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Using liposuctioned fat for breast augmentation may be a viable alternative to implants for some women, according to a new study.

The use of fat injections for breast augmentation has been the subject of ongoing debate because of a lack of research and worries that the fat may calcify and obscure mammograms, be mistaken for cancer or be re-absorbed by the body.

The study included 50 women, aged 17 to 63, who had 55 fat-grafting procedures (five women were grafted twice) to their breasts with fat taken from their upper thighs and other areas. The patients were followed-up for between nine months and five years, with an average follow-up of three years.

The researchers found that the grafts didn’t obscure mammography and that the women didn’t have any suspicious breast masses, nodules or lesions that might interfere with cancer detection.

Among the other findings:
Graft survival averaged 85 percent.
The average increase in breast volume at six to 12 months was 210 milliliters.
The procedure can be performed in 90 minutes.

The study was scheduled for presentation at the annual meeting of the American Society of Plastic Surgeons, held Oct. 23 to 27 in Seattle.

Another study scheduled for presentation at the meeting found that injecting fat into the breasts gives breast-lift patients a new option for improving breast size and shape, with a reduced risk of some of the complications associated with breast implants.

Many women who have breast lifts require some amount of augmentation to fill out their breasts. Breast implants are typically used in these cases.

This study included 46 women who received fat injections to their breasts after a breast lift. The fat was taken from the thigh, abdomen or other areas on the patient’s body. After one year, all of the women had a significant improvement in breast size and shape, with no abnormalities in mammograms, the researchers said.

In 2008, more than 307,000 breast augmentations and more than 92,000 breast lifts were performed in the United States, according to the American Society of Plastic Surgeons.

Psychiatric disorders and sexual trauma in women increase the risk of lower urinary tract symptoms, such as incontinence and overactive bladder, a new study finds.

U.S. researchers analyzed the answers in two questionnaires — the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 — completed by 121 female veterans referred to a specialized urology clinic for evaluation of lower urinary tract symptoms. The researchers also examined the women’s mental health, history of sexual trauma, age, race and obstetric history. The women were compared to a control group of 1,298 women.

Compared to those in the control group, the women in the lower urinary tract symptoms group had higher rates of psychiatric disorders (64.5 percent versus 25.9 percent) and sexual trauma (49.6 percent versus 20.1 percent). Further analysis revealed that women who were younger than 50 and had a history of miscarriage had higher Urogenital Distress Inventory-6 scores, while those with psychiatric disorders and a history of miscarriage had higher Incontinence Impact Questionnaire-7 scores.

“This is the first study to our knowledge to characterize the association of psychiatric comorbidities and sexual trauma with the type, severity and quality-of-life impact of lower urinary tract symptoms in women using validated surveys. The prevalence of psychiatric comorbidities and sexual trauma is high in women veterans presenting for evaluation of lower urinary tract symptoms,” wrote Dr. Adam P. Klausner, an associate professor and director of neurourology, female urology and voiding dysfunction at Virginia Commonwealth University Medical Center, and colleagues.

Hearts attacks have increased among middle-aged American women in the past two decades, but their chance of survival has improved, two new studies show.

“We found that men still have a higher prevalence than women, but what has happened is that the gap has narrowed,” said Dr. Amytis Towfighi, assistant professor of clinical neurology at the University of Southern California, lead author of one of two reports in the Oct. 26 issue of Archives of Internal Medicine. “For women it has increased, for men it has decreased.”

Her study used data from two national surveys conducted from 1988 to 1994 and 1999 to 2004. While 2.5 percent of the men and 0.7 percent of the women reported a history of heart attacks in the earlier survey, 2.2 percent of men and 1 percent of women reported heart attacks in the more recent survey.

The narrowing of the male-female difference is easily explained, Towfighi stated. “Very basically, the risk factors are being better controlled in men than in women.”

In men, levels of “bad” LDL cholesterol remained the same between the two surveys, while levels of “good” HDL cholesterol improved. Blood pressure levels improved, and fewer men smoked.

The improvements for women were marginal, with LDL cholesterol levels about the same. The only risk factor that improved in women was HDL cholesterol. Diabetes and obesity increased in men and women, the study found.

“We don’t know exactly what is going on in terms of risk factors being better controlled. Women aren’t checked as often,” Towfighi acknowledged.

Societal changes may play a role, she said.

With more women in the work force, she said, their rising rates of obesity and diabetes can be attributed to job demands that limit their ability to exercise and follow dietary rules.

It is no longer assumed that female hormones protect against heart disease, she said. Doctors are paying more attention to heart risk factors in women because “there is a red flag about women not being absolutely protected against heart disease in midlife, as we had thought, and we are aware that more effort must be made to reduce their risk,” Towfighi said.

The second study used information from a different data bank listing death rate trends from 1994 to 2006. It found a marked reduction in hospital deaths from heart attacks in all patients, especially among women. For women under 55, the risk of dying dropped by 53 percent, which was the greatest improvement noted. The least reduction, 33 percent, was seen in men under 55.

A detailed examination of cardiac risk factors showed that “women experienced less worsening than men,” said Dr. Viola Vaccarino, professor of medicine and director of the Emory Program in Cardiovascular Outcomes Research and Epidemiology, lead author of the report.

But changing attitudes about women and heart disease may also have had an effect, she said.

“Perhaps physicians are paying more attention to the detection and treatment of women with heart disease,” Vaccarino said. “It could be the same thing happening in the general public, with women getting more knowledgeable about this.”

“Basically, both studies show that there still is a gap between men and women,” said Dr. Nieca Goldberg, clinical associate professor of medicine at NYU Langone Medical Center and a spokeswoman for the American Heart Association. “They both show the importance of continuing to pay attention to women’s risk of cardiovascular disease and treatment of their heart attacks.”

The studies offer some good news for women, Goldberg said. “I’d like to think that’s because we have increased the awareness of women themselves. But these two important studies show the need to continue research about reducing women’s risk of cardiovascular disease.”

As women age, their dietary needs change. A healthy diet is always important, but even more so as women get older.

The American College of Obstetricians and Gynecologists suggests women should consume:
At least 1,500 milligrams daily of calcium, which may be found in dairy products and leafy green vegetables, or dietary supplements.
Eight milligrams of daily iron — needed to help produce red blood cells. Healthy sources of iron include fortified breakfast cereals, spinach and beans.
Limited intake of saturated and trans fats.
Limited intake of salt (sodium) and added sugars.
Plenty of fiber.