Was too much fat grafted at once in fat graft breast augmentation? 500cc's were injected, I am 2 days post op.

Question

Had fat grafting to breasts 2 days ago. During preop/ consult dr indicated 180-200cc would be injected into each breast. This was fine but I knew that up to 50% of fat would not take so we did discuss overfilling to anticipate loss. Have had children so had room for the fat. Size prior: 36 b , 34 c. After surgery learned 500cc injected in each. After research, concerned too much injected at once, which I understand reduces the chance of fat survival, not to mention I don’t want large breasts.

Kenneth Bermudez, MD, FACS · Answer

In fat grafting, depending on the technique and study you look at, anywhere between 35-79% of the fat grafted will survive.
Most of the resorption will occur in the first six months.
At 2 days you have swelling from the procedure as well as the fat grafted, so you are going to be huge. Be patient, follow instructions and keep a good relationship with your surgeon by discussing your concerns.
In 6 months, see what you look like and then make a decision.

Daniel Barrett, MD · Answer

Dear Docevita2007,I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you are still in the very early stages of the healing process at 2 days  post op.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Harold Bautista, MD, FACS · Answer

Thanks for your question. . There is a wide range of percentage take of fat  injected into either breast or buttock. If you well eventually get 50% of the fat to survive you are talking a 250 cc net augmentation.  In my practice that we would be considered a conservative augmentation.  It's is too soon  to start worrying about your final result.  Just do your best with hydration, nutrition and rest to ensure the ootimal healing from your surgery. Hope that helps. 
Dr. B

Gabriel Chiu, DO · Answer

Thank you for your question. For grafted fat to survive, it has to be in contact with healthy tissue with a good blood supply. For this reason, some women can have up to a cup size improvement if they have an increased blood supply due to factors such as post-pregnancy. But the average improvement is a half cup size with a single fat transfer to the breasts, no matter how much more is injected. When you have 500cc injected into each B cup breast, you will still likely have a half cup to cup size improvement, but have to temporarily deal with all the extra swelling and weight. As for all the extra fat, most of it will be broken down and absorbed or become oil cysts. You also have a greater risk of volume asymmetry if significantly more survives on side. If you are worried that they are too large, don’t worry, they are swollen and can continue to swell for a few more days. It may take 6 or more weeks for all the swelling to go away, so be patient. Make sure you follow your surgeon’s instructions for best recovery and go to all your follow up appointments so you can give your surgeon feedback as well as receive instructions. Best of luck!

Curtis Wong, MD · Answer

and an important one is having the fat in contact with viable tissue to help establish a blood supply and improve survival and diminish risks for other things such as cysts.  While your grafts are on the generous side, if you wanted overfill in anticipation of losing almost half of it,  that is what you got.  You will not keep the size you have so focus on healing and following your surgeon's instructions and once healed, you can critique your results with your surgeon and see if any revisions would be beneficial.

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