Combination Breast Augmentation - Silicone Gel Implant & Fat Transfer?

  Fat transfer for contour irregularities or rippling or for volume discrepancy is a good utilization of the technique.  A breast augmentation with implants alone frequently produces a very nice result without the need for any fat grafting adjunct.  You could certainly fat graft the areas superficial to the implant, but the benefit of this approach for a primary augmentation would be little.  You must also consider risks of fat necrosis which would produce a less than desirable result than an implant augmentation alone.Kenneth Hughes, MDLos Angeles, CA

While there are procedures that start abroad and find a home here in the states, there are a thousand that fizzle before our patients ever hear of them. There MAY be docs doing what you want, but the vast majority of us are using fat primarily for correction of thin areas or areas of irregularity. Does that make it the RIGHT way to go? Not necessarily but it does give you something to ponder...

This is a common procedure in my practice and the results can be impressive.  However, many patients do very well with breast implants alone, so there needs to be a specific goal in mind to be addressed with the addition of fat.  I like to use fat in combination with implants in patients that have poor cleavage that will not be optimally improved with implants and to fill the lower half of the breast in patients with constricted lower breasts.You don't need to travel to Spain to find a qualified surgeon.  I suggest you look for a board certified plastic surgeon with experience in the procedures close to your home.

Fat transfer at the time of augmentation might be attractive if the natural breast cover is very thin and there is a concern the implant might show through. Consultations here in the US might help you compare.

Thank you for your question. Leaving the US where we have the most advanced medical care system in the world is not a good idea. Standards are different in foreign countries, and especially with fat transfer you will need follow up.Send an email to Dr Dan Delvecchio in Boston-he is an expert at fat transfer and should be able to advise you.

Fat transfer with implant placement is becomming more common and accepted but is still relatively unusual and performed by only selected surgeons. The idea of using fat is wonderful and I do this in my practice on a regular basis but it's not for everyone. The primary reason in combining fat grafting with an implant is to achieve a volume that fat grafting alone could not achieve while providing additional coverage over the implant - especially in thinner patients or women with less than adequate soft tissue coverage. However, there are concerns with both implants and fat graft - both of which involve the surveilance of the breast with mammograms as each has the side effect of potentially obscuring the breast from a full normal view. As such, combining both together may create more of an additive effect especially if there is a family history of breast cancer. In the end, however, you certainy do not have to leave the country to find a qualified surgeon who performs this procedure. I hope this helps and have a wonderful day! Dr. Kayser

Fat transfer is commonly performed in conjunction with breast augmentation.Fat transfer is  most useful in balancing differences between the two sides and adding volume where wrinkling may be an issue.