Explant 8 months ago.Will a fat transfer alone help the look of my breasts after my explant? (Photo)

Question

Will a fat transfer alone help the look of my breasts after explant? I also have been presented with the option of getting a skin/scar excision to lift the scar position to under natural breast crease and then do fat transfer. Are both procedures needed or will fat transfer alone cover the ‘dents’ and give enough volume to improve my breast shape leaving the existing scar location. I had my explant 8 months ago.

Daniel Barrett, MD · Answer

Dear miss1234567890,

fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.
In addition, the following scenarios are also reason to consider breast fat grafting:
•	If you have chest areas that appear creased and sunken
•	If you desire more permanent correction than is provided by temporary fillers
•	If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts
•	To fill in contour irregularities or hide obvious signs of breast implants
You should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. 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

Oliver Chang, MD · Answer

Based off your photo, fat transfer to the breast would be a good start before cutting anything. Those creases on the bottom of the breast likely will resolve post fat transfer once done healing. The volume and fullness as you once had with implants will never be achieved via fat transfer but maybe more than one round of grafting can achieve more projection and help smooth out the lower pole creases. Seek out a few opinions and choose your surgeon based off the consensus of the plan and outcome.

Karl William Schwarz, MD · Answer

I would certainly start with fat grafting before entertaining any idea of skin removal. But keep this in mind: it may take more than one round to get the final result you like using fat. Fat grafting to the breast is not like using an implant. You can't remove a 400cc implant and then replace it with 400 cc of fat. It doesn't work that way. The amount of fat is usually much less like around 100 cc or so depending on the breast size.

In my opinion though you would be an excellent candidate for fat grafting to the breast to refill your breasts and gain a little more cleavage and shape but the nice thing is you can slowing get to where you want to be and after the first round of fat grafting you can re-assess to see if that's where you want to be in terms of size and if you want to be a little bigger than undergo another round of fat grafting.

Mats Hagstrom, MD (license on probation) · Answer

Breast fat transfer can give modest increase in breast size.
The procedure is not very good at changing breast shape.
You can expect breast fat transfer to increase your breast size by approximately 1/2 cup.
The outcomes are somewhat unpredictable and provider selection has a lot to do with The type of results you can get.
Even when done correctly, the procedure is going to be modest.
Fat transfer is not good at restoring the volume in the upper half of the breast.
It basically gives you a slightly bigger version of what you have.
Doing several rounds of fat to transfer a can create cumulative effect that’s more impressive than a single session.
I’m not quite sure What procedure you’re thinking of to change the scar.
The best look would be using implants, but I guess that’s not an option.
Best,
Mats Hagstrom MD

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