Breast fat transfer expectation? (Photo)

Question

After two revisions from breast augmentation and complications continuing (capsule contracture, asymmetry, capsul tear, general pain/discomfort) I am going to have to have them removed. My doctor recommended fat grafting to the breast at the time of explant to help with volume. What aesthetic outcome can someone with little natural breast tissue (a small A) expect? My implants are 300 cc low profile plus and put in a C cup currently.

Jeremy Bosworth, MD · Answer

The degree of fat take, or fat that will live varies in each individual. The amount of fat you have to donate and the amount of healthy tissue remaining after all of your surgeries (scar does not have as good of blood supply as breast tissue and muscle) can be limiting factors to consider. In a primary fat grafting to breast with reasonable amount of fat to donate I usually like to say that if we can get you a 1 cup increase in size then that would be a good result. Of course some people get more, some people get less, but as a rule of thumb, thats what I like to go with. Sometimes it can take multiple rounds of fat transfer.

Joel Patrick Maier, MD · Answer

Fat transfer is ideal in these failed implant situations . . . Unlike implants, a proper round of fat transfer can be very successful in shaping and enhancing your breasts with very little long term complication and worry . . . Thank you.

Daniel Barrett, MD · Answer

Dear Lexrae,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

At the time of explantation, most patients are usually dissatisfied with the excess hanging skin and a simultaneous lift is required. Unfortunately, you have not provided photographs. However, you would benefit from explant with lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated 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 if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Since you are a small A, you do not have much breast tissue to hold fat. You might gain one half to maybe one cup. However, a fat transfer can be repeated if you have donor fat available.

Karl William Schwarz, MD · Answer

You should be returned to your previous cup size with implant removal so the fat grafting will help get a little volume most likely and get a better shape to your breast. The nice thing about fat grafting is that it can be repeated later on to add even more volume if you are initially disappointed with your breast size after implant removal.The other thing to consider is wrapping your implants in a mesh or strattice which can almost bring your chances of recurrent capsular contracture to zero.

Darryl J. Blinski, MD · Answer

Sister, no posted photos. The assumption is exploit and capsulectomy fall by Lipo and backing has limited outcomes. I usually recommend 2 to 3 stage surgeries to attain a perfect volume. Best to do virtual consult so a decision can be ascertain. Expect these per surgery to run $5000-$10,000. Regards regards.

Mats Hagstrom, MD (license on probation) · Answer

The biggest issue with breast fat transfer done in conjunction with explantation is there will be no basis for comparison regarding the outcome of the fat transfer.
There is simply no way to judge if the fat transfer was of any benefit whatsoever.
You will not have proper before and after pictures.
Delivering consistent quality, liposuction and fat transfer outcomes is more difficult than most people realize.
The number of plastic surgeons who truly mastered these procedures are in a small minority.
To get an idea of what the procedure can accomplish. You need to see a multitude of before, and after pictures that are honest representations of the work of your provider.
I generally recommend patient schedule multiple in person consultations When selecting providers for fat transfer.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients with similar body characteristics to your own.
It may be difficult to find someone who can show you quality before and after pictures of your scenario since it is basically impossible to get accurate before and after pictures when the transfer is done in conjunction with explantation.
Still, you can get a general understanding if your surgeon has sufficient skill and experience for liposuction and breast fat transfer by asking them to show you examples of previous patients who had this procedure whether they had explantation done at the same time or not.
An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. 
Recognize that early fat transfer results can look very impressive, but do not in any way represent long-term final results.
That transfer results are somewhat meaningless unless they are put in context of when the photos were taken.
After pictures did not begin to be representative until at least three months after the procedure at which point the fat transfer has settled down and what remains is most likely going to be permanent.
It may or may not be a good idea to have fat transfer done in conjunction with your explantation.
The success of transfer is primarily based on technique and the abundance of host tissue to support the grafted fat.
It is a very technique dependent outcome and each individual Patients candidacy for quality outcomes will vary substantially.
Breast fat transfer can typically increase breast size consistently by 1/2 cup, sometimes as much as one cup.
This typically means a 50 to 100% increase in total breast volume per procedure.
Breast fat transfer mod the increase breast size it does little to change breast shape.
Most patients benefit from breast augmentation by obtaining projection and volume and the upper half of the breast.
Unlike implant, augmentation breast fat transfer does not give great projection, and does not deliver volume Specifically in the upper half of the breast.
It’s important to recognize that breast fat transfer is always a dual procedure that includes liposuction.
The ideal candidate for breast fat transfer should also benefit from liposuction.
Many times one breast fat transfer goes wrong. It is due to poorly done Liposuction leaving people disfigured from the harvesting of fat, rather than being a complementary procedure that enhances aesthetic outcomes. 
Considering how few plastic surgeons have truly mastered this procedure, I would be somewhat cautious about signing up for breast vet transfer to be done in conjunction with explantation.
There are definitely certain advantages to doing the procedure in conjunction, but unfortunately, it is very very difficult to assess quality outcome since there is no baseline to judge The impact of fat transfer.
Your breast will not look the way they did before your first procedure after removal of your implants.
If your surgeon has the necessary, skill and experience to deliver quality breast fat transfer, then having fat transfer in conjunction with explantation, maybe very solid advice.
Unfortunately, too many surgeons, lack the skill and experience to deliver consistent quality results in regards to both fat transfer and liposuction.
Best,
Mats Hagstrom, MD

Breast fat transfer expectation? (Photo)

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