Would a fat transfer be the best option for large breasts with low volume? (Photos)

Question

I’m a 20 year old 5’8 145 lb female with DD breasts. Because I’ve lost 40lbs my breasts lack a lot of volume, mostly on top. I wouldn’t say my nipples are too low so I was wondering if a fat transfer would be the best option for fuller, less saggy looking breasts

Mathew C. Mosher, MD · Answer

When the breasts deflate and overhang the fold, augmentation with fat or an implant alone will not restore a youthful shape and position. You appear to still have a lot of breast volume within a breast skin envelope that has stretched. A breast lift that repositions your breast higher appears to be the best solution. Fat grafting may or may not be a useful adjunct to the procedure. Congratulations on your weight loss success.

Alan Gonzalez, MD, FACS · Answer

Hello @Sageharttt, thank you for your question and showing your picture. If you want to improve the shape of your breast as well as the volume of it at the same time, you might consider getting a breast lift (pexy). Placing all the volume in one place will improve both the shape and volume of the breast. Breast fat transfer is not a suitable solution because you have a good amount of breast tissue. If more fat is placed in the breasts gravity can cause the breasts to sag more. For more information and recommendations is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS

Anna Steve, MD · Answer

Women with excellent breast volume, but 'deflation' of specific areas, and low nipple position are good candidates for a breast lift, also known as a mastopexy. Breast lifts have the advantage of shaping and dedraping the breast to achieve a perkier, fuller looking shape without the need for fat transfer or an implant to add volume in women who desire a natural looking result. If an increase in volume or more augmented, fuller look is desired, fat transfer or breast implant can be combined with breast lift.

Gary M. Horndeski, MD · Answer

You have large breasts and do not need more volume but do need a lift. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Hampton A. Howell, MD · Answer

Hi.  Based on your pictures you would be a good candidate for a breast lift.  A breast lift helps keep your own breast tissue but rearranges it with lifting and reshaping to redistribute the fullness in a beneficial way.  That can help give you additional upper pole fullness.  I would recommend consulting with a board certified plastic surgeon with good experience with breast lifts as well as breast reductions to help guide you through this process.
Good luck and take care, 
Dr. Howell

Ronald J. Edelson, MD · Answer

Not a good choice at all. You need a lift . Fortunately though you have enough breast tissue so you don’t need an implant of fat

Daniel Barrett, MD · Answer

Dear Sageharttt,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Christopher Pannucci, MD, MS · Answer

Hi Sagehartt,
Fat transfer (or an implant, for that matter) can fill out the loose skin of your breasts, to a degree. But your photos show that you have lots of extra skin, as well as descent of the breast tissue (from the side view, much of your breast volume sits below the crease where the breast meets the chest wall).
A breast lift would allow removal of extra skin, internal re-shaping of the breast tissue, and vertical movement of the nipple. It won't give you substantial and long lasting upper-pole fullness, but it can hugely improve the breast aesthetic. The attached video shows a great example.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, WA

Ashley Thorburn, MD · Answer

A fat transfer, also known as fat grafting or lipofilling, can be an option for increasing breast volume in cases where someone has low breast volume. It involves removing fat from one part of the body and transferring it to the breasts. However, whether it’s the best option depends on various factors, including your overall health, goals, and expectations.
Here are some considerations:
1. Consult with a board-certified plastic surgeon: It’s essential to have a consultation with a skilled plastic surgeon who can assess your specific situation, discuss your goals, and provide personalized recommendations.
2. Evaluate alternatives: Depending on your goals, you might also consider breast implants or a combination of fat transfer and implants. Each option has its pros and cons. 
3. Realistic expectations: Fat transfer can provide a more natural look and feel compared to implants, but it may not achieve the same level of volume increase. Your surgeon can help you understand what’s realistically achievable.
4. Body suitability: To undergo a fat transfer, you need to have sufficient donor fat in another area of your body. If you’re very lean, this may limit the amount of fat that can be transferred.
5. Risks and recovery: Like any surgical procedure, fat transfer carries potential risks and requires a recovery period. Discuss these with your surgeon.
Ultimately, the best option for breast enhancement depends on your unique circumstances and goals. Consulting with an experienced plastic surgeon is crucial to determine the most suitable approach for you.