Pleasanton Fat Transfer doctors

Thanks for your question -

Fat injection in the tear troughs can cause contour deformity - exactly what you're describing.  The issue with fat transfer here is that the skin in this area is very thin and the distance between the skin and the bone is relatively short.  This means that injection contour can sometimes be seen through the skin.

Sometimes this fat can be directly excised as part of a lower lid blepharoplasty or through micro liposuction to try to debulk the area.  Typically more injections don't make things better.

Find experts in the area.  Syd Coleman has a great deal of experience in facial fat grafting and would be a useful consultation.  Good luck!
 

Breast reconstruction using fat grafting is a viable and safe alternative to expander-implant or free tissue transfer in the right circumstances.

There has been extensive research and clinical experience in this field.  There have been several clinical teaching courses, including the Miami Fat Grafting course directed by Dr. Roger Khouri. See the links below.

You must have sufficient fat, however, to achieve the size you want, and this will be the limiting problem.  If you have moderate excess fat, then perhaps a B cup, or about 200 cc per breast may be achievable.  

The other issue is that the grafting is done in 2-5 stages and requires the use of an external tissue expander, called the Brava device.  This device was first used to try to enhance breasts without implants or fat grafting. It has been found to be an essential and effective adjunct to breast enhancement or reconstruction with fat grafting alone.

It works be applying negative pressure to the breast over a period of weeks. This induces a rich vascular supply to the tissue under the skin. This  vascular bed, as it is called, is then receptive to transplantation and permanent survival of your transferred fat.

I have attended this course and believe the results are credible.  

If a patient is too thin, however, or wants more than the available fat that can be removed from their body can deliver, then expander-implant reconstruction is an excellent method to achieve a very natural breast reconstruction.  In fact, with a nipple sparing prophylactic mastectomy, using an infra-mammary incision, a very natural and soft breast reconstruction with minimal visible scarring can be achieved.

Thank you for your question. In our San Francisco area practice we routinely perform fat transfer for buttocks enhancement, facial rejuvenation and breast enhancement.  The challenge in your situation has to do with the amount of breast sag you have and the amount of excess skin.

In most cases, fat transfer can't match the changes that a breast lift (mastopexy) can provide.

Find a board certified plastic surgeon familiar and experienced with both techniques and see what's right for you.

I hope this helps.