This article describes the theory and success principles of the author used within the Megavolume Autologous Fat Transfer  (250 ml) at breast level.

When large volumes are grafted in narrow spaces, the interstitialfluid pressureincreases, aggravating the capillary circulation and graftedfatdropletsjoininginconglomerate leads to a diminished interface between the graft and recipient tissue.  From a historical point of view, these factors have always restricted the volume of adipose tissue which can be grafted when talking about small recipient breasts.  Because of diminished interface, the distance that oxygen needs to disseminate until the grafted adipocytes is increased, this thing favoring the necrosis before the neovascularization.  The increased pressure of the interstitial fluid decreases the capillary circulation diameter, reducing the supply of oxygen to the grafted tissue. The Brava external expansion device uses the regenerative capabilities of mechanical forces to increase the volume and the vascularization of the recipient site, preoperative, thus allowing the diffuse megavolume autologous fat transfer  without significantly diminishing the graft – recipient interface and without increasing the interstitial pressure. Applying these principals has allowed the authors to successfully perform the megavolume autologous fat transfer on more than 1000 patients, having a substantial retention for …

Dr Roger Khouri , Prof. Rigotti – Megavolume Autologous Fat Transfer : Part 1 . Theory and Principles