After fat transfer, will I be left with loose skin to the area that the fat has been removed?

Pictures of the donor area would be helpful.  It is important that the plastic surgeon is an expert at liposuction so that the liposuction is smooth and even.Kenneth Hughes, MDBeverly Hills, CA

Fat grafting to the breasts is getting more popular, especially if implants are removed.  The fat won't provide the exact result of the implant, but it will help replace volume.  Fat grafting should improve the donor site, and donor sites are chosen based on where they might provide the most accessible, largest quantity of fat that will still benefit the donor area.  Your age and skin quality will affect the donor area healing.

Fat grafting requires that fat be harvested from another part of the body and then be transferred - most often to the breasts or face.  The harvest site is usually the abdomen, but may also be the thighs (harder to get to).  The tissue is harvested by liposuction, so there can be improvement to the harvest site, as well as worsening.  Thus, harvesting should be done very carefully - just as if it were an aesthetic only liposuction procedure.  Not all patients who need fat grafting are also good candidates for liposuction.  You can indeed see sagging skin and irregularities.  This is more acceptable in the breast cancer reconstruction setting as the area is considered a donor site.  In the aesthetic setting, patients are reasonably more concerned.  The best approach is to take only as much fat as needed for a particular procedure (may need to leave some for a secondary procedure, anyway) and to have a well consented patient.  Aggressive liposuction of the abdomen with abdominoplasty can be a good solution.  Face grafting patients require small enough volumes that a donor site problem is unlikely unless the patient is particularly thin.