title: Our Experience with 131 Cases of Simultaneous Breast Implant Exhange with Fat (SIEF).
abstract: BACKGROUND
  Breast augmentation with fat injection is a growing trend in Japan. Many Japanese patients experiencing breast implant complications are requesting to have their breast implants removed and simultaneously exchanged with autologous fat injection. The keys of our simultaneous implant exchange with fat (SIEF) process are to embrace the "Coleman technique" and to carefully detach implant capsules when removing breast implants. Furthermore, we carefully inject fat to avoid necrosis.
  
  
  METHODS
  Between January 2010 and January 2015, we investigated consecutively 131 Japanese patients whom we could follow up for over 6 months postsurgery. We ascertained the usefulness of SIEF by assessing changes in breast size, complications, and a satisfaction survey.
  
  
  RESULTS
  There were no serious complications. We had experienced mild complications in 9.2% of patients (12/131). Partial fat necrosis with inflammation occurred in 2.3% of patients (3/131), seroma in the capsule in 3.1% (4/131), complaints of nodules (cysts, lumps) in 3.1% (4/131), and 1 hematoma patient (0.8%). At 6 months after surgery (n = 131), breast cup size (by Japanese Industrial Standards) had decreased by less than 1 cup size, despite SIEF. At 6 months, we performed a postsurgery satisfaction survey, and only 4% of the patients (5/131) were not satisfied with their surgery results.
  
  
  CONCLUSIONS
  SIEF is a very safe and effective procedure. Breast implants removed with a low invasive traumatic approach and centrifuged fat injected with the "Coleman technique" are important principles in our practice. Furthermore, avoiding fat necrosis is one of the most important considerations, and our SIEF approach allows us to better control this potential complication during the surgical process.
authors.affiliation: The Clinic Tokyo, Azabu Body Design Center 1F, Nishi-Azabu, Minato-ku, Tokyo, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Ohashi
authors.affiliation: The Clinic Tokyo, Azabu Body Design Center 1F, Nishi-Azabu, Minato-ku, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamakawa
authors.affiliation: The Clinic Tokyo, Azabu Body Design Center 1F, Nishi-Azabu, Minato-ku, Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Chiba
authors.affiliation: The Clinic Tokyo, Azabu Body Design Center 1F, Nishi-Azabu, Minato-ku, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagano
authors.affiliation: The Clinic Tokyo, Azabu Body Design Center 1F, Nishi-Azabu, Minato-ku, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nakai