Fat Transfer Breast Augmentation: What You Need to Know

If you’re after more balance or a modest size increase, with natural results, fat grafting can be a better alternative to breast implants.

For most patients, fat transfer can achieve a size increase of ½ to 1 cup (with 200cc to 500cc of grafted fat per side), less than what many breast augmentation patients are after. However, the procedure can be repeated to create fuller breast volume. How much fat your surgeon can inject will be limited by the envelope of your breast skin: patients with more skin laxity and volume may be able to achieve an increase of up to 2 cup sizes, while those with tighter skin and smaller breasts will have less room for the transferred fat. Over-filling can reduce the rate of fat cell viability and lead to uneven results. 

“In simple terms, you can roughly double the size of your breast at the time of breast fat transfer surgery. After the swelling goes away, your breast will be 50% larger than you started—possibly up to 70%, if you are lucky,” Dr. Shortt explains. 

Size aside, it’s important to realize that fat cannot change breast shape in the same way implants can. If you’re looking for obvious cleavage and contours, fat transfer may not be the right solution for you.

An experienced plastic surgeon who regularly performs both procedures will be able to assess your breast envelope and determine whether you’d be likely to get the volume increase you want with fat alone, or whether implants would be necessary to create your desired result.

Traditional breast augmentation is performed with breast implants, filled with silicone gel or saline (sterile saltwater). 

Some surgeons perform fat transfer in tandem with breast implant surgery, rather than on its own. “Finishing off” the implant with a fat transfer can smooth out any contour issues and allows for a more natural look and feel. 

Although breast augmentation with fat alone has several advantages over implants, it’s also good to be aware of the downsides.

Pros

• Studies show a high satisfaction rate (92%) among patients having undergone fat transfer to the breasts, and the procedure has an 87% Worth It Rating on RealSelf.
• The procedure creates a subtle increase in breast size using fat that’s harvested from your own body. Along with creating fuller breasts, this technique has body contouring benefits in areas where excess fat is removed via liposuction. 
• Permanent results can look and feel very natural. 
• Incisions and scars are minimal—just small incisions (about four millimeters, or one-eighth inch) made for harvesting the fat through liposuction and tiny injection points along the areola and breast crease. 
• You won't have to worry about breast implant surveillance or the risk of implant side effects or complications, including rupture, leakage, or capsular contracture (when the tissue around the implant hardens and contracts).
• Some doctors consider fat transfer breast augmentation to be a safer treatment option than implant surgery. “Overall, it’s a low-risk procedure, especially when compared to breast augmentation with implants,” says Beverly Hills, California, plastic surgeon Dr. Justin Yovino.

Cons

• Results are less predictable than with breast implants because only about 50–70% of transferred fat cells survive. “Implants give a more guaranteed size result,” says Dr. John Burns, a plastic surgeon in Dallas.
• Asymmetry is possible.  
• Patients seeking a large enhancement (more than one-two cup sizes) may not be able to achieve their desired results with fat alone.  
• Fat grafting to the breasts can be expensive, and some patients may want more than one breast fat transfer procedure to achieve their desired results.
• All breast surgery may impact breast imaging. Fat transfer can make mammograms more difficult to interpret, due to potential fat necrosis, oil cysts, and calcifications that may be mistaken for suspicious tumors on imaging.
• Breast fat grafting does not appear to significantly increase one’s risk of breast cancer, (although research is always ongoing), but it may make radiologic interpretation more difficult, resulting in an increased number of breast biopsies to rule out breast cancer.

RealSelf Tip: “Fluctuations in weight will cause an increase or decrease in the size of the fat cells, so your breasts will change size with weight fluctuations,” says Dr. Ashley Gordon, a plastic surgeon in Austin, TX. This can help keep you looking proportional, but it may also give you larger or smaller breasts than you want.

• Average Cost:
• $10,860

• Range:
• $5,400 - $19,500

Your fat transfer breast augmentation cost will depend on the amount of fat you’re having transferred, the experience level of your doctor, their practice location, and the specifics of your procedure.

Cosmetic procedures like this one aren’t covered by insurance, but most surgeons offer payment plans or accept third-party financing options, such as CareCredit.

See our complete guide to breast fat transfer costs

The fat transfer breast augmentation photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

To be an ideal candidate for fat transfer to the breast, you’ll need to: 

• Be in good health. Your doctor will request a full medical history, including any preexisting conditions. 
• Not smoke. Smoking can negatively affect your body’s ability to heal. If you’re a smoker, you’ll have to quit for at least a month before and after the surgery.
• Have enough available fat to achieve your desired results. Most procedures harvest 500 to 1,000 milliliters of fat, so if you’re on the lean side, you may not qualify. 
• Have enough breast volume to receive that fat. “For patients with smaller breasts, more than one procedure may be required for more fullness,” notes Dr. Shortt.
• Have realistic expectations about the outcome. For example, the procedure doesn’t lift sagging breasts or improve the appearance of stretched, crepey skin, so patients need good skin tone and elasticity—or they may need to combine fat transfer with breast lift surgery.

There are certain scenarios where breast fat transfer procedures are particularly beneficial, says Dr. Burns. “Women whose breasts have changed as a result of weight loss or pregnancy tend to be wonderful candidates for a fat transfer breast enlargement, since it can restore the fullness of the breasts, increase roundness, and help you go up to two cup sizes larger,” he says.

“Although not required, an aversion to having a breast implant is often something patients seeking breast fat transfer talk about,” Dr. Shortt adds. “This is important as ‘ideal’ sizing goals cannot always be met with breast fat transfer, but it is a great trade off for patients looking to avoid an implant.”  

A fat transfer procedure takes two to four hours, depending on the volume of fat being transferred and the experience of the surgeon. It has three stages.

1. Fat harvest. 

• The liposuction portion of the procedure is performed under either general anesthesia or local anesthesia with twilight sedation. 
• Your surgeon will create tiny incisions in the chosen areas and insert a blunt-tipped cannula directly into the fat, sucking it out.  
• Many doctors use traditional tumescent liposuction to remove the fat, but others prefer energy-assisted options like ultrasound-based VASER lipo or BeautiFill. 

2. Purification. 

• Various techniques are used to remove non-essential fluid and particles to prepare the fat, but the most common are centrifuging, decanting, and filtration. “There is no one technique that has proven conclusively better than all others,” Dr. Shortt notes.
• The processed fat is transferred to smaller syringes for the transfer. 

3. Transfer and injection. 

• A small cannula is also used for this part of the procedure, to reduce the risk of bruising around the injection points and allow for smooth insertion of tiny parcels of fat cells into the breast tissue. (Tiny amounts of fat have an easier time establishing blood supply than larger blobs.)
• Multiple injections will be placed into the breasts, to create a symmetrical, natural shape. These injection marks heal well, often without requiring stitches.

After surgery, patients are placed in a specialized bra and compression garments for the liposuctioned areas, to help reduce swelling and provide support for the healing tissues.

Related: Top Surgeons Share the Ins and Outs of Breast Augmentation with Fat Transfer

Patients can get back to most regular activities within a couple of days, but full recovery from fat transfer breast augmentation requires several weeks. It can take months for all of the swelling to resolve.

Here’s what to expect as you recover:

• For the first few days post-op, it’s normal to experience a mild soreness or even dull pain in the breasts and other areas of the body where the fat was harvested via liposuction. Your surgeon will prescribe pain medication or recommend over-the-counter pain relievers.
• You can also expect some swelling and bruising. Bruising from liposuction typically lasts a couple of weeks, while bruising on the breasts should subside within a month. “Breast bruising and swelling [following fat grafting] are more intense than with breast implants,” says Dr. Burns.   
• Avoid strenuous exercise, including heavy lifting and sports, for the first few weeks of healing time. You’ll be able to ramp up to cardiovascular exercise after three weeks and weight training and yoga at six weeks.
• Your surgeon may have you wear a compression bra for the first few days before switching to a regular bra for the next month, to provide gentle support while preserving the blood supply to maximize fat survival. 
• Sleep on your back or side, to avoid putting pressure on your breasts for at least the first month.
• “Avoid any manipulation of the breast tissue for three months,” says Dr. Edward Bednar, a plastic surgeon in Charlotte, North Carolina. “You can be intimate, but try to protect your fat cells as much as possible until that point in time.”

You’ll see more volume immediately after your procedure, but it can take up to a year to see your final result. Here’s a typical timeline:

• At the one-week follow-up visit, your surgeon will examine your breasts, to ensure they’re healing normally. They may look larger than expected at this point, but that’s in part due to swelling, which will also cause them to feel very firm or even hard. Gentle massage can help ease discomfort and reduce swelling.  
• Within six weeks, swelling in the areas where the fat was harvested will have gone down enough for you to appreciate changes from your liposuction. 
• During the first three months, breast swelling significantly resolves and nonviable fat cells are resorbed. At this point you will have a pretty good idea about your final result, although subtle changes are still possible. 
• By six months post-op, most of the swelling in the breast area will be gone, and your breasts will feel mostly normal.  
• By the one-year mark, your breasts will have settled into their final shape and size. 

Multiple fat grafting sessions may be necessary to achieve your desired final result. Complications are less likely when smaller volumes are injected, so the tissue isn’t overfilled and compressed and the grafts have the best chance of survival.

See fat transfer breast augmentation before and after photos

Though no large clinical studies with long-term follow-up have been done on the longevity of fat transfer breast augmentation results, the transferred fat that remains three months after your procedure is widely believed to be permanent.  

It’s difficult to predict how much of the transferred fat will be resorbed within those first few months and how much will survive, according to Dr. Shortt. “There is notable variability between patients.”

A 2016 meta-analysis of volume retention with autologous fat grafting found 62.4% volume retention in eight studies, with an average follow-up period of just less than 17 months. (The review included selected studies published between January 1996 and February 2016, which involved at least 10 patients who had a minimal mean follow-up period of 1 year.) 

Another meta-analysis published in the Aesthetic Surgery Journal in 2018 reviewed 89 studies involving the use of fat to correct contour deformities in the breasts. According to the researchers, “Though evidence on the long-term volume retention is lacking, based on the current data it was calculated to be 52.4% at one year.”

A more recent review on fat grafting to the breasts states that “patients should expect about 40% volume loss of transferred fat over time, though reported ranges are highly variable and depend on technique.”

Some surgeons overfill the breasts in anticipation of volume loss, while others transfer smaller amounts of fat in a series of procedures. New technologies and techniques continue to try to  improve fat viability rates.

When you achieve your desired results, the fat cells that have been successfully incorporated into the breast tissue will remain permanently.  For that reason, Dr. Shortt prefers to work with what you have and does not want patients to intentionally manipulate their body weight before surgery. “That fat will increase and decrease in size with changes to your body weight, so it is important to go into surgery at a stable weight that you are likely to maintain in the future”, he states. 

Of course, your breasts will age naturally along with the rest of your body, so they may change due to the effects of age and gravity. However, the fat that was transferred and fully incorporated won’t need to be removed or replaced down the road, as is often required with breast implants. 

It’s important to maintain your weight so that your breasts remain relatively the same size as you age, notes Dr. Gordon. “Significant weight gain can increase the size of the breasts and the additional weight can lead to sagging.”

Doctors say that breast fat transfer is safe, but like all surgery, fat transfer procedures come with potential risks. 

• Some patients develop temporary or permanent lumps, firm areas, and nodules in the breasts and indentations or irregularities at the harvest site. 
• Not obtaining your desired size or aesthetic result is also a risk.
• An estimated 30–50% of the transferred fat cells will die. Usually, dead fat cells are naturally eliminated, but it's possible to develop fat necrosis or oil cysts.
• Persistent pain, numbness of the skin or nipple, hypersensitivity of the nipple, skin discoloration, infection, bleeding (hematoma), and wound healing concerns are possible. 
• Fat injections may pose risks to breastfeeding. Currently, there’s no scientific research on its effect on women’s milk ducts or glands, but there is a potential for them to be injured during the procedure.
• Fat injection may also interfere with mammograms. The volume of fat required to enlarge the breast makes the technique prone to microcalcifications (when fat cells die but don’t dissolve). They’re not cancerous, but microcalcifications can interfere with mammograms and may make your results more difficult to interpret. This could increase your need for a biopsy to rule out breast cancer. Make sure your technician knows that you’ve undergone this procedure. 
• Although rare, general anesthesia, liposuction and fat transfer have potentially serious systemic risks that you should discuss with your surgeon and anesthesiologist. 
• Your surgeon can go over risks in more detail than listed above and tailor them to your specific medical history and situation.

In terms of the safety of a fat-grafting procedure for breast reconstruction patients, doctors “are presently unable to state that autologous fat grafting is a safe method,” concluded the authors of a 2019 review. “While there is no clear clinical evidence that fat grafting in breast reconstruction increases the risk of breast cancer, further studies are needed to obtain more definitive findings.”