If you have previously had breast fat transfer, then you should be fairly familiar with the process. The procedure can generally add 1/2 to maximum one cup of volume to someone’s breast. Equality outcome at about 50% total breast volume. The procedure can increase breast size by modest amount, but does not do very much for changing breast shape. I personally do not perform fat transfer in conjunction with mastopexy surgery. Generally speaking second round of fat transfer, are at least as good, if not better than the first round of fat transfer. Women with larger breast have more host tissue to support larger volumes of grafted fat, and can successfully accept significant amounts of fat grafting. I personally tried to double the size of the breast during a fat grafting procedure sometimes grafting even 300 percent to compensate for fat loss overtime. Delivering consistent quality, liposuction and fat transfer results is not as easy as most people realize. The number of providers who truly mastered this procedure are in a small minority. The most important variable is provider selection at the patient candidacy. if you’re happy with the outcome of your previous procedure, then follow up with that provider and get an assessment for a second fat transfer procedure. If you choosing a new provider, I suggest patient start the process by having multiple in person consultation with plastic surgeons in their community we seem to have a lot of experience doing both Liposuction and fat transfer. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients with similar body characteristics to your own. An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. being shown a handful of pre-selected images, representing only the best results of a providers career is insufficient to get a clear understanding of what results look like in the hands of each provider or how many of these procedures they’ve actually done. Being board-certified in plastic surgery does not mean somebody is mastered anyone single procedure especially not liposuction and fat transfer. Recognized that transfer always includes both Liposuction and fat transfer. Verifying that your surgeon has appropriate section skills since when things go wrong with this procedure it is often related to poorly down Liposuction. Poorly done Liposuction can be very difficult to correct, and can leave people permanently disfigured. Considering how much variation there is in Liposuction and fat transfer skills among plastic surgeons, I recommend patients have multiple consultations before selecting a provider. There’s no correct number of consultations needed to find the best provider. The more consultations you have the more likely are to find the better provider. The biggest mistake patient’s bank is having only one consultation and then scheduling surgery. Without having multiple consultations, you eliminate the ability to select the better provider. You seem like a very good candidate for having another round of fat transfer. By far the biggest variable is going to be provider selection. One more thing to be aware of. Early results from fat transfer can look very impressive. Early results, however, do not represent long-term results. When reviewing before, and after pictures, always confirm the timeframe of when after pictures were taken in relationship to the date of surgery. In order for after pictures to be representative, they should be taken a minimum of three months from the date of the procedure. Taking pictures a few weeks after the operation creates the illusion that fat transfer can create results, consistent with results that breast implants. In reality, the final, long-term results were far more subtle and patient should recognize the limitations of the procedure. Best, Mats Hagstrom, MD.