5'6, 140lbs - best areas for lipo for breast fat transfer after explant?

Question

I plan to have breast explant surgery and considering fat transfer at time of explant. Dr. said he will transfer what he is able to but said it may be about 80ccs per breast to fill in any areas that need it due to my capsular contracture in one. He suggested abdomen and outer thighs. I am afraid of losing my hourglass figure and looking like a cylinder if he skims off my outer thighs. I don't want my butt to sag either. I am 5'6" 140lbs. Is it better to wait for Fat transfer?

Gary M. Horndeski, MD · Answer

Fat transfers are usually good for about 1 cup size change. If you are size 32 or 34, each 100 cc of fat would correspond to 1 cup size change. If you are size 36 or 38, each 200 cc of fat would correspond to 1 cup size change. However, not all fat survives so you will need 150 cc of fat for 100 cc of fat to survive or 300 cc of fat for 200 cc of fat to survive. 80 cc is a small amount and depending on the donor site it may not be a significant contour deformity. If you are very concerned, you may want to avoid the outer thighs and use the anterior thighs.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. So you after an explant you can wait before deciding whether or not you want a fat transfer to the area. Even with 80-100 cc of fat graft only about 50-60% of that fat grafted survives. If the surgeon were to liposuction 400-600cc of fat from those areas, it really wont create a large change to your body contour. Those areas suggested by the surgeon are good areas to harvest the fat from since they have better chance of fat survival and also hold lot of stem cells. Go over your questions with your plastic surgeon to express your concerns.

Daniel Barrett, MD · Answer

Dear RCoceanlover,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

It is always better to wait for the breast to settle down and do the fat transfer later. However, the amount he has planned will probably work well.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality results with both Liposuction and fat transfer is more difficult than most people realize. A substantial number of plastic surgeons despite being board-certified and having overall good reputations are not particularly talented at either one of these two procedures. A substantial number of plastic surgeons don’t take liposuction seriously enough to bother attempting to master how to do it well.
 Liposuction results very dramatically based on who does the procedure and results are permanent and more or less irreversible. patients should be very selective before committing to having permanent and irreversible cosmetic procedures.
Anybody interested in liposuction and fat transfer should have multiple in person consultations with local board-certified plastic surgeons. During each consultation ask each provider to show their entire collection of before and after pictures.
Seeing a handful of pictures which must likely represent the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
An experienced provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures. if your surgeon is only going to graft 80 cc then that amount of fat should be easily obtained from any one area without causing a substantial change in body contour. 160 mL fat is a tiny amount to be grafted regardless of what size breast someone has.
My average breast fat transfer is closer to 500 cc per side.
The least I’ve ever grafted is 200 cc and the most has been 1200 cc.
The biggest problem with fat transfer at the time of explantation is that patients have no way of assessing the outcome of the fat transfer.
Your breast will not look like they did pre-augmentation and without recovery from explantation before grafting you have no reference or before and after pictures.
If you want to have fat transfer you should probably find a plastic surgeon who has ample experience with a proven track record of getting quality results on a consistent basis with that procedure. there are advantages and disadvantages of grafting during explantation. The major advantage is the surgeons access to the ability to graft from inside the breast towards the skin.
Breast fat transfer results even when done correctly are still fairly subtle and typically do not deliver more than 1/2 cup increase in breast size.
Fat transfer also does not change the shape of the breast in any particular manner simply increases the volume.
When in doubt I suggest patients slow down and have more consultations to make sure that they found a most talented and experienced provider for their needs.
This is especially true for procedures that are permanent and irreversible.
Best,
Mats Hagstrom MD

5'6, 140lbs - best areas for lipo for breast fat transfer after explant?

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