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Is Fat Transer for Breast Augmentation Getting More Popular?

I am really interested in getting this procedure done. I've noticed most PS don't offer this and those that do are picky on who they treat. Will there be more surgeons offering this as an option with less limitations in the near future? I'm not at all comfortable with getting implants.

Doctor Answers (10)

Fat Transfer Becoming More Popular for Plastic Surgeons

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The good news is that Fat Transfer is  Becoming More Popular for Plastic Surgeons. You are right, many plastic surgeons do not offer this procedure but it is already changing and in the future many more will. I personally have substantial experience in this procedure and after reviewing the scientific literature (much of which is done by Plastic Surgeons) it appears to be a good procedure and I have had good success in the right patients. No doubt this is just the beginning, and many PS will be involved in the near future. I think you should stick with a board Certified Plastic Surgeon to be in good hands. Remember all procedures have benefits, risks and complications - Implants and Fat transfer to the breasts included.. The good news is that side effects and complication rates associated with fat grafting to the breasts are not, overall, unduly high.

Common Risks, side effects and complications include infection, bleeding, fat embolism and graft volume loss; over filling, under filling, asymmetry, fat necrosis, and ectopic calcification among others. Although, there are risks and complications associated with autologous fat grafting, cases of severe complications and death appear to be extremely rare.

Concern regarding the interference of autologous fat grafts with breast cancer detection is not validated by the limited number of studies available on the topic but it appears that radiologists in general can differentiate artifacts from fat transfer and malignancies. However, caution should be used  in patients at high-risk for breast cancer including a positive BRCA-1, BRCA-2 and/or personal or familial history of breast cancer.

Results of fat transfer remain dependent on a surgeon’s technique and expertise, therefore make sure your surgeon is board certified by the American Board of Plastic Surgery.

There is no doubt that Board Certified Plastic Surgeons and their main societies: the American Society of Plastic Surgery and The American Society for Aesthetic Plastic Surgery represent the most talented and longest trained aesthetic surgeons in the business. That being said they are relatively conservative and demand extensive study before "jumping in" to a fad or a procedure that has later proven dangerous. This is wise and has resulted in a long and safe track record. Check out their websites to find out more on this subject.


Orange County Plastic Surgeon
5.0 out of 5 stars 41 reviews

Fat transfer for breast augmentation not universally accepted - yet

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As you can tell from the variety of responses, there is no consensus at the present time about fat transfer for breast enlargement. One concern is that some of the fat can condense into lumps that may be hard to distinguish from cancer. As techniques have improved however this has become less of an issue. The main problem in my opinion is that there is a limited volume of fat that can be placed into the breast in a way that it will last. For example, about 100 to 150 cc's seems to be the max, while an average breast implant is twice that size or more. Additionally, with an implant you have control over the dimensions and shape.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

Fat grafting is another option

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There are limitations to any procedure.Fat grafting is not a good option for every body, but there are few patients that are ideal candidates for fat grafting. I do mainly implant removal and fat grafting for implant failure patients and I have done more than 250 cases of fat grafting. If you are more interested in the quality of the result and not just the size ,fat is a good option for you. I have a meeting on fat grafting every year in New Orleans and our next meeting is April 13. The web site is fatgraftforum.com.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 54 reviews

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Breast augmentation by fat transfer alone

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Fat transfer has become almost universal in treating patients following mastectomy, usually as an adjunct to other modalities of reconstruction.  However, fat transfer for breast augmentation is a different matter entirely.  Use of fat transfer alone for breast augmentation implies adequate fat donor sites since the demand is for a large volume, the likelihood of multiple lengthy procedures, and as yet a fairly unpredictable result.  This compared to the simplicity of breast augmentation using implants.  It is probably true to say that the use of fat transfer for breast augmentation is not ready for prime time.  in 2012, fat transfer remains a useful adjunct to reconstructive and aesthetic breast surgery, but cannot necessarily be relied upon as a primary procedure for breast augmentation.

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

Fat grafting for breast augmentation

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Once thought taboo, fat grafting to the breast for breast augmentation and breast reconstruction is becoming more widely accepted as the science of the procedure continues to demonstrate safety and positive results. While it is true, only modest augmentation may be possible with each session of fat grafting, it should not be dismissed as a non-viable procedure and in the hands of a surgeon who has experience with this technique, the results can be quite nice.

Antonio Gayoso, MD
Saint Petersburg Plastic Surgeon
5.0 out of 5 stars 14 reviews

NO

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There are a few surgeons who are suggesting this surgery. Most of us feel it is something that should not be done. At most you get one size larger with multiple surgeries and as the fat goes away it can leave calcifications which can look like cancer and cause unnessesary surgeries.

Implants are safe and have been done for YEARS and the results are predictable not like the fat injections.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 9 reviews

Fat Graft Breast Augmentation is NOT recommended!

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Fat grafting has been performed for many years and in many different areas of the body. Its popularity really "took off" in the mid 1980's when liposuction began, providing lots of "available" fat that otherwise was discarded. Of course, the most ethical and scientific-minded plastic surgeons realized that the high-vacuum "standard" liposuction aspirate consisted of mostly dead fat cells that had been "boiled" at room temperature because of the extremely high vacuum. Freezing the fat "for later use" further damaged any possibly-intact cells because of ice crystal destruction of the fragile adipocyte cell membrane. So the expensive "grafted" fat was really a slurry of your own dead cells, intracelleular lipid (akin to Mazola oil), and fluids. Little or none of this actually survived, but it took a patient's body months to years to fully removed the dead debris.

By then, the "surgeon" was on vacation with your absconded funds! Pretty sad, actually.

Fat grafting can indeed work, but only if harvested carefully under controlled (low-vacuum) atraumatic conditions, and implanted in droplet-by-droplet amounts that allow proper oxygen and nutrition to the transplanted fat cells so they survive. Simply shooting in blobs of mostly-dead fat won't work. And even when done properly, it takes lots of tiny grafts and lots of time (and money) to actually build up volume that can be seen or felt. Some of the fat dies, even under the best and most stringent grafting conditions. Meaning: multiple sessions are virtually always necessary.

In the breasts, any fat that dies can cause scar tissue and microcalcifications that can interfere with the detection of breast cancer via mammogram or other technique. This is the precise reason that fat grafting for breast augmentation is bad at worst, and controversial and potentially bad at best. Other (bad) reasons include firm lumps, distortion, skin puckering, fat cysts, and other irreversible issues!

These are the reasons that the vast majority of ABPS-certified plastic surgeons utilize saline or silicone breast implants for breast augmentation. (And it's not because we're outdated, out-of-touch, or not embracing the "latest and greatest and up-to-datest" developments)! It's because we truly care for the entire well-being of our patients and do not wish to cause them harm that may come to haunt them in years to come. Regardless of your age, I certainly hope you have many years to come! Fat grafting is something every ABPS-certified plastic surgeon is not only aware of, but likely performing in our own practices. But not for breast augmentation.

The main reason it is becoming "more popular" is because a very small minority of people raise awareness of this, making otherwise scholarly and cautious surgeons who usually rely on scientific proof rather than internet hype, fall prey to their own insecurities that they may "miss out" on the "next best thing." For supposedly smart human beings, doctors in general, and plastic surgeons in particular can sometimes be really stupid "herd animals"--always trying to keep up with their colleagues who are driving the latest bandwagon. You should NOT be there with them, IMHO.

BTW, "stem cell" augmentation is a new "twist" on BA via fat grafting. It's even more "latest and greatest!" Except in a few rare research instances, "stem cell grafting" is mostly hype by a few practitioners trying to steer more patients like yourself towards their practices.

But, don't take my word for all of this--see several ABPS-certified plastic surgeons and see what they say. Perhaps you will begin to see a consensus emerging!

 

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 116 reviews

Breast augmentation and fat injections

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Fat injections to the breast for breast augmentation is still not the state of the art for breast augmentation. There are still a lot of unanswered questions.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Fat transfer to the breast is very popular for now

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The truth is that fat grafts for breast augmentation have produced very modest results, perhaps a half cup increase in size, and the procedure is frought with problems of lumps and cysts, calcification in the breast, and dents where fat is harvested, and disappearance of fat is common. There is a postion statement by the American Society of Plastic Surgeons you should see, and you should be careful about claims made. There is no doubt that if it really worked, everyone would do it.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 27 reviews

Breast Augmentation with Fat Graft

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I have personally performed thousands of fat transfers on the face and body including, face, breast, and buttocks. Fat transfer to the breast is becoming the new frontier in breast augmentation, its particularly advantegous for the women who has a breast with unusual shape or very thin tissue coverage. Fat transfer can be done inconjuction with breast augmentation allowing a better camoflouge of the breast. It is also especially important in correcting ripple and bony look of the decollete. If you want breast augmentation with fat alone and you have a good shape to the breast it is still an acceptable procedure. It may require a couple of sessions, it is usually reserved for a more modest B+ augmentation. Fat transfer to the breast is also quite advantageous to correct asymmetry.

Christian G. Drehsen, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.