Fat Transfer to Breasts - My doctor says they can get me up 2 cup sizes. I am about 5'4 107 lbs and 22 years old.

I'm looking to get a fat transfer to my breasts. My doctor says they can get me up 2 cup sizes ( I am about 5'4 107 lbs and 22 years old). They're going to be using UAL technique. I've been hearing so many different opinions and I just want to know the truth. I dont know what to do, I'm really stuck. I want larger breasts but if I can do it without implants, I'd be ecstatic. My biggest fear out of all of this is the results of the Liposuction (I don't want to end up like Tara Reid with all the dimples). Can someone advise me on this matter?

Doctor Answers 63

Fat injection to the breasts

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It is so intuitively appealing... natural tissue injected into the breasts, all natural breast tissue that survives. What could be better?
Here's the rub.
Fat injection consists of mainly dead cells, with a disputed amount of living cells. Our research showed 20-25% alive, other studies have shown as low as 3% if you look at the ability of the cells to "breathe" (metabolize).
Those dead cells, when injected into the breasts, either are dissolved away by the body's white blood cells, or form chronic inflammatory reactions and are walled off (granulomatous reactions) or form fatty cysts. Lumpiness can also occur with the above problems as well.
It is the walling off process that causes the most worry. Calcium formation is common in granulomatous reactions. Calcium is what clues off mammographers to the presence of cancer. So will there be false positive mammograms for cancer in patients who have this technique? We'll have to wait and see.
In five years' time, we will have our answers. Until then, patients receiving this technique will take a certain risk. We won't be using this technique in our practice until more data are available.
UAL, by the way, (and also the laser) melts and destroys fat cells with ultrasound waves (or laser heat). This technique would guarantee only dead cells are introduced.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Fat transfer works but not after ultrasound-assisted liposuction

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I been doing fat grafting for more than 11 years and fat grafting to the breast for 3 years. It works, but:

1) You cannot increase the breast size more than a cup size

2) You do not have a lot of fat, UAL is ultrasoinc harvesting and will kill all the fat cells

3) I am concerned that your doctor does not have enough experince, otherwise he would not suggest UAL

4) Make sure to ask for referral from previous patients, and also ask for mammogram of the previous patients

5) I have an on-going study with NIH. You can check it under clinicaltrials.gov and search under fat injection.

Thank you.

Consider your options very carefully

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The previous answer is accurate, but you need to know that at this time in the U.S. the option for fat grafting to the breast is specifically banned by the American Society of Plastic Surgeons, so no board-certified plastic surgeon would do it for augmentation unless it is part of an approved clinical trial.

Also, the use of VASER here doesn't make sense to me; I do use it frequently but the ultrasound actually destroys the fat cells so it would not be suitable for grafting. We do hope to have the option of using fat in the breast in the not too distant future but for now caution is advised.

Breast lipoaugmrntation or fat transfer to breasts

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I do perform this procedure for selected patients. It is not suitable for everyone and is usually twice more expensive. However you can simply not use dead cells after UAL or laser lipo. The cells are damaged after such procedures reducing their survival. Also, you can not go up more than one cup size at a time at best. Thus you will need two procedures at least.

Fat transfer is a great technique for enlarging the breasts, but we have to be realistic about expected long term results

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I would be more concerned about the expectations in volume and projection for your breasts than the results of the liposuction.  Done properly, liposuction is a very safe procedure with low complication rates.  However, I think that 2 whole cup sizes of increase as a long term result for a single treatment with fat transfer to the breasts is ambitious.  I'm not saying it CAN'T happen, or never HAS happened, but I would not advise my patients to expect it to happen.  You might get that volume early, but in general, for a lasting result (assuming weight remains stable) I would expect something more along the lines of a single cup size, if that, depending upon how much volume you have available for harvest.

Just a couple of side notes to round out the discussion too:  Fat transfer, especially to the breasts, is a very technically demanding and sensitive procedure, meaning it is very important HOW you harvest the cells, purify them as a graft, and inject them.  All of these things can significantly influence the percentage of living cells that will survive long term versus injured or dead cells which won't.  Thus, with respect to harvest, the most recent studies have shown that UAL of the Vaser type, with the lowest setting - so low that it doesn't really heat up the cells or kill them, rather it "vibrates" the tissues and "pushes" the liposuction fluid between the cells to better separate them, results in the highest survival rates of living fat cells.  If you are having a UAL harvest, just be sure the surgeon is experienced and uses this technique, because all UAL isn't created equal, and some UAL harvest can in fact result in more cell death.  With regard to cell purification, the old methods of centrifugation kill the most cells, whereas the newer technologies, especially PureGraft filtration system, have been shown to preserve the living cells better.  Then lastly, you can't just squirt these cells in in a big clump; of course they'll die.  Grafting the cells properly should be a very tedious and time consuming process, which is why most surgeons can't tolerate doing it properly.  The fat has to be injected in tiny amounts so that the individual cells have the greatest chance of contacting blood vessels for blood supply. It's sort of like painting a wall with one of those little watercolor brushes we used in school.  It takes awhile, but it is worth it.  When the fat is injected in amounts to large, the cells die and that results in cysts, fibrosis, and calcifications.  Studies done by radiologists have demonstrated that there is little confusion between the kind of calcifications seen with fat necrosis (which also happens with breast lifts and breast reductions by the way) and tumors, so the concern about confusion of fat grafts with tumors or masking of tumors has been debated, and at the present most surgeons don't believe that the concern is warranted.  In general fat grafting can be an excellent adjunct to enlarging breasts, but I can't stress enough that it must be done correctly or the results won't be optimal.  It is not the procedure or the technique that fails in these situations, it's the technician.  If you haven't already, seek out consultation with an experienced board certified plastic surgeon who can properly advise you about the procedure.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Ultrasonic liposuction for fat transfer is not good

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For fat transfer to work, the cells harvested must be injected alive. Ultrasonic liposuction kills the fat cells. The injection will then only last for a brief time.

Also, for someone who is 5ft4inches and 107 lbs, it highly likely that you do not have enough fat to make a significant difference. Herein lies the dilemma for Fat Transfer for Breast augmentation, most small breasted woman do not have enough fat to make a difference.

Typically, 200 cc of fat is one cup size improvement.

Fat Transfer for Breast Augmentation and Breast Cancer

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In my San Francisco area practice I do a fair amount fat grafting (face, hands, buttocks) and I do not perform breast augmentation using this technique.

The issue here becomes one of fat survival and scar tissue. If a portion of the fat dies (which typically happens) this area can heal with scar. Usually it is not enough to be cosmetically noticeable. The problems start when screening for breast cancer. Both mammograms and MRIs can detect this scar tissue as calcifications.

These can be difficult to differentiate from early breast cancer. Your oncologist or general surgeon may recommend multiple biopsies to follow evolving calcifications which can add to the scarring and create a real sense of concern for patients.

Speak to a few plastic surgeons about using fat transfer for breast augmentation before making a decision.

This procedure can be especially difficult in cases where more volume is required.

I hope this helps.

Breast Augmentation Using Your Own Fat

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Breast Augmentation using your own fat a potentially great procedure.  You get liposuction of the fat in the unwanted areas and also get a breast augmentation using your own fat, a 100% natural substance.  Once fully healed these breasts are indistinguishable from 'normal' non-augmented breasts.

HOWEVER, patients always overestimate the amount of fat that they have for the use of breast augmentation.  If you are 5'4" and 107lb, you will barely have enough fat for a half cup increase.  There is just no way I can imagine that you will gain two cup sizes.  I think you should seek a second opinion from another board certified plastic surgeon who has experience with fat grafting.

When you go back to visit your surgeon again, ask him/her about his/her board certification.  You also want to see before and after pictures of other patients that had a two cup size increase.  And you want to make sure the after pictures were taken at least 3 months after the surgery.  If the doctor is reputable, he will certainly have at least one happy patient that is willing to talk to others potential patients about her experiences.


Martin Jugenburg, MD

Fat transfer for breasts - Very controversial and inconsistent procedure at best

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Using fat liposuctioned from other areas in your body has been written about for over 15 years. It is most often performed by physicians who are not board certified plastic surgeons and are looking for a way to break into the breast augmentation market. Since fat reabsorption is inconsistent, the question arises as to whether to overinject fat, with the assumption that a certain percentage will reabsorb. That's how it's done in many other parts of the body such as cheek augmentation. In addition, fat that does not survive may undergo calcification, which may suggest to a radiologist, the presence of a malignant breast tumor, on mammogram.

From a cost standpoint, some of the "cosmetic surgeons" charge more for breast augmentation with fat than most board certified plastic surgeon charge for breast augmentation with implants. In addition, fat injections do not produce a long-term result, especially if the fat is harvested using ultrasonic liposuction, which emulsifies fat cells

Breast augmentation with liposuction and fat injections: NO UAL

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Dr. Seify had succinctly summarized some of the concerns with breast augmentation using fat injection.

I only have one, but very important concern.


The fat obtained with UAL is completely dead and you will essentially be injecting oil into the breasts which will result in cyst formation and other potential complications.

Although fat is easy to put on and hard to eliminate, it is an extremely delicate tissue and the cells must be obtained using a delicate technique. Many surgeons strongly advocate syringe liposuction (rather than a suction machine). The fat is typically prepared to eliminate the ruptured cells as well as any blood.

However, as Dr. Seify stated, this is largely investigational and currently not the standard of care. There are many exciting options in the future inlcuding the use of stem cells harvested from liposuction material but this remains to be put in to widespread use.

I hope this helps!

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.