Fat Transfer with Breast Implants? Is this something I should consider or should I just get new implants?
Doctor Answers 4
Implants versus fat transfers
Fat grafting over implants to improve appearance is an option
Fat grafting can be an excellent option to add fullness to the upper pole of the breasts, without implants or even over the top of implants. Fat can also be used to improve assymetries and help with rippling.
However fat grafting is very technique sensitive, and surgeons who do not pay attention to each aspect of the process may not get consitent results. Every component of the procedure from fat harvesting, to fat purification, to micrografting, and even preparing the bed of time with techniques like the Brava device, can make a difference. With careful attention to every step, anywhere from 70-90% take of the injected fat can be expected to survive.
We have installed the first Liquid Gold mini fat bank in the US, and with just one liposuction procedure we are able to successfully store fat, which allows us to save as much fat as needed for one or more procedures.
That sounds like a plan from a doctor that doesn't do breast augmentation.
That treatment plan sounds like something I frequently hear from family practice doctors or others that are trying to develop "fat grafting" clinics and don't perform breast augmentation otherwise. If this is not the case with that doctor then my apologies.
You have 2 issues going on here; 1)rippling saline implants with minimal soft tissue coverage, and 2) most likely some capsular contracture.
I would suggest switching to silicone implants and separating the scar tissue to prevent implant distortion. If you still have areas that require filling THEN you may consider fat transfer to the breasts.
Please know that fat transfer to the breasts is a very contested topic right now because of problems with some of the fat not surviving and creating lumps and mammographic (x-ray) abnormalities which may lead to unnecessary breast biopsies. Please make sure if you have fat grafting to your breasts you see a plastic surgeon that is very well aware of these issues.
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Fat grafting to the breast for implant wrinkling
I think you'll probably be disappointed with the results of this treatment plan. The fundamental issue you are facing is a wrinkling implant with minimal soft tissue coverage. The most reliable way to correct this problem is to change to silicone implants and move them behind the muscle. I've done fat grafting for a few patients with their implant and coverage situations optimized (as described above), and have still not had complete correction of implant wrinkling. The use of acellular dermal matrices (Strattice from Lifecell) is helpful in this situation, but it is expensive. Seek out a board certified plastic surgeon to discuss your breast revision questions.