Want to fix asymmetry and loss of volume - Would a Breast Fat Transfer be the best option for me? (photos)

I think what's settled is the lift part, although we could debate the merits of a unilateral lift versus bilateral (both breasts). The other part is increasing volume, and that comes as either the use of implants or fat grafting, the results of which are different. Although it is hard to tell the difference when a small implant is utilized, typically implants give more projection and upper pole fullness when compared to fat grafting. Further, the amount of volume enhancement is assured with implants, with fat there will some attrition of volume (but what survives stays forever, like fat on the rest of the body). The other big issue that doesn't seem to register with many potential patients is that fat grafting requires liposuction, a common procedure, but nonetheless one that involve other body parts that require care after surgery and the potential for unintended contour defects. So, fat grafting of the breasts requires candidacy for liposuction too, and all that that entails (risks and benefits). Finally, fat grafting a breast simultaneously with a breast lift carries some issues too, and I prefer to stage it into two procedures, typically lift first and fat grafting as a second surgery; this avoids the potential for more graft loss and maximizes circulation to the freshly lifted tissues enabling optimal healing of incisions.

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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

You could have a lift with or without implants. Fat transfer is a total loser. Results are poor and can have problems such as lumpiness or cyst formation.

Hi, from your photos you look like you would be a good candidate for fat transfer or implants, and I agree you would benefit from a lift in conjunction with either. The most common harvest sites for fat transfer are abdomen or flanks, but thighs are good option as well. Hope this helps in your decision process.

Dear andi514,
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

A lift and fat transfer could be done, but probably in two sessions. With fat, you won't have a lot of upper breast fullness that you can have with implants. With fat, you may only gain one half to one cup with each transfer. If you don't want much more fullness, then fat may be a good option. If you want at least 2 cups increase in size, implants will work better, especially long term.

I agree with your first two surgeons. The best option is a unilateral mastopexy (lift) with bilateral implants (provided you desire larger breasts, one implant if concerned with the size asymmetry)
Fat transfers to the breast do not work well. This is why the vast majority of patients have augmentation with implants vs fat transfer.

First based on the photos you need a lift. If a lift was the only procedure performed I would excise more tissue on the right then the left to correct the asymmetry. If you want to go a little bigger and have better upper pole fullness then a lift and fat transfer is a good solution. if you want to be considerably bigger or have much more upper pole fullness - ie no bra then a lift, implants and galaflex mesh for support would be the best option

Thanks for the questions and posting excellent photos. I usually recommend doing asymmetry cases in stages. Stage 1 would be to do lift on lower breast (right side in picture) to attempt to even out the volume and lifting. After this Stage 1 you might be satisfied? If not then either implants or fat grafting after liposuction would be available. Expect fees in $20,000 ranges.

Fat transfer is an option depending on how much larger you want your breasts to be. I would do this in 2 stages: First lift the lower breast, then 6 months later do a fat transfer. Learn more in the link below.