Parasternal infiltration composite breast augmentation.

[BACKGROUND] The simultaneous combination of both fat grafting to the breast and mammary implants has been recently proposed as a useful technique in breast augmentation surgery. The purpose of this study was to evaluate the aesthetic benefits of selective parasternal fat grafting at the time of primary implant breast augmentation.

[METHODS] Fifty-nine consecutive primary breast augmentation patients were studied retrospectively. Patients were divided into two groups: group 1 patients (n = 38) were treated only with breast implants, whereas group 2 patients (n = 21) received breast implants and parasternal fat grafting of 60 to 140 cc of adipose tissue. The length between the medial border of each breast, defined as the parasternal vertical aesthetic line, was measured preoperatively and postoperatively for both groups and compared through statistical analysis.

[RESULTS] The mean length between the parasternal vertical aesthetic lines in group 1 postoperatively was significantly higher, 2.26 ± 1.24 cm (p < 0.0001); whereas this length for group 2 was significantly lower after surgery, 0.60 ± 0.32 cm (p < 0.0001). No cysts or fat necroses were observed in group 2, presumably because of the low volume of fat used.

[CONCLUSIONS] Parasternal fat grafting performed simultaneously with breast augmentation is a safe procedure, and seems to provide a valuable cosmetic advantage by improving the medial transition zone of the breast implant with the presternal area. It prevents a "separated-breasts" deformity, which may produce unnatural results in implant-based breast augmentations, especially in thin patients.