Can an 18 Year Old Get a Fat Transfer Breast Augmentation?

I turn 18 on Aug. 5 this year and i want to get a boob job but i dont want implants and ive heard about fat transfering or fat grafting and wondering if an 18 year old can get this surgey? And what doctors specilize in this department?

Doctor Answers 8

Fat Transfer Breast Augmentation

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The short answer is that if you want to be just a half cup size bigger in a single operation and have substantial fat available for harvesting and you accept that the results are vary in the best of hands you may be a good candidate. However most young women of your age want to be one or two cup sizes larger. There is no doubt that using a breast implant is predictable and the best chance to achieve your goals.

In case you want to know some more about breast implants using your own fat here is some information. In my practice I mainly use it in women undergoing lifts with atrophy on the upper part of their breasts and refuse implants.

An alternative to breast implants is fat transfer also known as fat grafting or lipoinjection. This technique allows women the option of enhancing the appearance of their breasts without the potential problems of saline or silicone implants such as hardness, rippling or rupture.

Who is a candidate?
Any woman who is healthy
Women with sufficient body fat for the procedure
Women considering breast augmentation who wish to be one cup size larger or less
Women who have had breast augmentation or reconstruction but who lack fullness or have contour concerns. Fat transfer can further enhance and reshape your breasts while smoothing out visible or palpable edges of breast implants. This will disguise implant rippling and wrinkling.
Women with normal mammography
Dr. Nichter and Dr. Horowitz have successfully transplanted fat into the face, buttocks and other body areas for decades and are now using this same technology to enhance breast shape and size. Plastic surgeons have been transplanting fat to the breast since 1995 but caution and study were necessary to make sure there were not harmful effects. Furthermore, results in the past were variable, dependent on surgical equipment, technique, surgeon’s skill, and individual patients healing abilities.

Since 1995, recent advances have led to the development of special instruments made just for fat grafting.Though this procedure is still considered investigational to a degree, more and more qualified plastic surgeons are using this technique successfully.   The advantage of this technique is its ability to create a natural augmentation without an implant. Fat grafting (also called lipoinjection or fat transfer) to the breasts is indicated for different reasons: as an alternative to implants for mild to moderate breast augmentations, to provide fullness to the upper part of the breast during a breast lift, after pregnancy, age, or weight loss, following breast reconstruction, or to minimize the visibility or rippling of existing breast implants. Typically up to one breast size enlargement is possible in most patients. Fat transfer to the breast is usually done as a single procedure resulting in approximately half a cup volume increase. In women desiring additional breast enhancement a subsequent procedure can be performed. Each surgery consists of two components:

Harvesting the fat: Fat is removed from your abdomen, hips, “love handles” or other areas using a fine cannula similar to the one used for liposuction but skinnier. This fat is rinsed with sterile saline solution and then packaged into syringes and prepared for transfer. Approximately 20% of fat removed is suitable and available for fat grafting.
Fat transfer into the breasts: The prepared fat is injected in small amounts at a time and widely distributed within the layers of the breast so that these living fat cells can pick up a healthy new blood supply.
Advantages of Fat Transfer to the breasts:
Fat cells are natural and you are using your own tissue without any foreign body or implant.
Harvesting of the fat by liposuction has the added benefit to enhance your shape by removing unwanted fatty deposits
The breast can be shaped or sculpted in more detail than is possible using implants alone.
Minimal incisions reduce the possibility and degree of scarring
No implant is used, therefore there is never a need for replacement, or any potential for capsular contracture (hardening of the implant).
Fast Recovery Time: Recovery time is about 1 week and usually less uncomfortable from implants that are placed beneath the muscle.
Although, breast augmentation performed with the lipoinjection technique takes longer than traditional breast augmentation (with implants) the benefits are substantial including no need for implant replacement in the future.

In the past, significant questions were raised about the ability of Mammograms or MRI to detect breast cancer after injecting fat into the breast. However, there is no evidence that fat transfer to the breast is less safe than any breast surgery. Large studies have begun over the last several years to study fat grafting to the breast. With or without breast surgery, calcifications and lumps can occur. Breast diagnostic studies including physical examination and mammograms should be used to monitor every patient diligently using standard guidelines.

As a general rule, surgeons with extensive experience in grafting large volumes of fat to the body are most likely to obtain the best results. We believe fat transfer should only be performed by surgeons certified by the American Board of Plastic Surgery that have experience in  fat grafting. Few plastic surgeons have this experience. This ensures that your surgeon has advanced knowledge and technical familiarity, but also the subtle anatomy and aesthetics of breast augmentation.

Fat graft augmentation

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If you review many of the opinions previously submitted to Realself about fat grafting for breast augmentation, you will notice that many plastic surgeons advise against this procedure.  Some surgeons who promote it may talk a good game, but the procedure is far from reliable at this time.  You are better off getting implants, in my humble opinion.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Can an 18 Year Old Get a Fat Transfer Breast Augmentation?

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Yes, but a bigger question is will it give you the results you are looking for...In all cases I have seen so far, the results are very unrewarding...I have seen several patients that completely lost any gain they had after the transfer and they ended up getting implants..But then, I only saw the ones that were unhappy but even at the meetings I attend, the results seem....modest...

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Fat transfer for breast augmentation

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Yes, fat transfer is becoming more popular and does work for breast enlargement.  Two sessions may be necessary and a reasonable expection is an increase of one cup size. If you have small breasts and tight skin, then you may benefit from external pre-expansion with the BRAVA system.  There are not that many surgeons trained to do this but it works very well.  I have done it with success.  I recommend you discuss this with a supportive parent and when you are 18, schedule two or more consults to have all of your questions answered and be informed before proceeding.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Fat grafting the breast is still controversial.

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Fat grafting has been around for a long time and the techniques for removing and mainaining grafts has steadily improved. It can require multiple treatments and seems to be best for only smaller changes to the breast. 

That said, fat grafting to the breast remains controversial and is not yet main stream. The fat that is inected into the breast may sometimes leave small marks on mammogram called microcalcifications. This can lead to the mistaken diagnosis of a breast cancer.

Before you rush into this you must be sure you understand the expected outcomes and consider the long term risks.

Hope this helps.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Fat transfer for breast augmentation

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Transferring fat to the breast for augmentation is still in it's early stages of development and is being studied very carefully. It is by mo means a main stream operation at this time and you would be bet served consulting with one of the few currently recognized experts in the field. This is a very costly procedure at this time, considerably more than implants. At the age of 18, you are only a candidate for saline implants as per FDA recommendations.

Todd C. Case, MD
Tucson Plastic Surgeon

Fat grafting for breast augmentation

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Most proponents of fat transfer for breast augmentation feel you can get probably only one cup size increase. Some advocate an improved outcome with the use of specialized suction domes preop to stretch out your skin envelope and enhance vascularity of your breasts. My impression is that lots of experience is not yet available in most regions of the country yet.  I would do allot of research on your surgeons experience and outcomes before having this done. Best wishes

Craig Harrison, MD, PA
Tyler Plastic Surgeon

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.

There is a reason 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. At 18, 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.

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! Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 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.