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