Should I have fat transfer to my breasts or BBL first?

Question

It’s up to me to decide which operation I want to have first. I was considering having my bbl, Liposculpture, mini arm lift, and thigh lift first then 6 months later having Lipo and fat transferred to my breasts. Now I’m thinking that I should have the transfer to breasts initially. Which procedure do you suggest to have first?

Kenneth Hughes, MD · Answer

It does not matter, but the recovery from the breast fat transfer will probably be shorter. In general, 200 cc per breast is typically the upper limit of fat injection recommended by most PSs. It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer. Fat transfer to the breast could improve the fullness of the breast, particularly at the top of the breast. If you want more than a one cup size increase, this may require multiple treatments to reach the size you desire as only 50% of the fat typically survives. In general, the abdomen and thighs are preferred areas for harvesting fat.

Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Michael Baumholtz, MD, FACS · Answer

Your question without pictures is a hard one to answer. 
Some general thoughts:

For MOST of my patients - fat grafting as a PRIMARY means of breast augmentation is an unsatisfactory choice. Fat in and of itself does not give the shape or projections most of my patients are looking for. No one can control how much fat is lost in the transfer process which can lead to iatrogenic asymmetry and disappointment in volume.

Without your pictures my recommendations would be:
1. Save the fat you have for your BBL - fat is generally a better option for the BBL than an implant.
2. Use an implant to achieve the breast volume you are looking for.

Seek out a board certified member of ASPS / ASAPS for your consultation and good luck!

Alain Polynice, MD · Answer

It sometimes is a simple questions of how much fat is available. In my practice the average amount of fat used for transfer to the breasts is 200-250cc and for the BBL 600-1000cc so if a patient does not have a lot of available fat they may get more of a result transferring to the breasts. Also keep in mind that in many cases it may require multiple sessions of fat transfer to get the desired volume.
Alain Polynice, MD, FACS
Board Certified Plastic Surgeon, New York

Marcus L. Peterson, MD · Answer

When you are considering multiple procedures that need to be staged you want to do your first priority at the beginning.  Your surgeon can also suggest procedures that go well together because of position and recovery.  Another thing to keep in mind is that fat grafting can often require multiple sessions to get the final results you are looking for so you may want to do fat grafting to the breasts and butt at each surgical event.  This will mostly be needed if you are looking for a large enhancement.Best WishesDr. Peterson

Tiffany McCormack, MD · Answer

I think it depends on which surgery is most important to you.  You might consider breaking even more of it up and adding arms to the breast surgery and doing the thighs with the BBL since recovery with arms and thighs together could be rough.  Your plastic surgeon can help guide you with respect to positioning after surgery according to his or her post operative protocol.  Good luck!

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