Why are so many unhappy with the results of fat transfer to breast?

There is no procedure that is ideal for everyone.  Every procedure has advantages and disadvantages.  The best procedure in the wrong hands or selected for the wrong patient will always result in unhappy patients.  There are limitations in what fat transfers can do such as the maximum volume that can be achieved per transfer session (usually not more than one cup size).  Unless you are willing to maybe have to do more than one session to achieve more than one cup size, then the procedure is not for you.  Also it may cause some lumpiness (but so can implants) but in more experienced hands and for patients who are better candidates, there is less chance of this.  Not all surgeons have the same type of experience or have the same hands or use the same techniques so choosing the right surgeon who knows not only how to safely perform the procedure but who also knows how to select the proper patient is very important.  Being a good candidate is also important.  If you have more good quality fat to give, if you have more breast tissue to begin with and if your breast skin is not too tight, then you would be a better candidate.  Also having the right expectations is key.  If you are wanting to be 2 cup sizes bigger and are not open to having to possibly do more than one fat transfer session, then you should give serious consideration for breast implants.  If you choose fat transfers to the breasts in place of implants, you would be able to avoid inherent risks of implants such as rupture, capsular contracture, rippling, wrinkling and migration of implants.Getting a consultation from some reputable board certified plastic surgeons who have a lot of experience doing this is a good place to start to see if this is a good option for you.Best wishes.

This is one of my favorite procedures.Its hard to tell you how large you will be after because the breast swells a lot and women tend to like this size. Once it settles down they are not as happy which is why it sometimes requires multiple surgeries.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr schwartz

According to posting by patients on RealSelf, 94% reported that breast augmentation with implants was worth doing while 77% felt that way about an augmentation using fat transfer to the breasts.While it is possible to do fat injections to the breast as a
cosmetic augmentation, currently, it is felt that only up to 50 of transplanted
fat successfully survives in its new location. The remainder doesn’t go
elsewhere. It is just resorbed by the body. Fat injections to the breasts may
be useful in making small modifications and correcting asymmetries, but many
plastic surgeons feel this procedure is not as reliable or predictable as an
augmentation with breast implants. The concerns: Long term results do not yet exist, like any
procedure there are potential risks including infection, oily cyst formation, mammographic
changes which can be confused with breast tumors, asymmetry, the results are
not totally predictable and are inconsistent as compared to breast implants
which are the most extensively tested and FDA approved medical devices with a
lengthy record of safety and efficacy, it is a lengthier procedure, more
costly, may require additional sessions of fat injection, and to optimize the
results usually requires a prolonged use of an external device called BRAVA
which is uncomfortable and has a poor record of patient acceptance and compliance.
There are an increasing number of satisfactory reports of
this procedure being performed, but there are still a wealth of additional unresolved
issues: The extent of resorption of the fat, the large volume of fat that is
required to produce an improvement, the limitation of the amount of the very
modest augmentation that is possible (usually only up to ½ or one cup size), and
specifically a concern about long term safety with regard to tumor stimulation,
which all need to be further investigated with valid scientific studies before
fat injection should be viewed as a standard procedure for cosmetic breast augmentation.Keep in mind that following the advice from a surgeon on
this or any other website who proposes to tell you what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of each operative
procedure would not be in your best interest. I would suggest you find a
plastic surgeon certified by the American Board of Plastic Surgery and ideally
a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.Robert Singer, MD FACSLa Jolla,
California