Fat transfer vs. implants? (Photo)

Before evaluating patients' cases, I generally prefer to conduct a physical examination. Especially in the context of breast aesthetics, it's crucial to carefully assess the patient's breast tissue, skin structure, and body shape. From your photos, I can say you need a Mastopexy to lift the sagging skin and underlying breast tissues. Combining mastopexy (breast lift) surgery with the placement of implants in the desired size can achieve the desired size and shape for the patient. I usually prefer to do fat grafting on breast only if patient has a firm breast tissue. However, it's important to have a one-on-one discussion with the patient and conduct a detailed evaluation to determine a precise treatment plan.

I tell patients fat transfer is not an exact substitute for implants. It is very difficult to make a person at least 1-2 cup sizes larger with fat alone. What is becoming more common is the hybrid breast augmentation where both implants and fat are used so you get both benefits.

Here is my take . . . the first thing to address is ptosis of the breast. I would first start with a proper, full mastopexy (breast lift) to optimize shape and lift. Then come back at least three months later to transfer the fat. This approach will provide for the most predictable, durable and optimal result with least complications. Thank you for sharing.

Hello @Julidsp12, thank you for your question. Breast implants and fat transfer could potentially help in your situation. However, the best choice depends on your individual goals and circumstances. Breast implants can increase breast volume and fullness. On the other hand, fat transfer can also add volume and avoid potential risks associated with implants.I understand your concern about scarring from a lift. My technique uses the BRALift technique with a minimal L-shaped scar. But, this is a personal decision. I recommend scheduling a consultation with a board-certified plastic surgeon. This will allow you to examine and discuss the best options for your specific case and goals. Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Dear Julidsp12,
based on your photos, it looks like you would benefit from breast lift. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Fat transfer simply doesn’t work as well as you may think. Your photos don’t show your breasts well. As far as the abdomen is concerned a tummy tuck is a far better option than liposuction

If you are already a 36 D then you do not need implants. You are an excellent candidate for a breast lift using 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.

Congratulations on your weight loss! First, I would suggest doing a lift and bring the girls back up on your chest. After the lift, then you can consider fat or implants. If you want more than a cup size increase, you will need implants. Do the lift first. You might fine you are happy with your size. Smaller breasts will stay up longer than larger breasts.

You have lost fullness superiorly, have excess skin and your nipple sits way below you fold. All of this will first need to be addressed with a breast lift. Fat transfer at the same time as your lift will improve the upper pole fullness and would make you a cup size larger but will not give the exact same round augmented look that comes with an implant. Implants are devices and do come with some additional risks that you will need to consider before surgery. In some patients a breast lift can be done at the same time as breast augmentation to produce a nice round and perky result but based on your photos I do not think this would be a safe option for you. With your current breast size and how low your nipple sits on the breast, the two procedures should would need to be done in a staged fashion with the breast lift first then an augmentation with implants after. Ultimately, I would recommend an in person consultation with a trusted plastic surgery to help determine the best procedure for you. It might be a good idea to go to your consultation with goal photographs so that you can easily communicate the exact type of results you are looking for.

Your breasts are sagging so that needs to be addressed .
In terms of volume enhancement fat is a good option if you have sufficient fat elsewhere .
I may however need to be repeated several times to achieve the desired volume .