Doctor says the fat transfer to my breast will regain its volume after 3 months - Is there validity to his explanation?

Thank you for your questions. This answer can be tricky as the data and long term results from fat grafting are hard to pin down because there are so many techniques and practice variations in the publications. Generally speaking, immediately after the procedure are usually the best things are going to get. Whatever was injected (fat, fluid, etc.) will fill the volume. Over time, some of that fat will "take" and some of it will be absorbed and carried away. This process can take anywhere from 3-6 months. The bottom line in your case (with breast fat grafting) is that with additional time, the results are not likely to improve unfortunately. In my practice, I use a specific system to refine the fat prior to injection so that the cells injected have a high quality and probability of survival. If other material in injected at surgery (fluid, dead cells, etc.), things might look great early on, but over time that goes away and patients end up disappointed. Any time I do fat grafting, I tell patients it might take several rounds to achieve the desired results. It is unpredictable and that is the nature of that technique. In regards to your other question, there has been some early data in facial fat grafting that some of the stem cells transferred during fat grafting can cause an uptick in growth and over a period of 6 months to a year or two out from surgery, there is evidence that there is additional growth beyond what was initially grafted. That being said, this applies to areas of very small fat grafting in a highly vascular area and this is just a few small studies. I would not use this data to imply to someone that at three months, the fat graft is going to improve, that is unrealistic. In your case, I guess time will tell. If you are unhappy with your results at 6 months, consider a second opinion with a plastic surgeon who is board certified by the American Board of Plastic Surgery.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

If the lump is the result of swelling, seroma, or  hematoma,  it should resolve quickly.  If the lump is fat necrosis or viable fat that becomes discrete and remains palpable, it may require further treatment like aspiration or removal. About 50% of the fat obtains permanence.  If a second procedure is indicated, you can usually tell by 6 weeks.  Depending upon healing characteristics, it may be reasonable to perform the second surgery at 3 months. You have to consider not only which areas will have perhaps the best fat, but also you have to consider which donor sites will have the fewest problems afterward with the liposuction.  In general, the abdomen and thighs are preferred, but, if those sites are not available, other areas can be used.

You will never get back the same volume you had immediately after surgery when there was swelling, but hopefully you will not have much more decrease in size from this point. I have not seen or heard of fat increasing in volume between 3 weeks and 3 months after surgery unless you gain weight. The areas of necrosis will soften, but if the body absorbs them you may notice less size, not more. You can’t repeat fat transfer if the volume isn’t what you pictured. Good luck. 

In my experience, the swelling decreases in the first couple of months, and then what volume of living fat that is present remains. The fat necrosis and oil cysts, if present, sometimes do get smaller. If you gain weight, the fat can enlarge. The fat does not enlarge on its own. Only so much fat can be safely transferred at one time.

I have experienced fat transfer issues in patients whether breasts, face or buttock. In the breasts the sine qua non is fat acts as only a slight filler not real large increases in volume as seen in buttock. After 1st 3 weeks post transfer the amounts seem to stablize more in a downward direction. I prefer combining fat and smaller implants. Photos help?