Why is Fat Transfer For Breasts a More Difficult Procedure than BBL?

It is still relatively, compared to BBL , hard to find a Dr for fat transfer breast aug. The breast aug by fat 'less safe' and satisfactory as implants however the opposite for the butt. Yet both inject fat to an area where fat hardening and loss through time can occur. With implant in both butt and breast it is a foriegn matter that can and has burst and needs to be replaced every 10 yrs. Not everyone wants fake big breasts just to fix after children. What is the factual real explanation?

Doctor Answers 6

I dont think it is

They are about the same difficulty, and fat transfer to breast works best in women who have invloution of pregnancy (breasts that have shrunk after a baby.)  The thing that limits both procedures is that as the fat is placed into the breast or buttock, eventually the skin gets tighter and tighter until no more fat can be placed.   Hence it is hard to go up more than one cup size for a fat transfer to the breasts, it also takes longer so it costs more.   Most patients want more than one cup size enlargement and also would rather pay the smaller cost for breast augmentation.  I am happy to perform fat transfer to your breasts, just contact me at my office (google me to find me.) 


Best regards,


Dr. Lane Smith

Las Vegas Plastic Surgeon
4.5 out of 5 stars 93 reviews

Natural Breast Augmentation

You bring up a great point.  The short answer is experience.  Buttock implants have been around for a long time.  Buttock implants have given a lot of trouble so the alternative has won.  Buttock cancer is not an issue so fat transfer is a safe option.  Breast cancer is a hot topic and implants have been around for a long time.  Breast augmentation with implants has been a gold standard for decades.  Breast augmentation via fat transfer is a newer approach and only became accepted recently.  Most surgeons haven't been trained in it and therefore feel unsure.  The reality is that it's a great way to add volume without an implant.  At this time, we can't increase the breast size 2 cups with fat transfer, but we can increase it one cup size.  The focus is to increase the volume more in the upper aspect of the breast.  This is usually where the volume is needed.  The nice thing about fat transfer to the breast is that is can be performed under local anesthesia.  This is different from a breast augmentation with an implant.  Plus, fat transfer is your own tissue so there is very little risk.  Come to Beverly Hills and see me.  It's a great option. 

Justin Yovino, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 91 reviews

No single answer to why surgeons do not perform fat transfer to the breast

There are many "factual real explanations" to answer your question.  The reasons may not be scientific, but they are, none the less, real concerns of some surgeons.  I am sure this is not a complete list, but here are several answers:

  1. Scar tissue and calcification on mammogram can limit effectiveness of mammogram
  2. One cup size is typical enlargement and not enough for most patients desires
  3. The need to use the BRAVA device before surgery is cumbersome to patients and, as a result, is not used effectively or completely
  4. Difficult to obtain enough fat to accomplish the procedure
  5. The procedure take 2 to 3 times as long as a typical augmentation, making it too expensive

These answers do not apply to all patients seeking the procedure, but I think they give a reasonable overview of the concerns.  Hope this helps.

Michael S. Hopkins, MD
Albuquerque Plastic Surgeon
4.9 out of 5 stars 83 reviews

Natural breast enhancement with fat grafting

Fat transfer to the breast is a procedure that has come under criticism and scrutiny by the plastic surgery community for many years.  Long term studies have demonstrated that there is NO increased risk of cancer or increased difficulty in detecting cancer after fat transfer to the breast.  Once patients accept that the amount of augmentation is variable, patient satisfaction is very high.  The breasts are natural appearing and feeling with really none of the potential long term complications of implants.  The American Society of Plastic Surgeons has reversed their position on the procedure and surgeons are slowly adopting the procedure.  


Mark Glasgold, MD
Highland Park Facial Plastic Surgeon
4.4 out of 5 stars 41 reviews

Fat Transfer to Breasts More Difficult than Brazilian Buttlift?

    Fat transfer to either area is not a particularly difficult procedure for those surgeons who fat graft to many areas of the body.  Fat transfer to the breasts creates for a more conservative augmentation than some patients are willing to accept.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Concerns about fat transfers to the breasts

When you harvest fat to transfer it, at one point it is dying in a syringe with no blood flow.  Unless the fat regains a blood flow from the tissue you put it into, it will finish the dying process and either be resorbed by the body or turn into scar tissue, making potentially hard lumps.  This may cause problems in breast cancer detection.

That is why may of us are still not sold on this "hot" new idea that has actually been around since the 1980's at which time it was resoundingly denounced by the American Society of Plastic Surgeons.  I'd still consider it experimental and potentially something that can set you up for problems down the road.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 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.