Fat grafting to the breasts
are done with success and takes of over 50% of what is grafting. All that means is that more than one procedure may be required to achieve the desired results. There are many ways to process fat and I prefer the PureGraft system as its simple and effective. Restricted activities are needed post-op to help the graft improve its take. And with any procedure, you cannot expect guarantees.
As you have correctly stated there are many variable factors that affect the results of fat injectionmany of these are currently under investigation .including at our hospitalExternal pre expansion (BRAVA) ,Platelet rich plasma and addition of stromal vascular fraction has been found to be of value
Breast fat transfer is different in the fact that a very specific body type is a candidate. In order to be a candidate for fat transfer to the breast without an implant or a lift, the breasts must be youthful and perky with no ptosis and a nice tight skin envelope. This means that there is not a lot of space in the breast for the fat. Unlike the buttocks, the small envelope of the breast can only safely hold ~250-300cc of fat. Once you take into account that 30-50% of the fat volume dies (just like it does elsewhere), the remaining volume is low ~150. 150cc is about one cup size of fat on a good day. Woman who are looking for fat transfer usually want the results of an implant but want to use their own fat. Very rarely when woman get implants do they pick an implant size as small as 150cc. So it is actually successful but our expectations are not the same as they are elsewhere in the body. Make sure you find a board certified plastic surgeon that is experienced in fat transfer and that you are informed and fully understand the expectations for this procedure.