Breast augmentation with fat grafting: how long do the results last, and how much fat is retained?

I am trying to decide btwn implants and augmentation with fat grafting. Only want to be a cup and a half bigger. It's a lot of money to spend (for fat grafting), so I want to make sure that the results will last and that I can see a change in the size and shape of my breasts. Some of the photos I've seen don't seem to show much difference in size or shape. Has anyone had this procedure a not been happy with it? It seems like most all comments are very positive, so I'm optimistic. Thanks!

Doctor Answers 12

Fat transfer to breasts

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Fat transfer is one of the most common procedures I perform in my practice today. I utilize it alone for surgeries to the breasts or butt or in combination with Facelifts, body contouring surgery, and others. I perform more fat transfer than any one else in Virginia. The key to success are advanced techniques that I use that have been proven in plastic surgery literature. The best one can do is have 60 to 70 percent of the fat you inject stay. Most Of the fat that does not make it will do so in the first 6 months. Therefore you have the rest of the fat the rest your life.

It is the most natural way to perform breast enhancement today. Depending on your current size now and how much breast tissue you have drives how much you can transfer and enhance. You should have no problem getting to the  size you desire; not to mention a BRAVA is not needed. My patients are very happy after this procedure and do great in such a minimally invasive and natural way. Visit my blog or website for more on fat transfer.  Best wishes.

Fat grafting vs Implants

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Fat grafting is an effective method to obtain natural moderate increases in size without the long term maintenance issues of implants (capsule, leak, mechanical affects, etc).  The amount of graft take is roughly 50% and depend on the density of the breast, vascularity, skin elasticity and processing method of the grafts.  I warn patients it may take more than one procedure to obtain the optimal results and build that into my fee structure.  It is not a good procedure for a patient that wants an "augmented look" who is best served by implants.  There are permanent radiologic changes to the breast that occur with fat grafting and some form of imaging should be done before and after surgery to document the changes (preferably read by the same radiologist).

Fat grafting versus implants

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Hi.  It's a tough choice, as both methods have some advantages, and some drawbacks.

Implants: are less expensive initially, can give you a more dramatic size change, can give you more upper pole fullness...but have the potential issues with capsules, leakage, secondary surgery, and more costs down the road, when future surgery is required.

Fat grafting:  more expensive initially, but the fat that survives the transfer (about 65% if you use BRAVA) is yours to keep.  No issues with capsules or leakage, and the benefit of liposuction in the donor site area.

Fat that survives the process is permanent

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The best way to understand fat transfer survival and permanence is that every time fat transfer is performed, some fat always lives and some fat always dies. The fat that lives is permanent.
The survival of fat transfer depends on a number of factors that include the surgical technique and the ability of your tissues to accept the fat and help it survive. The amount of fat that can be expected to survive is highly variable ranging from 40 -80%, but studies show that with good technique in combination with the use of BRAVA 70-80% survival can be expected.
Despite some surgeons claims that BRAVA is not required, published studies strongly support the use of BRAVA showing an average of 150cc fat survival per procedure without BRAVA and 250cc average fat survival with BRAVA.

Breast Augmentation with Fat Grafting

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There are many benefits to breast augmentation with fat transfer. If you are looking for subtle, natural-looking results, fat transfer may be a great option. The procedure also does not run any risk for allergic reaction, as the material being used is the patient’s own fat. However, with breast augmentation with fat transfer, some of the fat will dissolve into the body. It is not known how much fat will be dissolved, so patients run a risk there.

With breast augmentation with implants, the patient can be sure that noticeable results will be seen. Breast Augmentation for breast enlargement is still the gold standard.  Often since one is taking fat from one place and putting it in another, it may not be possible to get enough fat for the breast augmentation.  It is common to place a 300 cc implant in a patient.  For a patient wishing to have fat transfers instead of breast augmentation would necessitate at least 600 cc of fat harvested to get 100% take of the fat.  It is very unusual to get 100% take of fat during a fat transfer procedure.  The fat transfer procedure net is usually between 30-75% take. Therefore it is not uncommon for an individual to have more than one fat transfer operation. I would recommend weighing your options with a board-certified plastic surgeon to determine which choice is best for your individual lifestyle and budget. Good luck!

Fat Grafting to Breasts

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Typically, the transferred fat results in a significant increase in volume of the body site being treated. Fat for lipoinjection, also called fat transfer, is removed from unwanted areas of the body by a narrow blunt tip surgical instrument with side holes, called a cannula, through a small incision. The fat is then cleaned with sterile saline solution before being restored to the body. The fat is then injected into the desired area using either a smaller cannula or needle, or it may be placed directly through an incision. Since some of the fat that is transferred does not remain over time, your surgeon may inject more than is ultimately needed to achieve the desired end result. Over a few weeks, the amount of transferred fat will decrease.
There is a limit of how much fat can be safely injected into one area. The amount of fat that remains over time is variable from patient to patient. For some patients, more fat or other fillers may need to be transferred in a subsequent surgery to maintain or supplement the desired results.

#fattransfer #fatgraft

Comparison between implant and fat transfer breast augmentation is the $64, 000 Question!

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This is probably the biggest question right now on the minds of both surgeons and patients that have any interest in considering fat transfer to the breasts for augmentation.  There are patients who aren't interested in having this done, and there are surgeons who will only use implants, but for those who consider it as an option, the questions that you ask are most pertinent.  I think most studies show, and most surgeons agree, that the expected survival volume of transferred fat is around 65 - 70 % in the best of circumstances.  Because there is so much variability in the ways that the fat is harvested, the techniques of graft preparation, and the methods of injection, there will always be variability in the reported success rates of the procedure.  Assuming that a single surgeon is consistent with his techniques, you should see consistent results from that individual surgeon.  The results that do last beyond a few months postop should be lasting results for the long term, as the fat that survives is living fat tissue that will be a permanent addition to the volume of your breasts.  If you lose weight, you stand a chance of losing this volume however, so you must bear this in mind.  Many of my colleagues here have said that fat transfer is less predictable than implant augmentation, and I agree with this totally.  It is an excellent procedure, but the key is to manage expectations.  I would not advise my patients to expect more than a cup size in volume increase, and if that is what they are looking for, I recommend an implant augmentation.  In addition, if your breasts lack fullness or projection, that is a certain roundness or fullness of the shape, fat transfer is not as likely to improve that as a cohesive gel implant with sufficient projection height to do the trick.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Breast augmentation with fat grafting: how long do the results last, and how much fat is retained?

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    Breast implants create predictable results, whereas fat grafting to the breasts is not as reliable.  The fat that survives is living tissue. 

Kenneth Hughes, MD

Los Angeles, CA

Fat graft

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Fat grafting has a tremendous future. If we could consistently harvest healthy stem cells reliably, it would be a slam dunk. However , we are not there yet. The results vary greatly,  I do a lot of fat grafting but traditional implant augmentation is still the standard in my opinion.

Breast augmentation with fat grafting: how long do the results last, and how much fat is retained?

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With recent improvements in fat grafting techniques  it is  now possible to enlarge a breast to a reasonable size with fat grafting.
Fat grafting is also used in combination with breast implants to enhance the shape,to correct breast complications and even to reconstruct a breast after mastectomy.
In patients who have undergone radiation after mastectomy fat grafting softens the radiated tissue and offers considerable relief to these patients.The beneficial effect seen with fat grafting is believed to be due to stem cells which are present in the fat graft
On average 50% of grafted fat remains .It is preferable to graft smaller volumes and repeat the process two to three times to avoid scarring due to fat that does not survive

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.