What is the minimum amount of fat that should be transferred to each breast for best results (fat transfer procedure)?

Question

I had a consult with a reputable surgeon as I am interested in a fat transfer. My breasts are probably an A cup and have lost a lot of volume post-babies (I was a full B beforehand). I’m only interested in a modest increase, so I think this is a good option for me, but the doctor thought I might be too slim to harvest much fat. I think he said 250 cc total, but I’m hoping he meant to each breast (I have a message into his office to clarify). I’m 5’4” and 110 lbs if that helps. Thanks!

Kenneth Hughes, MD · Answer

In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons.  It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer.  Multiple transfers would be required for additional cc's.  In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used.
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival.  Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. I typically transfer from 250 cc to 400 cc or so per breast.  Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant.  
Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation to determine the available fat stores.

Robert Cohen, MD · Answer

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. For those women who prefer a "Natural Breast Augmentation" without implants, fat grafting is a safe, natural, and minimally invasive approach that offers low-maintenance, long-term improvement in size and contour. After harvesting the fat from your body, we purify and enrich the fat before injecting it in the desired areas to improve volume and shape.
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

Farbod Esmailian, MD · Answer

I would only consider breast fat transfer for filling in hollowing such as the upper pole area rather than using it for volume in general.  I feel that the disappointment is great when patients look at fat transfer as an alternative for breast implants.  No matter which surgeon is performing the fat transfer, some of the fat will dissolve and some would.  A matter of how much will stay is partially dependent on the technique, and part of it is not predictable.I would recommend you see a board certified plastic surgeon to discuss your options.  Specially if you are very thin and your surgeon could not harvest much fat, as it appears so, 125 cc per side is minimal volume.Hope that helps.

Ronald J. Edelson, MD · Answer

I am not a fan of fat injections to the breast because in most cases the fat dissolves over time.  Before embarking on this ask your surgeon to show you pictures of patients after one year.  There seems to be a lack of good results long term and very few good  photos on the internet.  It’s a real hit or miss procedure.  I know surgeon that do fat transfer to the breast and recommend it.  Then I’ve gone to their website to look at their photos and there are either only a few or none.  That tells you a lot.  Whatever you do, don’t get talked into gaining weight to increase the available fat for transfer.  Believe it not many surgeons recommend this!

Daniel Barrett, MD · Answer

Dear westcoast1713,
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

Gloria Rockwell, MD, MSc, FRCSC · Answer

Not all the fat transferred will survive.  Typically I quote about 50%. The other half is absorbed by the body.  If you only have 250 cc total to harvest, that becomes 125cc per breast, then expect a retention volume of just over 60cc per breast.  Depending on the size of your breasts this could be enough (if your breasts are smaller)  It really depends on the volume/size you are trying to achieve.  Taking a photo of what you like to your surgeon will help them advise you on what is possible in your case.  Being able to harvest more fat is preferable, but not if this leads to irregulars in the skin where the fat is taken from.  In some cases a composite augment with a small implant and fat grafting to the overlying skin is a great option, especially if you have a thin skin envelop.  I would not suggest the long term risks of implant based breast augmentation (mechanical failure/replacement/capsular contracture) if using such a small implant.

Connie Hiers, MD, FACS · Answer

The amount of fat that can be transferred is limited by the amount of donor fat available, and the size of the breast. Fat is not injected into the skin or muscle, but into actual breast tissue. If there is little breast tissue, then the amount of fat transferred is limited. Usually, you can expect one half to one cup increase in size with a transfer. If you do not have donor fat, then an augmentation with implants would be best.

John J. Bandeian, MD · Answer

Approximately half of injected fat will not survive. I think that anything less than a 125 cc increase in the size of your breasts is the minimum amount of increase that will give you an acceptable increase in size of your breasts. Therefore, I think that you will need at least 250 cc of fat injected into each breast.

What is the minimum amount of fat that should be transferred to each breast for best results (fat transfer procedure)?

Answers (8)

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