Fat Transfer Side Effects

Nearly all the issues and complications with fat transfer (injection) are related to lipolysis (broken cells) of the injected material.  If you break/rupture/damage the fat as you remove it, not amount of good technique is going to provide a good result and the problem rate goes way up.  Exposing the harvested fat to the dramatic forces of a liposuction machine is problematic.  I prefer to harvest with a syringe technique, controlling the amount of vacuum with my own hands.  There is more to fat injection than meets the eye. 

Fat transfer to the breast is not a particularly high risk procedure. There are risks but they are relatively low as compared to fat grafting of higher risk areas such as the gluteal region. Additonally, the literature has demonstrated no increased risk of malignancy either as a function of impaired screening via mammogram or stem cell effect of fat transfer.Fat transfer to the breast has proven to be a useful tool for minor corrections in the breast. It is less reliable as a means of delivering volume (as compared to implants). There are questions of volume/graft retention and the effects on final outcome and symmetry. Patients should not expect to reliably gain more than a half to full cup size (depending on patient and technique).As always, discuss your concerns with a board certified plastic surgeon (ABPS).

The most common side effects would be fat necrosis and loss of the fat graft over time.  Make sure to go to a very experienced surgeon in this technique.

This is a very low risk procedure with minimal complications. The most troublesome would be infection or fat necrosis. Thankfully these occur very infrequently and are usually easily treatable. 

Swelling and bruising are common side effects that are considered temporary. Some of the fat may not take to the area, either, so you may need a few sessions to achieve your desired size. Some more serious risks include calcification of fat, oil cysts and scarring. These may be mistaken for cancer on mammograms. However, I have not found this to be a concern for my patients, and the procedure has been able to achieve great results! 

Fat grafting to the breast is becoming very popular.  It can offer a nice enhancement with minimal scars and the added benefit of treating another area with liposuction.   As with all surgeries the vast majority of the time you will have some discomfort but no real problems.  However, make sure that you are seeing a qualified plastic surgeon for this and that they do it as a regular part of their practice.  There are several things that they should discuss with you; too many to list.  Some of the key areas of your discussion should include the cosmetic concerns including under/over correction and dimpling.  That the percentage of fat that survives is variable and a second procedure may be required.  Of the fat that does not survive most is resorbed by your body but some may result in calcification which can influence mammogram interpretation.  And finally a discussion about the role of stem cell activation with fat transfer.

The biggest problem with fat grafting is donor site irregularity if you are trying to get as much fat as possible and fat graft loss at the recipient site.  Fat graft survival is related to fat becoming vascularized.  I would say on average about 70% of the fat injected survives.  There are several different ways PS talk about harvesting and transferring the fat as the "best" way but I do not believe that there is a best way. Sometimes graft survival is more dependent upon the patient than the technique.

Sometimes, the fat harvested does not fully incorporate into the breast(s) and can be of less volume than originally anticipated. In this case, you may need to repeat this procedure if there is fat available for staging. Also, if the fat does not fully incorporate, it can sometimes form firm nodules due to fat necrosis which can mimic cancer on mammogram. This may require MRI and/or biopsies to rule out malignancy if the nodule does not resolve completely. Fat transferring may also affect a woman's ability to breast feed in the future, but does not eliminate the possibility. 

I recommend the fat grafting procedure to the breasts for isolated cases needing revision or reconstruction. Fat grafting breast augmentation is currently in an experimental stage to gauge longterm risks. Raffy Karamanoukian, Los Angeles

There are Side Effects and Complications with all surgical procedures and Fat Transfer is no exception. The good news is that side effects and complication rates associated with fat grafting to the breasts are not, overall, unduly high.

Common Risks, side effects and complications include infection, bleeding, fat embolism and graft volume loss; over filling, under filling, asymmetry, fat necrosis, and ectopic calcification among others. Although, there are risks and complications associated with autologous fat grafting, cases of severe complications and death appear to be extremely rare.


Concern regarding the interference of autologous fat grafts with breast cancer detection is not validated by the limited number of studies available on the topic but it appears that radiologists in general can differentiate artifacts from fat transfer and malignancies. However, caution should be used  in patients at high-risk for breast cancer including a positive BRCA-1, BRCA-2 and/or personal or familial history of breast cancer.

Results of fat transfer remain dependent on a surgeon’s technique and expertise, therefore make sure your surgeon is board certified by the American Board of Plastic Surgery.