CAL breast augmentation details

Recently I received the following e-mail from a prospective patient from Canada. I post it here because of the important issues concerning breast augmentation with stem cell-enriched autologous fat (Cell-Assisted Lipotransfer, CAL):


I just had a few questions about where and who you have learned this procedure from.

I have been doing fat transfer to the breast since 1995 which is basically the same underlying surgery technique as CAL. My teacher was Pierre Fournier of Paris and a lot of other leading cosmetic surgeons in the U.S., Europe, and South America.

Adopting the new protocols of CAL to the breast was a matter of understanding how fat transfer works as well as the result of my thorough scientific research since 2003, when first information of the possibility of using autologous stem cells from fat reached the cosmetic surgery community. I met with Dr. Yoshimura, who was the first to perform CAL in patients, in Tokyo to exchange experience about CAL to the breast in 2007. The Japanese were pioneering CAL with the help of the Japanese government since 2003.

How long have you been performing this procedure?

We are doing CAL since 2006, being the first doctor in Europe and U.S. to perform CAL. Thus we have treated successfully a lot of patients and have ample experience with this challenging procedure.

I have had this CAL procedure done before in Japan. I am interested in getting it done again because I have lost some fat from the first time.

Sometimes doing a touch up can be a good idea as achieving the planned volume can take two procedures in some patients due to individual breast tissue details. Same applies when fat is lost. Typically not more than 5 % should be lost but individual patients may experience more volume loss sometimes.

Although I do not want to go back to Japan because I live in Canada and there are dents left over from their liposuction the last time so I’m concerned about going back.

Fat harvesting for CAL requires that 1,000 to 2,000 ml of fat are extracted. In case this is done with standard liposuction cannulas the risk of consecutive dents or irregularities after liposuction is considerable, especially in women that do not have ample fat deposits.

In these women microcannulas with diameters of not more than 2 mm need to be adopted. They allow for smooth and scar-free harvesting of big volumes of fat with minimal risk of dents. Aftercare is very easy as one week of compression typically is enough. Using delicate microcannulas we can correct those dents most probably.

Best regards,
DDr. Heinrich

DDr. Heinrich, MD

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