Trish: I’m here today with Dr Allan Kalus who is from Avenue Plastic Surgery in Windsor. He’s a plastic and reconstructive surgeon. Dr. Kalus is the pioneer of the fat transfer procedure, and we’re going to talk about fat transfer to the breasts today. Thank you so much for taking the time today.
Dr. Allan Kalus: Thanks, Trish, a pleasure.
Trish: We find this as being one of the most intriguing topics on the website, so we’re just wondering, can you tell us a little bit about it, and what’s so great about it, and why it’s something that’s a good thing?
Dr. Allan Kalus: Well, you know, Trish, it’s been a dream for many women for years to have natural tissue transplanted to the breasts rather than to have implants. It’s interesting that breast implants have served us well for about 30 years now, but we know that breast implants have a limited life span, and we know that often they need to be replaced after, sometimes as little as 6 or 8 years; and we know that breast implants are prone to complications – especially silicone implants. If they rupture the silicone can spread to the lymph glands and to other parts of the body. I think women who are discerning and for a long time have thought, “Well, is there something that’s more natural than breast implants and safer than breast implants?” Up until recently it was just a dream to be able to transfer your own fat.
I remember about 40 years ago when I was working in the UK a surgeon tried to just excise a large amount of fat from the buttocks and just put that as a big lump of fat in the breast, but of course that just didn’t survive. What’s happened about 3 or 4 years ago is, it’s new instrumentation and new techniques have developed so that we could use fat that’s removed in a way similar to liposuction and transfer quite large volumes into the breast. Where the procedure is done, we use special cannulas attached to a liposuction machine, but we don’t use the full power of liposuction because we found that the full power just breaks up fat cells. So, by tuning liposuction down to a very low power we’re able to remove cells and the cells are still viable. We’re able then after preparation to inject these cells directly into the breast.
Another advantage of this, of course, is that the patient does get effectively a liposuction. So, it’s ideal for a woman who’s got a little excess fat in her thighs or tummy and who would like to get rid of that fat, and who perhaps has lost some volume in the breasts, for example after pregnancy. We’re able to take the fat, and prepare it, and inject it directly into the breasts. Now, I think the limitation to the procedure, of course depends on how much fat’s available.
Dr. Allan Kalus: That’s the first thing. People who don’t have a lot of fat can’t have a lot of fat transferred. We find generally that we can get about 1 cup size increase and in some women 2 cup size increase. So, it’s very suitable for the group of women that would like that sort of modest increase. It’s probably not suitable for a person who doesn’t have much body fat who would like to have much larger breasts.
Dr. Allan Kalus: If you want a 2 or 3 cup size increase it’s probably better still to go to implants as a way of augmentation.
Dr. Allan Kalus: The other thing is, we’re finding that some young women these days; young women actually prefer almost a more stylized, a more unnatural appearance. For them, really, breast implants are the way to go.
Dr. Allan Kalus: Breast implants can give you a very full upper pole, and if you want that type of look breast implants are for you. If you want a very natural look, and I have to say that after fat transfer to the breasts, the breasts look and feel completely natural. There’s no firmness, there’s no lumpiness; they feel completely natural, just about one cup size larger.
Trish: The question I get asked all the time is: how can they not be lumpy? How do you make sure that they’re not lumpy?
Dr. Allan Kalus: Yes. So, this was one of our concerns a few years ago when we started doing this. We thought, “What would happen if there was a lump in the breast?” It’s a very real concern because apart from feeling lumpy it could possibly mask a breast cancer. About 3 years ago the radiologist told us that mammography had progressed to such a degree that if a woman did have a lump in her breast they could tell 100% of the time whether the lump was due to a breast cancer or just to a fat necrosis, or just a bit of fat that was lumpy. Once we knew that we could differentiate with a mammogram any lump in the breast, that really gave us the ability to go ahead and do fat transfer. Now, in all the cases that we’ve done, and we’ve done many hundreds of cases of fat transfer, I have to say, surprisingly, we’ve not had a single lump.
Dr. Allan Kalus: I think the reason is that the technique of doing it, the way we prepare the cells, the way we inject the cells with a very small needle into multiple little pockets in the breast. For example, we might do perhaps 30 or 40 injections, putting very small amounts of fat into the breast, and then we massage the fat, we spread it throughout the breast, and it seems to integrate beautifully, and we’ve just not had anyone with breast lumps.
Trish: Great. You said you’ve done how many of these procedures roughly?
Dr. Allan Kalus: Well-
Dr. Allan Kalus: I think we’ve done, probably between one and two hundred procedures now.
Trish: Wow. Fantastic! Well, that’s great. Thank you so much for taking the time for us today.
Dr. Allan Kalus: It’s a pleasure, a pleasure.
Trish: If you’re looking for a breast augmentation, don’t want to go down the implant road, definitely a visit to Dr Kalus might be really, really helpful for you. Thank you so much.
Dr. Allan Kalus: Thanks, Trish.