You sound well educated on options but just to emphysize the point about fat grafting in the breast...the jury still seems to be out on it. As you probably know the ASPS actually came down strongly against the practice in the late 90s. The reason was a concern that it would infer with mammograms and the unknown risk of potentiating breast cancer. A year ago all this was called into question by Dr Sid Coleman, the guru of fat transfer, who showed beautiful results (and clear mammograms) on patients he had grafted at our national meeting. Will grafting replace implants? NO. Do 99% of docs get his results? NO. Are there folks who will promise you the world to get you to book? ABSOLUTELY. So I'd be careful...this isn't one of those procedures "anyone can do". Continue to do your homework, and good luck.
Breast Lift with Fat Transfer Makes More Youthful Breasts
I think your plan is reasonable. Fat grafting at the time of mastopexy is a viable option. By the way you definitely need a lift and areola reduction as fat transfer by itself will not lift your breast.. I have successfully transplanted fat into the face, buttocks and other body areas for decades and are now using this same technology to enhance breast shape and size. Plastic surgeons have been transplanting fat to the breast since 1995 but caution and study were necessary to make sure there were not harmful effects. Furthermore, results in the past were variable, dependent on surgical equipment, technique, surgeon’s skill, and individual patients healing abilities.
Since 1995, recent advances have led to the development of special instruments made just for fat grafting. Though this procedure is still considered investigational to a degree, more and more qualified plastic surgeons are using this technique successfully. The advantage of this technique is its ability to create a natural augmentation without an implant. Fat grafting (also called lipoinjection or fat transfer) to the breasts is indicated for different reasons: as an alternative to implants for mild to moderate breast augmentations, to provide fullness to the upper part of the breast during a breast lift, after pregnancy, age, or weight loss, following breast reconstruction, or to minimize the visibility or rippling of existing breast implants. Typically up to one breast size enlargement is possible in most patients. Fat transfer to the breast is usually done as a single procedure resulting in approximately half a cup volume increase. In women desiring additional breast enhancement a subsequent procedure can be performed. Each surgery consists of two components:
Harvesting the fat: Fat is removed from your abdomen, hips, “love handles” or other areas using a fine cannula similar to the one used for liposuction but skinnier. This fat is rinsed with sterile saline solution and then packaged into syringes and prepared for transfer. Approximately 20% of fat removed is suitable and available for fat grafting.
Fat transfer into the breasts: The prepared fat is injected in small amounts at a time and widely distributed within the layers of the breast so that these living fat cells can pick up a healthy new blood supply.
Advantages of Fat Transfer to the breasts:
Fat cells are natural and you are using your own tissue without any foreign body or implant.
Harvesting of the fat by liposuction has the added benefit to enhance your shape by removing unwanted fatty deposits
The breast can be shaped or sculpted in more detail than is possible using implants alone.
Minimal incisions reduce the possibility and degree of scarring
No implant is used, therefore there is never a need for replacement, or any potential for capsular contracture (hardening of the implant).
Fast Recovery Time: Recovery time is about 1 week and usually less uncomfortable from implants that are placed beneath the muscle.
Although, breast augmentation performed with the lipoinjection technique takes longer than traditional breast augmentation (with implants) the benefits are substantial including no need for implant replacement in the future.
In the past, significant questions were raised about the ability of Mammograms or MRI to detect breast cancer after injecting fat into the breast. However, there is no evidence that fat transfer to the breast is less safe than any breast surgery. Large studies have begun over the last several years to study fat grafting to the breast. With or without breast surgery, calcifications and lumps can occur. Breast diagnostic studies including physical examination and mammograms should be used to monitor every patient diligently using standard guidelines.
As a general rule, surgeons with extensive experience in grafting large volumes of fat to the body are most likely to obtain the best results. We believe fat transfer should only be performed by surgeons certified by the American Board of Plastic Surgery that have experience in fat grafting. Few plastic surgeons have this experience. This ensures that your surgeon has advanced knowledge and technical familiarity, but also the subtle anatomy and aesthetics of breast augmentation.
Is breast lift with fat transfer possible for me?
You should know that fat transfer is actually NOT new to plastic surgery, as plastic surgeons have been harvesting and grafting fat safely and with excellent results for many years now.
What IS relatively new, is interest in using fat for enlargement of the breasts... It is very important to understand that not all things that are possible are necessarily in your best interests...
I am concerned that fat grafted to the breast area can be associated with scar tissue (from the procedure) which may complicate the diagnosis and treatment of breast cancer later in your life were it to occur. So while you may find someone willing to do this, I would caution you against it. It is not a safe assumption to make that if you can find a doctor willing to do something it must be good for you.
I also would agree with my colleagues that a crescent lift would be a mistake for you- I would recommend a vertical breast lift.
Breast lift with auto augmentation
Given your goals and concerns I would recommend a breast lift (mastopexy) with auto augmentation. This is a way to "up lift" the breast and decrease the areolar diameter as well and utilize a small area of natural breast tissue that in some techniques would be discarded as a way of giving you some added upper pole fullness. Most breast lifts end up looking a little smaller than before. This is a technique that preserves all of your breast tissue and repositions it higher on the chest wall which will lead to a good, youthful shape, improved upper pole fullness, and projection of the breast. This is the best option for patients that are not interested in augmentation with breast implants.
As far as fat injections to the breast, there are certainly some plastic surgeons that have been able to get good results with fat injections to the breast; however, it is still a controversial topic among plastic surgeons and is not universally "accepted" as of yet as there are some concerns about mammographic surveillance as well as lumpiness, etc.
I agree that I absolutely would not recommend a crescentic lift (or crescent lift) which will make the areolae more vertically oblong and not truly provide any lift to the breast.
I hope this helps!
What you are asking for is not conventional and can lead to potential problems down the road. As Dr. Placik said, a crescent mastopexy is a mistake for you as it will only enlarge your already large areolea and make them vertically oblong. A periareolar "lift" is virtually always done in concert with an implant but since that is "not negotiable" at least it could minimally lift you as much as a crescent but also make the areolae smaller.
As long as the implant is out of the question, why don't you consider a true lift to restore the nipples to a higher position, reduce the areolae, and tighten the lower pole of the breast where you have a substantial horizontal skin laxity.
Lipoinjection for breast lift
Your areolae are already large and a crescent lift in combination with lipoinjection will serve to make them even larger so you may want to reconsider. The other alternative is a full circumareolar lift to limit the size as well as to lift the areola.
Is it possible to have a Breast Lift with a fat transfer for volume, instead of implants?
The #NaturalBreastLift or #CaliforniaBreastLift is an alterantive to using #breast #implants to add #volume or contour the upper breast. Instead of adding an implant, #fat from your own body is harvested and then transferred to the upper breast. This fat will help shape of the breast.
Breast lift and fat transfer
Although there has been a lot of talk and presentation on fat transfer to the breasts, it is still not widely accepted. You certainly can have a lift.
Breast implants with a lift can provide you with more youthful appearing breasts
Hi kit kat - A breast lift is great for you, but fat transfer (grafting) is relatively new. Breast implants are very safe, FDA approved, and will give you great results without compromising safety. Removing fat from elsewhere on your body is a plus, but the amount of fat that is required to make your breast larger may not remove all of the fat that you want. Standard liposuction is great for this and it's also safe and effective. Fat grafting to the breasts is great for correcting small contour problems, but make sure you see some before and after photos from your plastic surgeon before getting the fat grafting. Good luck!
Breast Lift with Fat Transfer is possible
The use of fat for enhancing the breast is a new procedure. I been doing fat grafting to the breast for the last 4 years. You can check my study protocol here: http://www.clinicaltrial.gov/ct2/show/NCT00775788?term=fat+breast&rank=1
I have done fat grafting on more than 150 patients. I have done breast lift and fat grafting in single stage on more than 50 patients.
If you decide to have this procedure done, please make sure that your doctor is board certified plastic surgeon and familiar with fat grafting. There are few plastic surgeon in U.S that are qualified to do this.