Would a fat transfer hide implants and bony chest? (Photo)

Question

I have 300cc Silicon motiva implants under the muscle. When I lie down the gap between them is made very prominent by the lack of tissue coverage in this area. (See pics) Would some fat transferred to this area be effective in disguising my ribs and the edges of the implant that are on show in between and above my breasts? I've heard mixed things about how well the fat can survive in this sort of area, where the skin is both a bit thin and perhaps a bit too tight. Thankyou!

Rodger Shortt, FRCSC · Answer

Breast fat transfer can be used in conjunction with a breast implant to provide additional concealment of the edge of the implant as well as the boney prominences of either the ribs or the sternum. This is a fairly nuanced procedure and probably best left to a surgeon that does a fair bit of a fat transfer to the breast.

Everyone needs the opinion of a plastic surgeon in person to go over the procedure, risks and benefits to determine if it is suitable.

Dr. Rodger Shortt, Oakville, Ontario plastic surgeon.

Everyone needs the opinion of a plastic surgeon in person to go over the procedure, risks and benefits to determine if it is suitable.

Dr. Rodger Shortt, Oakville, Ontario plastic surgeon.

Zoran Potparic, MD · Answer

It is very good indication to place fat grafts in the medial and upper pole of the breasts. Creation of cleavage and fullness of upper pole are best indications for breast fat grafting, in particular in the presence of implants. In person consultation with a board certified plastic surgeon with experience with this procedure (check website) or teleconference,  is recommended. Good luck.

Kenneth Hughes, MD · Answer

The fat must be injected through multiple planes in small amounts to the tissue through one tiny incision under each breast. About 50% of the fat obtains permanence
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival. Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant. Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and the patient's expectations.

Daniel Barrett, MD · Answer

Dear Toto134,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You need to have donor fat available, first. Fat must go into tissue. If you have little tissue in that area, then fat won't be too helpful.  Standing upright photos would be much more helpful.

Ralph M. Rosato, MD · Answer

Fat transfer can soften this area. It appears that your trunk has no excess fat.  However, you would need a donor site on your legs to obtain the fat.  Not all the fat that is placed will survive.  The result will be very minimal.

Hilton Becker, MD · Answer

Fat grafting is an excellent option for contouring around implants, provided that you have sufficient fat to graft.The fat particles should be micronized for optimal effect.

Mats Hagstrom, MD (license on probation) · Answer

Implant position should be done so that the center of the implant is appropriately aligned with the center of the breast or nipple areola complex. if the implants are too far apart then the pocket can be opened mediately bringing the pants closer together. to compensate for opening the pocket immediately either the pocket needs to be closed laterally to stop the implant from sliding in that direction or a larger diameter lower profile implant needs to be used. it’s not possible to make an accurate assessment based on pictures alone. as you know breast implant aesthetics are quite dynamic and change with body position etc.In order for fat transfer or fat grafting to work there has to be a sufficient layer of host tissue to support the graft. in your case as you’ve described there is very little tissue between the skin and implant. that means only food layers or small amounts of grafted fat will survive making the procedure not very effective. manipulating pocket shape with potentially altering implant shape is probably going to be a more satisfactory option than fat grafting for you.
It’s very normal for women’s breast to diverge and not maintain an appearance of strong cleavage when laying on your back.
There’s definitely something to be said about not messing with good enough.
The phrase commonly said by plastic surgeons is “ The enemy of good is perfect“
There are other techniques that can reinforce an ad volume to the tissue envelope holding the implant such as the use of Alloderm or other cadaveric dermal products.
Follow up with your surgeon or have a few in person consultations with local board-certified plastic surgeons who have a lot of breast implant experience.
Personally I don’t see a strong indication for fat transfer.
Best,
Mats Hagstrom MD