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Is Fat Grafting Necessary for Breast Lift?

I am a 28 yr old mom of three. I breast fed all of my children one of them two years! I also lost 30 lbs in 6 months. Since then my usual 34DD breasts are sagging and the skin wrinkles when I raise my arms above my head. The nipple sinks down into the breast tissue when I lay down.

Currently I am a 34C and I've had a breast consultation. My surgeon and I have decided on a Breast lift. My doctor suggested that I do Fat grafting to prevent the slope appearence. I don't believe the slope will bother me as long as it looks natural. Will my breast appear deformed without the Fat grafting or just natural?

Asked 32 months ago by idez36 in KS

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breasts breast size

Fat Grafting for Breasts?

Thank you for the question. No, fat grafting is not “necessary” and your breasts will not appear to be “deformed” effect grafting is not performed. Based on your description it is likely that you will be pleased with breast lifting alone. If, after-the-fact, you decide on more volume or superior pole fullness, breast augmentation may be your best option. For patients planning on breast lifting surgery it will be very important to... more

Tom J. Pousti, MD

San Diego Plastic Surgeon

ASAPS ASPS

Fat grafting for breast lift

Fat grafting is an excellent technique for adding volume to certain areas of the body. Whenever translating fat to one area approximately 20% of that fat will melt away. When this fat melts away it may leave small calcium deposits. This is usually not an issue except in the female breast. A patient who has had this procedure may have these calcium deposits detected at a later date during a mammogram. These calcium deposits may be read as a possible sign of breast cancer by... more

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Fat grafting and Breast Lift

Depending on your skin elasticity (which is probably lost), as the breast settles after surgery you may develope some emptiness in the upper pole of the breast. If that bothers you then that emptiness can be treated with an implant or fat graft. Do the lift and then decide if the upper pole bothers you and you want to do something about it. You have not burned any bridges behind you after the mastopexy.

Samir Shureih, MD

Baltimore Plastic Surgeon

ASAPS ASPS

Do not need fat grafting for breast lift.

Hi. You sound like such a reasonable person. We use fat grafting only in special situations and you do not need it, going by your description. You should be very happy with a breast lift. In New York City, we do an internal breast lift, which does not rely on tightening the skin, because skin stretches (Lejour technique). You have a lollipop scar.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Don't do the fat grafting

People that get my blog know that I am a huge fan of facial fat grafting. I have even modified my cannulas to 1.2mm for even smaller fat. But this is the key for fat grafting-small product through little cannulas. This is ideal for the face. It is not appropriate for the breasts. You are experience the loss of upper pole fullness. This is due to the stretching of the tissues, aging, breast feeding etc. If you want to replace that depression in the upper breast it is best done by doing... more

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Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Fat grafting with breast lift is experimental

A breast implant is often used in conjunction with a breast lift to provide fullness. This is a time proven excellent technique that produces good results. Recently, a paper was presented at the American Society of Aesthetic Plastic Surgeons meeting in Las Vegas showing fat injections to improve fullness after reduction mammaplasty, a procedure similar to the breast lift. While these results were good, this technique has to be considered experimental at this time. The doctor presenting... more

Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Fat grafting in conjunction with a breast lift sounds unusual

It is unlikely that fat grafting is the correct procedure for you. If you lack breast volume then the accepted method for rejuvenation of your breasts would be a breast lift in combination with a breast implant. It sounds like a second opinion is in order.

Jeffrey Zwiren, MD

Atlanta Plastic Surgeon

ASPS

My strong opinion

This smells fishy. Fat grafting is currently not approved for breast augmentation by the ASPS. The problem is that it can obscure future mammograms, and that it is not predictable. The accepted way to augment the breast is with implants, and in your case, it sounds like a breast lift would be in order too. Check the doctor's credentials to be sure he is certified by The American Board of Plastic Surgery. sek

Scott E. Kasden, MD

Dallas Plastic Surgeon

ASAPS ASPS

Fat grafts vs implants

You sound like you need a breast lift for sure. If you feel that in a bra, you are large enough and don't need any padding, an implant might not be necessary. For upper pole fullness, an implant is the best option. Fat grafting is not yet mainstream and concerns are that it can produce problems in breast cancer detection.

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Fat graft not yet mainstream

There is literature that supports that when performed properly, fat grafting can be accomplished to the breast. The problem is if the plastic (or any) surgeon is not meticulous, the graft may not heal and in fact cause scarring that the radiologist may be concerned about on a mammogram. If your plastic surgeon has a lot of experience and can show ou photos of patients they have treated, that may be an option for you. Best of luck. Dr Edwards

Michael C. Edwards, MD

Las Vegas Plastic Surgeon

ASAPS ASPS

Fat grafting to breasts

Fat grafting to breasts is still a bit controversial. You probably can have a breast lift to achieve the fullness that you want. Even with fat grafting the sloping that you describe may still appear as the tissues relax overtime.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Fat grafting breasts

Fat grafting in breasts is not a generally recommended procedure for augmentation. First of all, fat grafting is not highly predictable. Second, lumpiness or cysts that form can confuse the physical exam. In addition, it is difficult to achieve a uniform, smooth contour across a large area of the chest that is symmetric. A better strategy would be to do the lift since that is the only way to get close to the result to want. Then see what result you get. If you are still unhappy about the... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Breast Lift and Fat grafting

Dear Idez36 You are asking a very good question. A breast lift can be done without any other procedures and you can have a nice result. The procedure and result will depend on your starting breast shape. Sometimes the addition of other procedures will improve the overall result, but this is not absolutely necessary for a 'normal looking result' i do perform fat grafting for breast shaping - particularly the upper pole of the breast for patients undergoing a lift or primary augmentation (... more

Trevor M. Born, MD

Toronto Plastic Surgeon

ASAPS

Fat Grafting with a Breast Lift?

Hello, In my opinion, women tend to look more natural after a breast lift without fat grafting. The question is: "Will you like it?" Far grafting is not standard practice in breast lift surgery. I would look carefully at your doctor's before and after images before I'd let that grafting occur.