Fat transfer & implants? Is fat transfer addition really necessary? (Photos)

Question

I recently had a breast augmentation consultation, and the plastic surgeon suggested that because I am thin and my breasts are spaced far apart, fat transfer + implants would give me the best result. I am going to another plastic surgeon for a second opinion but wanted to ask here as well. Is the addition of the fat transfer really necessary / will it make a big difference in my final result?

Gianfranco Frojo, MD · Answer

I do not think that a fat transfer would be necessary. I believe that choosing the correct implant for your breasts would provide an adequate outcome. You should see a surgeon who has a 3D imaging system in the office (we have a Vectra, there are many), which can help visualize your outcome (it is 98% accurate in simulating the surgery). Please come on in for a consultation with us at Virginia Plastic Surgery!-Dr Gianfranco Frojo

Jeffrey Lisiecki, MD · Answer

To answer this question, you need to be examined in person to see where the medial edges of your pectoralis muscle and breast tissue lie. If they are sufficiently far apart, then fat grafting can be helpful. If they are close enough together that you would be okay with that spacing between your breasts, then you could go without. Subfascial implant placement can be helpful here, as well, to get the implants a little closer together. If you're not sure, fat grafting can also be added later in a secondary procedure.

Leyla Arvas, MD · Answer

Hallo thank you for your question indeed you are ideal candidate for breast augmentation with implants but according to the picture you sent its hard to evaluate ıf fat transfer will give you the desired result.you look a bit skinny so you might not have enough fat tissue for fat transfer. in this case we recommend patient personal examination

Gary M. Horndeski, MD · Answer

Your breasts are very low on the chest wall. Breast augmentation alone will be insufficient. You will need a lift and the technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Hampton A. Howell, MD · Answer

Hi.  That is certainly a reasonable thing to consider in terms of fat transfer.  For sure it is not "necessary", but it might give a nice improvement along that area.  Just based on the imited photograph, though, it may be difficult to find much extra fatty tissue to use.  Fat can have its potential down sides as well though in terms of variability as of what takes and does not take as well as possible nodularities etc.  The nodularities are generally uncommon.  Certainly worth getting another opinion if you are not certain about whether you want to proceed with that.  You could also do fat transfers at a future surgery (it does not have to be done at the time of your breast augmentation).  I would recommend consulting with a board certified plastic surgeon with good experience with breast augmentation that you feel a high level of comfort with and who shows you nice results.  
Good luck and take care, 
Dr. Howell

Michele A. Shermak, MD · Answer

Hello!
In my practice it is usually one or the other - implants or fat. One can use both to build up the cleavage and bring the breasts closer but not sure this is necessary. Implants can likely do a great job on their own. Plus there is the question of fat donor sites. . . you need fat to donate to the breasts.
I wish you the best of luck. Be sure to see a board certified plastic surgeon!

Daniel Barrett, MD · Answer

Dear Anonymous3419,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

Run. Don’t walk. Run. It’s an extreme waste of money. By the way where does the surgeon plan to get the fat? Will it leave a dent. I know some surgeons think the whole worlds problems can be solved with fat transfer. It’s nonsense

Justin K. Williams, MD · Answer

I agree with your surgeon. I think that the addition of fat to breast implantation would help to give you an optimal result. Fat grafting can help to fill in the cleavage area and can also help decrease the visibility of rippling. If you have enough fat on other areas of your body for harvesting, this to be a good addition.

Connie Hiers, MD, FACS · Answer

Implants look best when there is natural tissue to help hide them. However, you appear thin and may not have much fat to offer. I do recommend placing the implants behind the muscle for a better look.