Is (breast) fat transfer a risky procedure?

Question

BBL has a high mortality rate, I was wondering if Breast Fat Transfer is risky as well since it also does inject fat into the body.

Gerald Minniti, MD, FACS · Answer

First, a bbl performed in the evidence based best way, has a zero mortality rate. The last five years of research has shown us why fat emboli occur: disruption of the gluteus maximus muscle fascia. Keep that intact and no emboli, no death. Second, contrary to 'dr old school', his fears should have been extinguished in 2006, when the data showed that fat grafting to the breast on average created no different calcification patterns as other breast surgeries, and that those calcifications were far different than microcalcifications of cancer. Finally, fat grafting is a great way of augmenting the breast for some people, but its results are not the same as augmenting the breast with an implant. And sometimes both are used. Go to a few true experts to get real answers.

Casey Anderson, MD, FACS · Answer

BBL mortality rate is quite low when done in the superficial plane. The historical practice of injecting the fat into the muscle is what made it dangerous. Breast fat grafting is very safe. Fat is generally injected in multiple planes and does not have the same embolism risk that BBL does. As always, be sure to research who performs your surgery to ensure the best likelihood of a positive result.

Jonathan Saunders, MD · Answer

i admit that i am old school. that being said , i only do fat transfer to the breast for reconstruction. i don't believe it is harmful for cosmetic reasons, but i have read there is a 25% rate of future biopsy in order to rule out malignancy. radiologists assure us that  they can tell the difference between malignancy and benign calcifications. i am not willing to rely on that and perhaps miss a life threatening malignancy

Ronald J. Edelson, MD · Answer

The thinking is that in the bbl fat gets injected into the large veins in the muscle which causes the fat embolus. In the breast it is much easier to stay out of the muscle. The numbers bear out the fact that fat injection of the breast doesn’t have the high risk compared to bbl.

Daniel Barrett, MD · Answer

Dear CLME,
fat transfer is a safe procedure. 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

Kenneth Hughes, MD · Answer

It's been proven that injecting fat cells from other parts of your body into your breasts is not going to cause cancer. Cysts, lumps, necrosis, failure of the graft, and microcalcifications are the enumerated risks. Radiologists assure us that they can differentiate calcifications from cancer.
In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used. The fat must be injected through multiple planes in small amounts to the breast tissue through one tiny incision under each breast.

Connie Hiers, MD, FACS · Answer

BBL does not have a high mortality rate if done properly and carefully. Fat can also be safely transferred into the best. However, the amount that can be transferred is dependent upon the size the your breast. At most, you can expect up to a cup increase in size. If you want more, I would suggest implants. Also, if you loose weight, you may loose some of your fat.

Johnson C. Lee, MD · Answer

The risks of fat transfer have been more carefully examined over the past decade as it has become a much more popular procedure. Plastic surgeons should now be aware of ways to minimize the risk such as low pressure retrograde injection techniques and keeping the injections away from the muscle and larger blood vessels. With new understanding of the risks of fat transfer, the mortality rate is much much lower. Fat transfer to the breast is even lower risk. Breast tissue does not contain as many large vessels as the buttocks and the volume that can be injected into the breast is much lower than the buttocks. Discuss your concerns with your plastic surgeon. He or she should be able to explain what techniques they use to reduce your risk. If they take your concerns seriously, then you should feel comfortable that you are in good hands. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Mats Hagstrom, MD (license on probation) · Answer

No one has documented a significant relationship between developing fat embolism with breast fat transfer other than the BBL or in the gluteal vein.

There may be some risk of breast fat transfer because we’re working close to the ribs. I personally graft fat in the pectoralis muscle and do not believe it is a high-risk procedure.

Went to providers who are rug players without any training in plastic surgery represent 10 BBL fatalities from this single complication by themselves and the great many plastic surgeons in the United States not only have not had a fat embolism in the practice but probably don’t know anyone who’s had a fat embolism in the practice it should tell you something about how these numbers may have come to be about.

I think all modern conscientious plastic plastic surgeons who do this procedure recognize there is a potential risk and we should take all the recommended proper safety measures to not have this happen.

Fat embolism has not been reported in fat transfer to the breast

There is risk with all surgical procedures.

Best,

Mats Hagstrom MD

Frederic H. Corbin, MD (license restricted) · Answer

The simple answer is No.  Though not as much fat can be transferred in one sitting as with a BBL, if performed properly, it is a very safe procedure without any reported deaths or major complications

Dr Corbin

Is (breast) fat transfer a risky procedure?

Answers (10)

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