Will a breast fat transfer help me achieve firmer breasts that hold their shape?

Dear Dynamic828035,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The things you are describing, feeling firmer and sticking out from your body (projecting) when laying flat, are more characteristic of implants than fat transfer. Fat transfer in general is a bit smaller volume and will end up giving a softer appearance to the breast. In other words, the breast will be less firm, less upper pole fullness, and less projecting than an implant. One is not necessarily "better" than the other, but you will get a very different result from both.

You do not provide photos so no recommendation can be made about what might be right for you. To answer you question though, fat and implants produce a very different result. Fat is soft, and has no structural capacity to lift, firm or tighten tissue. It will simple make your breasts bigger. This is actually really good for some people, and is why fat is loved by many surgeons including myself. Fat needs to be harvested from other sites via liposuction however, a procedure with its own additional risks and benefits. Implants are more reliable, safe, durable, and do not need to be changed out because some random period of time passed. Further, social media has amplified a pervasive anti-implant sentiment that has been brewing since the inception of breast implants in 1962. The truth is that silicone based devices and materials have been in circulation since the 1920's, and constitute tens of various indwelling medical devices placed in millions of people around the world, all made with the exact same materials breast implants are made of. Yet, only the breast implant has been alleged at causing human disease. Recent prospective studies have shown that women who feel they have symptoms caused by their breast implants are in fact suffering from misinformation campaign that is leading to their false beliefs. The actual quantitative data from theses studies show that there is no putative agent that comes from a breast implant that could account for their symptoms.

Transferring fat to the breasts is a great alternative to implants as long as expectations are inline with what breast fat transfer can achieve. The enhanced volume outcome from fat transfer is more mild when comparing to breast implants. The breasts may feel slightly firmer just by the fact that there is more tissue per area compared to preop anatomy. The breasts will have a fuller appearance in all positions including laying down.

Fat is very amorphous, it will not create firmer breasts and will not hold it's shape. Unfortunately, you have not provided photographs or told us your bra size. The breast lift 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Fat is soft tissue so your breast will not feel firm with fat added. Only breast tissue is firm. Fat can be added into actual breast tissue for more volume, but the volume achieved is limited. However, it can be repeated if you have more donor fat. Otherwise, consider implants.

When done correctly breast fat transfer can increase breast size by approximately 1/2 cup or about 50%.
Occasionally we see 100% breast size increase or one full cup.
Some of this is fairly subjective.
Fat transfer can consistently increase breast size by a modest amount.
Fat transfer is not good at changing the shape of the breast.
Patient who want to change the shape of breast should choose a procedure that accomplishes that.
To restore volume and the upper half of the breast implant augmentation is the preferred procedure.
Fat transferred does not restore the volume and the upper half of the breast in any significant way.Fed, transfer results are always going to be modest in comparison to implant augmentation.
The biggest difference is that fat transfer is subtle and does not change shape very much.
If your goal is to change the shape of your breast, then select a procedure that accomplishes that.
Without pictures, we can’t make an assessment.
Based on what you describe, you should have implant augmentation.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize.
The number of plastic surgeons have truly mastered. These procedures is quite small.
There are significant differences in skill and experience among board-certified plastic surgeons for all procedures, but the variation in skill seems to be more significant for liposuction and fat transfer.
Best,
Mats Hagstrom, MD