Fat transfer on top of implant augmentation? (photos)

Question

Why don't doctors add more fat on top of an implant? For example, a doctor in Spain, who specializes in composite augmentations, only adds 50cc of fat on the top of the implant. Why not add more? To look natural, the breast should go all the way up to the collar bone. The first pic is of a woman with large natural breasts. Her breasts go all the way to her collar bone. The other two are of Kylie Jenner and Scarlett Johansson. While they are beautiful, they could benefit from more fat on top...

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question
  
I perform a natural breast augmentation with fat. This can be removed from any unwanted areas including the breast itself as part of my lipo-lift procedure. I perform the fat grafting in multiple planes including under the muscle to give the best, most natural enhancement. Fat grafting is a great solution for someone who wants to bring their breast size up a cup or so and use natural tissue vs an implant. However, it can also be combined with an implant or used as a secondary procedure to fill in areas that are flat or thin. It should not affect nipple sensation, mammograms, cancer risk or breast feeding. It can be a little lump or hard at first but tends to soften over time. If you gain or lose weight, the transferred fat can do the same.  About 60-70% of the grafted fat survives.  At 6 months you will have a good idea of your results. Some women have a second or third procedure which continues to increase your volume safely.
  
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic breast plastic surgery.
  
 
  
Best of luck!
  
   
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Otto Joseph Placik, MD · Answer

I have often added fat to the top as well as to the cleavage areas in particularly thin women to soften the appearance of the breast and camouflage the edges of the implants. it is a great option

Julian Gordon, MD · Answer

The simplest answer to your question is that fat grafting to the breast has only recently become more popular and accepted within plastic surgery for cosmetic purposes.  Therefore, many doctors have trepidation about doing it.In my opinion, your statements are correct.  I have performed many composite breast augmentations, placing a breast implant and doing fat grafting to obtain the shape desired.  Although there are shaped implants which can help with some things, nothing beats the control in shaping you have with fat grafting.  Not only can fat grafting help shape the breast, in a patient with little breast tissue or a thin fat layer, it can help prevent the appearance of rippling.I believe as we move forward, more and more surgeons with incorporate composite breast augmentation into their practice.

Erika Sato, MD, FACS · Answer

I love fat transfer to the breasts...either alone or in conjunction with a breast augmentation or a breast lift. It is a great way to give a softer more natural appearance to the upper pole of the breast and also can close down the separation between breasts if patient have wide set breasts. You should go to more than one consultation as not all PS are comfortable with fat transfer to the breasts.

David A. Lickstein, MD · Answer

Fat grafting can certainly be done to improve the appearance after augmentation and avoid the "step off" at the upper aspect of the breast.  Most agree that a natural slope is the most attractive.  To some extent, this appearance is related to implant size and soft tissue cover.  Worth discussing with your plastic surgeon.

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Fat transfer on top of implant augmentation? (photos)

Answers (7)

Answer: Fat transfer on top of implant augmentation?

Answer: Fat transfer on top of implant augmentation?

Answer: Fat grafting with atumentation

Answer: Fat grafting with atumentation

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Recommended reading

Everything you need to know about Breast Fat Transfer

Our mission is to create a world where every investment in modern beauty is Worth It.