new shape, as well as the visibility of scars. Because she often wore dresses that exposed her armpits, she specifically asked to avoid a scar in that area. The surgical team decided to use an incision hidden under the breast fold instead. They placed a pair of two hundred and eighty cubic centimeter silicone implants directly above the chest muscle, a position that provides good projection but leaves the edges more exposed in thin patients.
The unique part of this procedure was how the team decided how much fat to add. Instead of guessing the amount before the surgery began, they waited until after the implants were in place. Once the devices were positioned, the surgeons looked at the actual shape of the breasts while the patient was still on the operating table. They examined the upper part of the chest, the area between the breasts, and the edges where the implant met the surrounding skin. They identified specific spots where the shape looked too sharp or where the implant edge was too visible. Only then did they harvest fat from the woman's inner thighs, process it, and inject it into the areas that needed softening.
Because the needs of each breast were slightly different, the amount of fat used was not the same on both sides. The team injected one hundred and thirty cubic centimeters of fat into the right breast and one hundred cubic centimeters into the left. This difference was not a mistake but a deliberate choice to match the unique contours of each side. The fat was focused mainly on the upper chest and the edges of the implants to create a smoother, more natural-looking curve. Three months after the surgery, the results showed a pleasing shape with no visible signs of infection, hardening, or unevenness. The patient was satisfied with the natural look and the absence of visible scars in her preferred clothing.
The author of the report suggest that this method of waiting to decide the fat volume until after the implant is placed allows for a more precise and personalized result. By assessing the actual shape created by the implant first, the surgeon can see exactly where the soft tissue is lacking and fill those specific gaps. While this report describes only one patient and the follow-up period was relatively short, it offers a clear example of how combining two different techniques can address the specific challenges faced by very thin patients. The approach highlights that the implant provides the main structure, while the fat acts as a custom-fitted layer to refine the final appearance, ensuring the transition from the chest wall to the breast looks seamless.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.