Combination Type Which Uses Both Round Cohesive Gel and Body Fat? (photo)

Hi. I'm very petite 5'4" and 103lbs and my breast size is AA. The surgeon recommended me to use combination method where he extracts my body fat from thigh and put it around the edges of the teardrop gel to look more natural. However, after reading through posts about disadvantages of using teardrop, I decided to stick with round shape cohesive gel.But still,I feel like adding body fat around the round cohesive gel implants would look more natural considering I'm skinny. Is this a good idea? TY!

Doctor Answers 5

Smaller implants best

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From your photographs, I would recommend a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast increasing upper pole fullness, reposition your breast higher on the chest wall and more medial to increase your cleavage.  The implant would then be placed through the same incision high on the chest wall underneath the muscle.  Silicone implants placed retro-pectoral look and feel more natural and have less rippling.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall will give maximum anterior projection with a minimal size implant.  Smaller implants will descend less, are more stable long term and need fewer revisions.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Fat grafting as an adjunct to breast implants

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The irony of breast augmentation is that the smaller the breast, the more the patient desires larger augmentation but the more unnatural the breast will be. This is not to say that you can't get "nice looking" breasts with relatively large implants but there is more and more unnaturalness the more disproportional the implant is. I usually start with the implant with the most natural fit to your breast and then work up in width, projection, and volume to match your desired look. My general suggestion is to try to accept the size that fits your natural breast without adding the unpredictability and potential complications of fat grafting, especially at your young age. The need to add fat generally means your implant does not optimally match your natural breast.

Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Fat grafting to breasts

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It appears as though you'll get a nice result with breast implants alone.  At 103 lbs I don't think you'll have much fat to spare!  Good luck! 

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Combination Type Which Uses Both Round Cohesive Gel and Body Fat?

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What you are describing is a "composite" breast augmentation being popularize by Dr Dan Del Vecchio, Boston. I use this approach now more often than you might think. But there are additional fees. The results are superb. 

Combination Type Which Uses Both Round Cohesive Gel and Body Fat?

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If the implant size you will be using is modest, I think the implants alone will be satisfactory. There are many photos on this site, almost done of which have this combination enlargement. 

Then look at your surgeon's photos of similar procedures, and if you see enough of a better outcome, consider the surgeon's suggestion.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.