THE latest kind of recycling has nothing to do with soda bottles. It entails liposuctioning fat from, say, thighs or buttocks and injecting it into breasts to augment them. After being condemned in the early ’90s, this procedure is generating newfound excitement among the handful of doctors nationwide who offer it and patients keen to enlarge their breasts without resorting to implants.
最新的資源回收無關飲料瓶罐。而是從臀部或大腿抽脂來隆乳。90年代初這種手術曾被譴責，現在的新發展激勵美國少數醫生為一些不願植入外物的隆乳患者施行。

Almost 20 years ago, the association now known as the American Society of Plastic Surgeons issued a warning to its member doctors to not inject suctioned fat into patients’ breasts, for fear that mammograms would be misread. Since some injected fat dies and calcifies, the thinking was that radiologists would not be able to distinguish between those calcifications (or calcium deposits) and suspicious ones that may indicate breast cancer.
大約20年前，美國整形外科學會警告其會員：勿將抽出的脂肪注回患者胸部，以免造成乳房X光攝影的誤判。因為放射科醫師不易區分鈣化或疑似乳癌。

A second concern was that too little injected fat survived being transplanted, because techniques for harvesting, refining and placing fat were not advanced enough. Even today, the success of fat grafting to the breast, as the procedure is also known, depends on the physician.
第二重考慮是當時的醫術和純化、置入脂肪的技術不夠先進。即或今日，手術成功與否仍取決醫師。

But this year, the plastic surgery society reversed its former position. A report from its task force reviewed the limited research on fat grafting to the breast and concluded that it “can be considered a safe method of augmentation.” On the issue of mammography, the report said fat grafting “could potentially interfere with breast cancer detection; however no evidence was found that strongly suggests this interference.” Thus, the task force’s statement turned a red stoplight into a yellow one, signaling to plastic surgeons: Proceed with caution.
今年整形外科學會一改過去立場。學會專案調查脂肪植入胸部特定案例報告，結論是「可被認為是安全的隆乳方法。」該報告關於乳房X光的議題，指出「仍有干擾診斷乳癌的可能，但並無明確證據。」因此專案小組將警示燈由紅轉黃，意即：謹慎從事。

And so some have. “The best way to create a normal breast is to use your body’s own tissue,” said Dr. Sydney Coleman, a Manhattan plastic surgeon who is an advocate of fat grafting. So much so that he no longer offers breast implants.
一些人如此。主張脂肪移植，在曼哈頓執業的整形外科醫師西尼‧科曼說：「重建正常乳房的最佳方法就是利用自己的身體組織。」

Sarah, a petite 34-year-old woman from Miami who asked that only her first name be used, considered implants, but said she didn’t want her breasts to “look hard or fake or extremely unnatural.” So she had Dr. Roger K. Khouri, a plastic and reconstructive surgeon in charge of the Miami Breast Center, take fat from her thighs and buttocks to fill out her chest.
只願透露名字，來自邁阿密，34歲的嬌小婦人莎拉，曾經考慮移植。但是她不希望她的胸部看來堅硬、作假或極度不自然。因此找上邁阿密乳房中心的整形外科醫師羅傑‧柯烏瑞，從她的臀部和大腿抽脂來填胸。

“I love that it’s just mine, my own fat,” she said. “I didn’t have to put anything foreign in my body.”
她說：「我喜歡自己的脂肪，沒有任何外物進入我的體內。」

At the October meeting of the American Society of Plastic Surgeons, Dr. Khouri presented a long-term study that suggested liposuctioned fat was now a “viable alternative to breast implants.” It tracked 50 women, ages 17 to 63, for an average follow-up of 3.5 years. (For weeks, participants wore a cumbersome bra-like tissue expander at night that was created by Dr. Khouri to create a scaffolding for their fat.) The study, which Dr. Khouri plans to publish in a peer-reviewed journal, found that the procedure does not impede the reading of mammograms and that on average, 85 percent of transplanted fat survived to give patients natural-feeling larger breasts.
十月間整形外科學會會議中，柯烏瑞醫師提出對50名17至63歲婦女，平均為時3.5年的長期追蹤研究，認為抽脂回填是「隆乳的可行替代方案。」（受測者每晚需穿戴柯烏瑞醫師特別設計的胸罩，以固定注入的脂肪。）柯烏瑞醫師將把這項研究刊登在學會期刊，述明手術不會影響乳房X光的判讀，植入的脂肪有85%的存活率，且讓患者感到自然。

This kind of breast augmentation is a two-fer: trim fat where you don’t want it and put it where you do. Another advantage is not having to worry about an implant breaking or hardening.
這種隆乳手術有兩個優點：將多餘的脂肪放在自己喜歡的位置，且不用擔心破裂或硬化。

But the disadvantages cannot be discounted. It’s usually more expensive than implants, it takes a year to see how much fat survived, and breast volume can fluctuate with weight. Dr. Scott L. Spear, the chairman of the plastic surgery department at Georgetown University Hospital, has enlarged a patient’s breasts only to have the patient undo his handiwork by losing weight. “They decide to run a marathon and their breasts go away,” he said.
但是不利之處也不少。通常比置入要貴，要一年時間確認植入脂肪的存活，乳房的容積會隨體重變化。喬治城大學醫院整形外科部長史高‧施沛醫師曾為一位為了減肥的患者施術。他說：「一場馬拉松後，她們的胸部消失了。」

But a far worse scenario is that a doctor’s technique is so wanting that much of the transplanted fat dies and complications ensue. “Anyone can take fat and inject it into the breast, and the patient will look good immediately afterwards,” Dr. Khouri said, but a few months later, the fat injected by a doctor with sub-par skills may result in “oil cysts, masses, nodules and scarring.”
醫師更不願看到的情況是移入的脂肪不再及併發症。柯烏瑞醫師說：「任何人都能接受這種手術，而且每個患者都想立竿見影。」但是幾個月後，技巧差的醫師可能造成「脂囊、結塊、瘤和疤痕。」

To some, this kind of fat recycling seems simple. But Dr. Michael F. McGuire, the president of the American Society of Plastic Surgeons, cautioned: “How you take the fat, how you process it, how you inject it are all factors in how successful fat survival is going to be.”
有些人認為體脂回收很簡單。但是美國整形外科學會會長麥克‧麥奎爾警告道：「手術是否成功與脂肪的存活取決於如何取出脂肪、處理與注入等因素。」

In some cases, radiologists can distinguish between innocuous and suspicious calcifications, said Dr. Sameer A. Patel, a plastic and reconstructive surgeon at Fox Chase Cancer Center in Philadelphia. But when they can’t, biopsies may be done. So he fears that fat injections for breast enlargement could increase unnecessary biopsies.
費城福斯癌症中心的整形、重建外科山美‧派特醫師說，放射科專家通常都能區分無害或可疑的鈣化。如果不行，也能以切片驗證。因此，他擔心如此將增加不必要的切片。

Last month, new guidelines from the United States Preventive Services Task Force recommended that most women should start mammograms at 50, instead of 40, to try to reduce the number of tests, including biopsies for false positives.
上個月，美國預防醫學工作小組建議，多數女性從40歲改為50歲起開始乳房攝影，藉以減少包括切片與偽陽性…的檢查次數。

But a baseline mammogram for a woman considering breast augmentation (or reduction) is a must, said Dr. Emily F. Conant, a radiology professor and the chief of breast imaging at the University of Pennsylvania Medical Center.
但是賓州大學醫學中心放射科教授暨胸腔影像主管艾蜜莉‧康南博士認為，做過胸部增減手術的婦女仍需要定期乳房攝影。

In recent years, fat injections have been used to correct irregularities from reconstructive breast surgery after a mastectomy or a lumpectomy. Because much smaller volumes of fat are used, some plastic surgeons felt comfortable, for example, filling in a dent in the cleavage area.
近年來，脂肪注射用於校治不當或因腫瘤切除的乳房重建。因為脂肪用於填補被割除部份的量較少，整形醫師較為放心。

But Dr. Stephen F. Sener, a professor of surgery at the Keck School of Medicine at the University of Southern California, wrote in an e-mail message: “I’ve seen enough injections of fat after mastectomies to tell you that fat necrosis is a real problem.” It can result in a “palpable mass” that needs to be biopsied to establish malignancy or infection, wrote Dr. Sener, the former president of the American Cancer Society.
前美國癌症學會會長，現為南加大克柯醫學院外科教授史帝芬‧西那博士在一封電子郵件寫道：「我看到相當多乳房切除注入脂肪後的案例，脂肪壞死是個大問題。」它會導致「可觸及腫塊」需要切片檢查，以確認為惡性或感染。

It’s a pivotal time to set the record straight on fat grafting to the breast. Recently, television news segments have featured doctors touting “natural breast augmentation.” In one segment available on YouTube.com, from an ABC station in Phoenix, a patient said she grew two cup sizes after injections. Most doctors injecting fat for breast augmentation say implants are a better choice for such an increase.
現在正是為抽脂隆乳術正視聽的時候。近來有一些電視新聞讓醫師吹噓「自然豐胸」。ABC電視網的鳳凰城電台的一節新聞在YouTube上也能看到，一名患者宣稱，她在注射後增加了兩號罩杯。大多數抽脂為隆乳的醫生都說以增加一號為宜。

The pleased mother of three in the news clip said her breasts grew “overnight,” which is misleading. Typically, doctors wait months to assess whether transplanted fat is there to stay. Others wait longer. “Unless you go a year, you can’t say ‘we succeeded,’ ” Dr. Spear said.
一位三個孩子的媽在新聞中說她的胸部「一夜」增長，這是誤導。通常醫師們需等待幾個月才能確知植入的脂肪是否就定位。施沛醫師說：「沒滿週年，你不能說：『我們成功了。』」

Yet, marketing for fat-enhanced breasts has ramped up. The Web site naturalaugmentation.com lists several doctors, mostly ob-gyns and family medicine physicians, not plastic surgeons, who offer coupons for “natural augmentation” and even something called “stem-cell breast augmentation.”
為行銷脂肪豐胸正方興未艾。naturalaugmentation.com網站登載一些醫師，他們大多是減肥或家庭醫師，沒有整形外科，他們發送「自然增大」折價券，甚至有些宣稱是「幹細胞豐胸。」

A company called Cytori Therapeutics makes a machine used in Europe that concentrates the cells within fat tissue that aren’t strictly fat cells, including stem cells. The company hopes that its Celution 800 system can “double the cells that act as fertilizer, so it’s possible to achieve a more predictable graft,” said Tom Baker, the director of investor relations.
一家名叫Cytori醫療器材的公司製造一部用於歐洲的機器，用於粹煉脂肪組織中的細胞，不是精確的脂肪細胞及幹細胞。該公司投資人關係部門主任湯姆‧貝克表示，它的Celution 800系統可以「使細胞倍增有如肥料，所以得達成移植成果。」

But Cytori’s machine hasn’t been approved by the Food and Drug Administration. Nor has “concentrating” cells in fat been proved to make a difference in controlled studies, said Dr. Karol A. Gutowski, chairman of the plastic-surgery society’s task force.
但是整形外科學會專案小組主席卡爾‧加圖斯基醫師說，Cytori公司的設備並未得到美國食品藥物管理局的核可。而且所謂「粹煉」細胞在控制環境研究中亦然特殊表現。

That hasn’t stopped Dr. Todd Malan, a board-certified ob-gyn in Scottsdale, Ariz., who is the surgeon in the ABC news clip, from anointing himself the “First in U.S. to perform Stem Cell Enhanced Breast Augmentation!” on his Web site.
這並未阻止在亞利桑那州Scottsdale執業的減肥醫師陶德‧馬蘭出現在ABC電視新聞。他在自己的網站宣稱「全美第一位施行幹細胞豐胸。」

Dr. Coleman, who was part of the task force, said, “it’s easy to kill fat,” and worried that Johnny-come-latelies won’t be meticulous. “Suddenly everyone is claiming to have 10 years of experience,” said Dr. Coleman, who is a paid adviser to Cytori.
小組成員之一的科曼醫師說：「脂肪存活不易，」並且擔心後起之莠不夠細緻。也是Cytori公司後酬顧問的他說：「突然間，每個人都自稱具有十年的手術經驗。」

Dr. Coleman has that experience. In 1998, when augmenting breasts with fat was “unheard of,” Linda Francipane, a hairdresser in Manhattan, had her modest chest filled out by him. “The best part is I’m in my 40s and I have these nice perky breasts,” she said. “They look like teenager breasts.”
科曼醫師有這種經歷。1998年抽脂隆乳「尚未聽聞」，曼哈頓的美髮師林達‧法蘭斯潘的秀麗胸部就是他完成的。她說：「最棒的是，40歲的我還有挺立的雙峰，就和青春少女一樣。」

原文參照：
http://www.nytimes.com/2009/12/03/fashion/03skin.html 

原本要找關於古又文的報導。結果歪打正著看到這篇，覺得應該給愛美的朋友們參考。