Autolougous fat grafting to the breast for cosmetic enlargement remains controversial because the efficacy and the complications due to fat necrosis are unclear.

Ten cases who underwent autologous fat grafting to the breast for enlargement and visited author's clinic from October 2006 to March 2008 were evaluated retrospectively. Mammography, ultrosonography, culture, cytology, operative findings and results were reviewed for each cases.

The study group consisted of 7 cases for additional augmentation mammaplasty, 1 case for breast abscess, 2 cases for breast examination. Two of 7 augmentation cases had multiple palpable masses. One of 2 cases for breast examination had fat grafts 20 months ago and have suffered from painful huge masses especially on exercise. One case with abscess had fat graft 4 months ago and have suffered from painful reddish swelling. On mammography of 9 cases except 1 breast abscess, malignancy could not be excluded in 2 cases because of bizarre forms of multiple microcalcifications. On ultrasonography of 8 cases, there were ill defined hypoechoic masses in 2 cases which needed additional cytology for rule out malignancy. There were implant puncture in all 2 cases with silicone implants, and in case with abscess, there were S. epidermidis in culture. Among 7 augmentation mammaplasty cases, removal of fat necrosis was performed simultaneously in 1 case with severely palpable masses but postoperative seroma formation and capsular contracture occurred.

Autologous fat grafting for breast augmentation can make masses, abscess and microcalcifications on mammography due to fat necrosis which compromise breast cancer detection. Additional study is necessary to evaluate the efficacy of fat stem cell grafts as an alternative to traditional method.