What percentage of your patients experience lumps after breast fat transfer?

Question

E.g. oil cysts, fat necrosis, etc. Are you more conservative in your transfers, or do you prefer to add more?

Alan Gonzalez, MD, FACS · Answer

Hello @passionfruity, thank you for your question. Regarding the percentage of patients experiencing lumps after breast fat transfer surgery, I can confidently say that it is quite low. In my experience as a plastic surgeon performing breast fat transfer procedures, I have found that most of my patients do not experience lumps or other complications. In fact, in many cases, the fat that is transferred to the breasts contributes to an improved and more natural-looking appearance. The success rate for this procedure is high thanks to the surgical technique, technology and 22 years of experience. For more information, you should consult one or several board-certified plastic surgeons. Best wishes! Alan Gonzalez MD FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Michele A. Shermak, MD · Answer

Small oil cysts may occur with breast fat transfer. Careful treatment of the fat to be transferred to the breast and conservative volumes in an unscarred breast make lumps less likely. Lumps are more common in breasts with scarring and/or radiation treatment in the past, when the fat is more damaged prior to transfer, and when larger volumes of fat are transferred. The good news is that when these lumps do occur, they are typically like small round pearls without overlying skin change and look benign. Ultrasound will better identify that they look benign. Biopsy may be done to assure there is no problem. Patients over 40 years old should definitely have a mammogram done prior to this procedure.

Jeffrey Lisiecki, MD · Answer

Palpable lumps after breast fat transfer are possible, but fairly uncommon, probably on the order of a percent or two of cases. I have not had any of my patients come back to me with palpable lumps after fat grafting to the breast, though I have seen a couple from other surgeons.
Regarding how much to add, it depends a lot on the patient's goals. In most patients, it is possible to transfer up to about 500cc per breast. Assuming that 50-60% of that volume will last long-term, that translates to 250-300cc of augmentation. Less is certainly possible as well if your goals are for a smaller augmentation, or to balance out asymmetries or improve shape without adding lots of volume.

Daniel Barrett, MD · Answer

Dear passionfruity,
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

Connie Hiers, MD, FACS · Answer

I am conservative with fat transfers to avoid the oil cysts and fat necrosis, which fortunately, I have had very little. Also, I am careful to select someone who has some breast tissue to actually accept the transfer.  Women with AA to A cups are not good candidates for fat.  Also, I will plan a second or third transfer if needed to be safer than cram in as much fat as possible.

Hilton Becker, MD · Answer

Lumps are more frequently seen after large volume fat grafting.
I perform serial low volume fat grafting and se very few lumps after grafting

Mats Hagstrom, MD (license on probation) · Answer

I really don’t have problems with either labs or oil cysts.
I graft aggressively but my grafting is extremely stratified.
These complications are avoided by not placing excessive amounts of graft tissue in one location.
The correct way to graft fat is the three-dimensional matrix.
Imagine a chessboard in three dimensions.Black squares are you are breast tissue with an active live blood supply and white squares represent grafted fat.Every white square has to be surrounded by black squares in order for graft to get revascularized and remain viable. it’s grafted fat is stacked on top of grafted fat then it will die, create necrosis and form oil cysts.
A typical breast grafting session is about 550 cc per side.
The smallest amount a graft an egg cup breast will be 350 cc.
 The most I’ve grafted is 1500 cc per side
I’ve had one patient develop lumps and she intern had a mammogram because of it.
No other patient has reported developing lumps or other complications with the exception of one patient who developed a breast infection.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe.
The learning curb to master these procedures is long and steep.
Each individual patient needs to be assessed in regards to candidacy for both Liposuction and fat transfer.
Likewise patients need to assess surgeons skills for both Liposuction and fed transfer to make sure they have sufficient skills to not create problems.
When things go wrong with breast-fed transfer it is often due to poorly done Liposuction leaving people with disfigurement.
I recommend having multiple in person consultations with local board-certified plastic surgeons who seem to have experience with the procedure.
The first step is to get a clear understanding of your own candidacy for both Liposuction and fat transfer.
Sufficiently skilled plastic surgeon should be able to accurately predict the type of results you’re going to get and show you accurate before and after pictures that are consistent with what can or cannot be achieved with the procedure.
Be careful with the very impressive pictures which may represent early fat transfer results that can look very impressive but do not represent final results.
After pictures for fat transfer it should not be taken until a minimum of three but preferably six or more months after the procedure.
During each consultation ask each provider to open up their portfolio and show you their entire collection and before and after pictures.
Providers will most likely prefer to show you preselected samples representing the best work of their career.
This is however insufficient to get a clear understanding of an average results look like or how many of these procedures they have actually performed.
Ask providers to show you only pictures of people who have similar body and breast characteristics to your own.
Bring pictures of your body and breasts with you for consultations to use as a reference.
Ask providers to show you examples of excellent results, average results and results that did not turn out as well as they had hoped.
Ask providers with a revision rate and revision policy is
Ask providers about all the complications Tim had with the procedure and how they manage to each of the complications.
When reviewing before and after pictures look very carefully at all areas treated with Liposuction.
There should be no skin contour irregularities on any treated area.
As providers to point out exactly what areas for treated with Liposuction and what areas were not treated. Then look very carefully a transition zone between treated and untreated areas to make sure it looks natural and appropriate.
Confirm the exact time frame that after pictures were taken in relationship to the date of surgery.
After pictures taken less than three months from the date of the procedure or not representative of final results.
An experience provider should have no difficulty showing you at least 50 set a before and after pictures of commonly performed procedures. Highly experienced surgeons will in fact have hundreds or even thousands on before and after pictures for these procedures.
You should feel very confident you’re in the hands of the best provider in your community for the procedure. If you have doubts slow down and schedule more consultations.
Best,
Mats Hagstrom MD

Derek Fletcher, MD - Account Suspended · Answer

Fewer than 5 percent of my patients experience oil cysts or fat necrosis. I use precise, micro fat injection techniques that ensure maximum contact of the each graft with the surrounding, native breast tissues. This is ensures the highest probability of fat survival. I never inject more fat than I think the breast tissues can support. My technique takes longer in surgery, and may take more than one operation to achieve the goal size. But, the complication rate is very low and the quality of the outcomes are high.

What percentage of your patients experience lumps after breast fat transfer?

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