Would a fat transfer help me with more fullness, improved cleavage, and under-boob without getting implants? (photos)

Question

A/B cup looking for more fullness with improved cleavage and “underboob” without implants. Would a fat transfer help me? 5’3, 125lbs. And, if so, would gaining weight before the procedure be a good idea to harvest more fat?

Kenneth Hughes, MD · Answer

Breast fat transfer is a great tool to balance breasts, improve symmetry, and gain up to one cup size in volume.  In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons.  It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer.  Multiple transfers would be required for additional cc's.  In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used.
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival.  Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. I typically transfer from 250 cc to 400 cc or so per breast.  Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant.  I place one incision under each breast and the fat can be injected to the locations specified by the patient.
Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation with a board certified PS to determine your available fat stores.

Gary M. Horndeski, MD · Answer

The technique I recommend is a lift using 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.  Later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

Douglas L. Vander Woude, MD · Answer

Thank you for your question and photographs.  Fat transfer for improved fullness and shape of the breast is an option in some situations.  There are limitations with how much can be transferred and how much of that will survive in the new location.  There may be a need for multiple procedures to achieve the desired outcome.  All of those concerns can make the decision more difficult.  Having a consult (or two) with a Board Certified Plastic Surgeon that has experience with these procedures will help you decide.  You would likely have a very nice result with a standard augmentation.  Best of luck.

Farbod Esmailian, MD · Answer

Fat transfer to the breast is not the best option or even a good option for increase in volume.  From what you are desiring, an implant is your better option.  Fat transfer is ideal for patients who are undergoing removal of implants +/- breast lift.  The fat can help replenish some of the fullness in the upper pole with removal of breast implants.  It is not meant or does it really work well for adding volume.  It appears to work well in the upper pole of the breast as the blood supply is greater in that region.Hope that helps.

Daniel Barrett, MD · Answer

Dear nubbin_luvin,
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 implantsYou 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

Devan Griner, MD · Answer

The short answer to your question is yes. You can definitely get an increase in volume to your breasts (both upper and lower poles), and improved cleavage with fat transfer. Fat transfer has been an amazing technique for breast enhancement and breast reconstruction in my practice. The factors to consider are these: 1) It can take several sessions of fat transfer to achieve the desired shape and volume. Even with the best techniques, it is estimated that 25-50% of the grafted fat will not survive.2) Fat transfer to the breast will change your mammogram. The fat that doesn’t survive can cause small micro-calcifications which are what radiologist look for as they are also the first sign of breast cancer. However, with digital mammography and well-trained breast radiologists, they are good at deciphering between calcifications from fat resorption and those from cancer.3) Breasts that are augmented with fat rather than implants will droop more over time as a natural breast would.4) You have a very slight amount of ptosis (drooping) right now. Fat transfer will not raise the level (or the appearance of lifting) of your nipples like an implant can without many sessions of transfer. Moving your nipple up can be done with a crescent mastopexy, but this would have to be done after the fat transfers are complete and the new breast mound is stable. I hope this information helps. I love fat transfer and have found it to be very transformative. You just need to know what you are getting into. It is the more natural way to go, but can be a lot more expensive.

Connie Hiers, MD, FACS · Answer

Don't try to gain weight before the transfer, since you may tend to loose the weight after the transfer. If you would be content with a half to one cup increase in size, then the transfer might work well for you. If you want to be fuller, implants would be best. Implants are more consistent with size, since not all the fat transferred survives.

Gilbert Lee, MD · Answer

Thank you for your questions and photos. Fat grafting is an option if your expectations are realistic. Normally patients will achieve areas of increased fullness and will increase  1/2 to 1 cupsize. You need to have enough fat to harvest to get a noticable result. Gaining weight specifically for harvesting purposes doesn't work well. As you lose weight to return to your normal weight, you will lose volume in your breasts. I recommend scheduling a consultation with a board certified Plastic Surgeon who has experience in fat grafting. They can assess your anatomy and develop a plan that is best for you.

Kenneth R. Francis, MD, FACS · Answer

Dear nubbin_luvin,
Fat transfer breast augmentation is becoming a more popular procedure in the armamentarium of the plastic surgeon.  As with most things in life, there are advantages and disadvantages to fat transfer.  Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of your goals and options.  Good luck!

Mary Lee Peters, MD (retired) · Answer

Thank you for your questions about improving your breast contour with fat transfer.  The procedure seems to work best when providing fullness in the upper chest and in areas beside your sternum (middle of your chest).  Fat transfer is most successful in people that have a little bit of extra body fat.  Gaining weight for this purpose is subject to disappointment, because your body will return to its natural set point.  A fat transfer can make change in your setting, but it may not be as much as you were looking for.  Have your plastic surgeon help you to understand your options.

Would a fat transfer help me with more fullness, improved cleavage, and under-boob without getting implants? (photos)

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