Dents after breast fat transfer, how can I fix it without implants?

Question

I had breast fat transfer 1 year ago. I had previously had breast explant 18 months prior to that. My surgeon put approx 120cc into each breast but I’m now left with really dented breasts. They are soft and palpable, no hard lumps. I don’t want implants again. Is this down to my body healing or surgeons skill? My surgeon has advised me if I done another round of fat transfer he can’t guarantee it would help ☹️ Feel lost and extremely sad

Alan Gonzalez, MD, FACS · Answer

Hello @bernadette1993, thank you for your question and showing your picture. In order to extract a larger amount of fat, it is important to revise the surgical process and perform Liposculpture. I can see from the size of the breasts that we are talking about 350 grams of fat that will be used to make a fat injection to add volume to the breasts. 120 grams of fat is very little and that is why you see the flaccidity that looks like those dents and that is lack of fat in certain places. For more information and recommendations is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS

Wess Cohen, MD · Answer

Thank you for your question. It Appears that your breast implants were likely larger than the volume of fat that was put into your breast. Therefore the skin has folded upon itself because there’s not enough volume to keep it plump. Additionally your nipples, based on this picture, are in asymmetric position. To correct this problem, you could combine a small mastopexy to not only smooth the breast out but also to provide a lift/symmetric nipple location, with an additional round of fat transfer to plump the volume. Good luck.

Daniel Barrett, MD · Answer

Dear bernadette1993,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

You need more superficial fat transferred in a few sessions to slowly build up the fat levels to correct the "denting". Fee per each case inthe $5,000 ranges. Best to virtual consult with...

Douglas Taranow, DO, FACOS · Answer

It is not uncommon to have dents, ridges and lumpiness with fat injections to the breasts.  I feel that you would have improvement with another fat transfer to your breasts.
Best wishes.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

The outcome is a direct reflection of how the procedure was performed. Your surgeon probably does not have sufficient experience with fat transfer to deliver consistent quality results. During you consultation how many before and after pictures did your surgeon review with you?
There are probably worse outcomes and worse complications. I think this could probably be improved upon quite easily. since there are no hard lumps or problems with fat necrosis simply evening out the superficial graft fat should not be that difficult.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe. This includes plastic surgeons. Many outcomes tend to be permanent any irreversible especially when Liposuction is not done well.
To help find the most talented provider I suggest patients have multiple in person consultations with local board certified plastic surgeons that seem to have a experience with these procedures. During consultations ask provider to show their entire collection of before and after pictures of breast fat transfer results. Make sure you look carefully at not only the fat transfer results but also liposuction results since a significant number of people end up having problems from poorly done Liposuction as well.
When looking at fat transfer results always confirm that after pictures were taken at least three months from the date of the procedure. Early post operative results from fat transfer are not at all representative a final results which take at least three months.
An experience provider should have no difficulty showing you at least 50 sets of before and after pictures for breast fat transfer surgery. Ask the provider to show as many pictures as they can of patients with similar body and breast characteristics to your own. You may want to ask the surgeons to show examples of excellent outcomes, average outcomes will last than outcomes. We all have them.
Finally I recommend reading all reviews on various physician review websites avoiding providers with any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
Your surgeon grafted too much fat right below the skin or did so in an uneven fashion. 
Best,
Mats Hagstrom MD

Dents after breast fat transfer, how can I fix it without implants?

Answers (6)

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