Seeking information for pros & cons of autologous breast augmentation (microsurgery)

Yes the microsurgery is for breast reconstruction. It entails some significant scars and as far as I know it’s not done for cosmetic purposes yet.

Hello,
Thank you for the question.
Autologous breast reconstruction or augmentation is when your own tissues, typically abdominal fat and skin, are transplanted to help create new breasts (typically following mastectomy or implant removal). Microsurgery is then performed connecting tiny artery and vein in order for the translated tissue to live and incorporate.
Fat transfer to the breasts is also a great option to help increase the breast volume and improve symmetry. This is done usually through tiny incisions which heal with minimal scarring. Breast lipofilling using fat grafting may require a few sessions (surgeries) to achieve a fuller cleavage, which is an important consideration for many patients.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Surgeries in order to discuss your goals and concerns for the best cosmetic results. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
Best wishes and good luck.
Best regards,
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Thank you for your question. Microsurgical breast reconstruction involves taking tissue from one part of the body and transferring that tissue with its associated blood supply ( artery and vein ) and transferring it to the chest to make a breast. This is a relatively rare subspecialty within Plastic Surgery, you should seek a provider that has special training to perform at this highly complex procedures. In its most elegant form, only the skin in that is transferred leaving any underlying musculature on damaged. The benefit is you avoid it having implants and ever having to deal with implant problems. The tissue feels and looks like a breast is your breast is made up of mostly fat. And lastly the tissue will change with your body as you gain and lose weight. Good luck.

Dear applepop,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

Yes, this long and very expensive procedure is used for breast reconstruction and not for cosmetic surgery. I would suggest meeting with a reconstructive breast surgeon to discuss your options. Insurance will not cover this for you.

Typically an in person consultation for this procedure typically takes about an hour.
Breast-fed transfer is in fact two procedures done at the same time the first being Liposuction which is necessary to harvest the fat and the second is then grafting that fat.
Ideally someone would be both a good candidate for liposuction and for fat transfer.
Grafting fat is in many ways no different than grafting other tissues such as a bone graft, skin graft, Cartlidge graft etc. There are multiple variables that determine the potential effectiveness of the procedure. The first thing to consider is the providers skills and experience. Delivering consistent quality in Liposuction And fat transfer results is not as easy as people believe it and this includes a substantial number of people who perform the procedure.
To have a good quality outcome for both Liposuction and fat transfer patients should be very selective and carefully vet plastic surgeons to pick the most talented and experience provider.
Not doing so can lead to poor outcomes with low patient satisfaction including disfigurement.
One of the other variables is the amount of tissue we have to graft fat into. I referred to this as the amount of host tissue. If there’s very little tissue to graft fat into than the potential increase in volume will be subtle. even when done well on patients who are ideal candidates the results will always be subtle and patients should not expect more than 1/2 breast cup volume increase. As well fat transfer does not change breast shape in any significant way.
Women seeking more than 1/2 cup increase in size or substantial change in breast shape are better off choosing other procedures.
It’s important to recognize that the procedure does not change breast shape.
This means if someone is unhappy with her breast shape because it lacks volume in the upper half it’s still going to lack volume in the upper half after fat transfer. fat transfer is not a good operation to change the shape of the breast.
For Liposuction I have to describe the ideal candidate as someone who is young tight and pudgy. The abdomen is the most usual area to harvest fat from and I usually treat the torso as a single anatomic unit and try to treat the entire tour so when doing Liposuction with or without fat transfer. by treating the entire torso patients are left with a natural even thin fat distribution without having transition zones between treated and untreated areas.I suggest anybody interested in this procedure start by scheduling multiple in person consultations with local board-certified plastic surgeons in their community. I recommend avoiding virtual consultations whenever possible. During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures. Bring pictures of your own breasts taken similar to how plastic surgeons take before and after pictures. You can use your own breast pictures as a comparison reference. when reviewing after pictures ask the provider how far after surgery the pictures were taken. Any picture taken less than three months from the date of surgery does not represent final results.
An experience provider should have no difficulty showing at least 50 sets of before and after pictures.
As providers to show you as many examples as possible of previous patient who had similar body and breast contours and characteristics to your own.
Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. you may very well find many plastic surgeons will immediately discount fat transfer as a viable procedure and instead recommend implants. This may mean that certain provider simply lax skills and experience to deliver a consistent quality results. that said, even the best results for this procedure are still quite subtle and anybody interested in substantial change should probably op for implants or alternate procedure.
Continue having consultations until you feel quite comfortable you found the most talented and experience provider.
Listen to plastic surgeons recommendations and be open to alternative procedures.
Fat transfer is a viable option for some people but the procedure is inherently limited and on top of that getting consistent quality result takes a substantial amount of experience and inherent skill.
In reality most plastic surgeons probably do not have sufficient skills and most likely will simply steer patients towards implants.
You’ll need to find plastic surgeons who have a demonstrated and proven track record with fat transfer and has the before and after pictures to prove it.
Always recognize that early postoperative results from fat transfer can look very impressive. Early results do however not represent final results in anyway.
After pictures should ideally be taken at six months from the date of the procedure.
Best,
Mats Hagstrom MD