How much fat can I expect to retain with fat transfer to breast? And how much fat is able to be injected?

Question

.i have been looking into this procedure for a few years but am reticent to make a decision based on the two consults I have had. one dr. would not put more than 100 cc into each breast as he said the lower the number, the better chance for survival. he said the enlargement would be about 1/4 cup. the second dr. said he could inject more more than that and that i would probably be a cup size bigger. for those that practice, can you share your median outcome? and how much do you inject? thx

Edward J. Bednar, MD · Answer

Depending on the amount of harvestable fat, you can get 1-2 cups of an increase in size.  We have seen a retention percentage of 50-90% but is definitely varies from patient-to patient.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question
  
I perform a natural breast augmentation with fat. This can be removed from any unwanted areas including the breast itself as part of my lipo-lift procedure. I perform the fat grafting in multiple planes including under the muscle to give the best, most natural enhancement. Fat grafting is a great solution for someone who wants to bring their breast size up a cup or so and use natural tissue vs an implant. However, it can also be combined with an implant or used as a secondary procedure to fill in areas that are flat or thin. It should not affect nipple sensation, mammograms, cancer risk or breast feeding. It can be a little lump or hard at first but tends to soften over time. If you gain or lose weight, the transferred fat can do the same.  About 60-70% of the grafted fat survives.  At 6 months you will have a good idea of your results. Some women have a second or third procedure which continues to increase your volume safely.
  
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic breast plastic surgery.
  
 
  
Best of luck!
  
   
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Michelle Lee, MD · Answer

Fat survives through the blood supply from the surrounding tissue. How much fat to inject depends on your breast size. Good luck!

Harry T. Haramis, MD, FACS · Answer

Personally, I do not inject a large volume of fat into the breasts. Usually, 50-60% remains, even after special processing.Large volumes are better served with implants. Some fat can always be added for final shaping, cleavage, right to left asymmetries, etc.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Kenneth Hughes, MD · Answer

It is difficult to determine without examining you.  I transfer from 250 cc to 400 cc or so per breast. About 50% of the fat obtains permanence.If you are comfortable with about a one cup size increase, fat transfer would be reasonable. If you want 2 or more cups, breast augmentation with implants would be better.  I typically reserve fat grafting for very small augmentations, particularly in women who have failed breast implants or who have been reconstructed.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Thomas S. Taylor, FACS · Answer

There are several factors involved in a successful fat injection procedure to the breasts: harvesting enough fat to make a significant difference (meaning if you are too thin you may not have enough fat to use for transfer);  harvesting the fat in a gentle manner to preserve fat cell integrity;  processing the fat to retain only the viable fat cells and stem cells; injecting the fat cells using a technique that ensures the highest level of fat cell viability and revascularization to provide an exceptional aesthetic outcome. To obtain a decent augmentation using fat one must inject a fair amount of fat which is determined by the amount of fat harvested and the tissue characteristics of your breasts. Typically I inject anywhere between 250 - 500 cc of fat per side which will usually provide a permanent 1/2 cup to full cup size augmentation.  I hope this was helpful!Thomas Taylor, MD, FACS

Daniel Barrett, MD · Answer

Dear genarose,maximal amount of transferred fat depends on the breast size, desired size, amount of collected fat tissue. You can probably expect to end up with one cup size bigger breasts. You can always look for a second opinion from another board-certified plastic surgeon.Daniel Barrett, MD, MHA, MS 
 Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Millicent Odunze Geers, MD, MPH · Answer

The amount of fat that can be injected into the breast is dependent on the amount of fat harvested, the laxity of your breast skin, and surgeon technique. If the skin of your breast has never been stretched out, then it will not be so accepting of the fat. On the other hand, if you've had prior weight loss or if you have breast-fed, there will be some looseness/laxity/loss of elasticity to the breast skin and your breast can accept more fat. With that explanation, you can see how the amount of fat that can be injected into a breast would vary depending on the individual. 100 cc seems a bit low as anywhere from 30 to 50% of the fat will resorb. I don't believe you'll see a significant difference with 100 cc. I have done ~700 cc per breast, but that was in a woman who was a bit older, whose breasts were mostly fatty and not dense, and she had laxity to her breast skin. She had a great result and was very happy. You may want to consider breast augmentation with implants if anything less then 200 cc is going to be injected per breast. If you are absolutely against implants, then you may just want to get what fat you can injected into your breasts, regardless of amount. Implants will always be an option for you down the road if you change your mind. Best of luck.

Jon A. Perlman, MD (retired) · Answer

With little doubt you can choose fat transfer as a means of avoiding breast implants if you will accept approximately a half cup size enlargement.  This depends on your having adequate donor fat to provide from 100 ccs to 400 ccs per breast.  It is true that too large a graft will diminish the successful revascularization of your grafted fat and becomes counterproductive.  Most patient who want a full cup size change need to consider having fat grafting repeated a second time.Best wishes,Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Member, ASAPS, ASPS
  
Extreme Makeover Surgeon, ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

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