Is Fat Grafting Now a Good Solution for Breast Asymmetry (Less Than One Cup Size)? (photo)

I'm 33 and planned to get implants to correct my asymmetry (B on left and prob an A and a half on right). I mentioned to a surgeon that I would wait to get implants until after I have children if I were symmetrical. He suggested fat grafting on the right breast. He is an experienced and board certified surgeon who has attended several seminars on the topic, but is still somewhat new to the procedure. I do trust this surgeon to do the best job possible, but I'm not sure that I should do this now.

Doctor Answers 20

Fat grafting is an option for breast asymmetry.

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Thank you for your question. Breast asymmetry is very common, particularly size asymmetry. If you are looking to decrease the asymmetry from one breast to another, then you have several options.
1) You can reduce the larger breast with liposuction
2) You can enlarge the smaller one with fat grafting or an implant
3) You can enlarge both but use different size implants
4) A lift procedure may also be needed to help address differences in shape and nipple position.I would visit with a board certified plastic surgeon to discuss your options in more detail.

Fat grafing for breast asymmetry

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Fat grafting is still not a reliable and cost effective procedure. There are better options. Consult with three board certified plastic surgeons to understand your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Fat grafting for mild breast asymmetry

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Thank you for your question and photos.

The answer is, Yes. For mild asymmetry of one cup size or less, fat grafting to a breast, in experienced and skilled hands, can get you the results you are looking for to correct asymmetry

Fat grafting is not for everyone and it is not possible to go from an A to a D cup. But, with two grafting sessions it is possible to go from an A on the right to a B on the right to match the left B. The results are subtle and your asymmetry is subtle.

Then, if you want to be larger after children, you can still get breast augmentation.

The question is going to come down to expense and predictable results.  The success rate of fat grafting is usually 60-80% "take" of the fat graft. This is why it sometimes takes more than one session. Also, you have to ask yourself the question, is it worth going through surgery twice to get my right breast the same size as the left without an implant. For you, the answer may be yes or it may be no.  Only you can answer that.

Fat grafting has not been shown to increase the chance of developing breast cancer.

Fat grafting techniques have gotten better and better. Whereas in the past success rates of fat transfer were about 30%, then they were 50%,and now they are 70%. Some surgeons report successfully fat grafting at an 80% success transfer of volume.

It's up to you. You may want to save your money for breast augmentation after children.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Breast Fat Transfer or Fat Grafting may work well for Breast Asymetry but wait until you have had your children

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Breast Fat Transfer or Fat Grafting is a very new and promising technique.

However many significant changes occur in the Breast during Pregnancy and Childbirth and after nursing

A year or two after having your last child is the ideal time to consider Cosmetic Breast Surgery. At that time you may desire augmentation of both breasts or a Breast Lift or both. Certainly in a few years Fat Transfer to Breast will be a more refined and developed technique. Fat transfer of Breast does create scarring an although it may not interfere with cancer detection, no one I am aware of has studied the effect on the breast during pregnancy.

I certainly would not consider a Breast Fat Transfer as a more conservative or safe procedure to have before you have children.

Hold off

Controversies over fat grafting breasts

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Yes this is a very controversial topic and you would certainly have to consider the risks before employing this technique.  The best option if you know children are in your future would be to delay breast surgery until done so you can have the best experience post-partum.  In addition, fat grafts do react to weight fluctuations and will increase in size disproportionaely to your native breast tissue if you gain weight.  But if you are willingn to accept the risks, it is a very nice way to correct small irregularities.  Removing the padding on one cup or using an external enhancer would correct your concerns for the moment.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Please don't put fat into your breasts

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Hi there-

While I am a huge fan of fat grafting for other purposes, the fact is that 1 in 8 women in this country are diagnosed with breast cancer EACH YEAR, and that most radiologists say that the scar tissue and cysts that can result from fat grafting into the breasts can make mammograms and ultrasounds a bit confusing when evaluating the breasts for cancer.

The technique may be acceptable for a woman who has already had cancer and had her breast removed, but for a young woman like yourself, I would never consider it until there is more data on the long term safety and implications for cancer diagnosis.


Fat grafting is unpredictable in all situations

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Although fat grafting is much touted in plastic surgery these days, it is neither reliable, nor predictable or safe.

Fat grafts to breasts are even less desirable since they can leave behind scarring and mislead mammograms  forever in future.   

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Fat grafting for breast asymmetry not a good idea

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I highly discourage this procedure on breasts. I've seen and had to correct fat grafting gone horribly wrong. Fat grafting is certainly helpful and successful in some instances, but the risks and complications are too high in my opinion when it comes to breast filling. Pregnancy/breast feeding can bring significant changes to them. I encourage you to wait until after you have children to attempt any cosmetic procedure. Best wishes, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Fat grafting to the breast

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There are two separate issues here. The first is the safety and efficacy of fat grafting to the breast. The second is the capability of your surgeon.

Fat grafting is an excellent technique for volumizing structures. It is well established in most areas of the body. Breast is controversial not because of the technique but because 1 in 8 woman in this country are diagnosed with breast cancer. Concerns about surgical changes in the breast caused by fat grafting interfering with diagnosis of cancer has led to delay in endorsing the technique by the surgical society. Fat grafting as a technique also has some drawbacks. 50% of what you place does not survive. Contour irregularities may develop in a percentage of people and repeat procedures are often necessary to reach desired volumes.

In my opinion fat grafting for small augmentations or correcting asymmetries is  an excellent technique. Imaging of the breast and standard surveillance for breast cancer will be necessary. Surgical changes to the breast are stable over time and easily detected by radiologists.

As far as your surgeon is concerned, ask specific questions about their fat grafting experience in the body face and breast. Ask to see before and after photos and to speak with individuals who have had the same procedure as you. As mentioned the technique is not new but the area grafted is, many surgeons are just beginning to perform this procedure and do not have a great deal of experience. Discuss this with your surgeon as well. a board  certified plastic surgeon will have the ability to fat graft the breast.

Good luck and I hope this was helpful 

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

Fat grafting for modest breast asymmetry

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From the posts you might have seen, fat grafting is controvertial because of the cysts and calcifications which can form within the breast. Despite this, fat grafting has been effective in filling out the breast after breast reconstruction, and for modest breast asymmetry. We use grafts well dispersed in the subcutaneous tissue over the breast, and grafting under, rather than within the breast. With good judgement the grafts can work out  for you, though know the risks well.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.