Implant Reinsertion Vs Fat Transfer For Revision?

asked 5 months ago by rshcah
Latest answer by Tom J. Pousti, MD
Question viewed 120 times
Tags: comparison, fat graft, implant, pros and cons, rupture

I have a single silicone implant (above the muscle) that was placed in 1979 for asymmetry at age 13. In 1983 I had a reduction on the other side. The implant was discovered to be ruptured - intracapsular - a few years ago and I am now considering removing it, but cannot decide whether to replace it with a silicone implant or try a fat transfer. What do you feel the pros and cons of each?

10 answers to Implant Reinsertion Vs Fat Transfer For Revision?

Breast Implant or Fat Injection?

Thank you for the question. What will work best for you will depend heavily on your physical examination and your goals. Generally speaking, breast implants allow for the most predictable increase in breast size with a single procedure. Fat transfer, in the hands of plastic surgeons who utilize this technique frequently, may help improve symmetry. Again, I would suggest in-person consultation with well experienced plastic surgeons. Best wishes. more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Implant exchange

The most reliable solution would be to have an implant exchange. If fat were to be injected( which may not be relaible), you wouald have to wait for the pocket to settle down and heal. Fat injection may require a series of treatments as well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Implant Revision: New implant or Fat Transfer?

Both have pros and cons. There is simplest solution is to replace the old implant with a new one. This would restore your normal appearance right away. Fat be used as a supplement to that to cover the edges of the implant and make you appear more natural. However, using fat alone will require more work. In most cases it takes at least 2 or 3 sessions depending on the volume to achieve and maintain the desired volume for the breast. While there are still... more

Adam Hamawy, MD
Westchester Plastic Surgeon

Old silicone breast implant rupture-what are my options?

A capsulectomy with implant removal is a must. I usually discourage any significant amount of fat transfer to breasts as these can become calcified or absorbed. Calcifications in breast area not a good idea with future mammography as they can appear as cancer. A small silicone gel implant behind the muscle sounds like a more reasonable alternative. Best wishes, Dr. H

Gary M. Horndeski, MD
Houston Plastic Surgeon

Implant Replacement vs Fat Transfer?

There are number of important issues to be considered in your situation. First, you have an old ruptured Gel implant which has not leaked extracapularly - which is good for you. But there is a real risk that you could develope extracapsular gel leakage, and should you should strongly consider having your old implant removed. This should be performed as an "En Bloc" capsulectomy to minimize the chance of getting gel material into your breast tissues... more

Braden Stridde, MD
Federal Way Plastic Surgeon

Fat grafting will depend on the volume that you need

Please send pictures for better evaluation. Fat grafting can be used in combination with implants if you need soft tissue coverage and large volume .

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Implant Reinsertion Vs Fat Transfer For Revision?

All three experts present valid outlooks. If the original implants were not over 300 cc's and you have over 1,000 cc's for liposuction I might consider Fat grafts with implant/capsule removal. I also might consider a combo of fat + smaller implant. Best to be seen in person. Over the internet very hard to advise.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Options for breast symmetry

In your particular situation, with a history of a previous implant, replacement of the implant seems like the best option. Fat grafting can be very beneficial but it depends on the volume you need and the size of the existing implant. A full examination would be needed to determine your best options.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Breast surgery revision with fat transfer

Fat transfer to the breast is controversial. The larger the volume of fat that is transferred the more likely is the need for revision secondary to unequal (and unpredictable) fat resorption. Adding stem cells to transferred fat improves the reliability of the graft but adds an unknown: how do stem cells in the breast affect breast cancer development and/or breast cancer screening? The most reliable source of volume for a breast is an implant.

Daniel Greenwald, MD
Tampa Plastic Surgeon

Fat grafting may be an excellent option

Particularly as you only had an implant on one side, and asymmetry is the main issue, fat grafting may be the perfect option for you. The beauty of fat grafting is that the fat can be placed exactly where needed to improve both size and shape, in order to make the breasts as symmetrical as possible.