How big is the risk that one breast will absorb the fat and the other not, leading to asymmetry?

If you have the chance go for fat transfer. This is the most natural way of augmentatoin. If you have a small asymmetry (as do 90% of my patients) your surgeron can use more fat for the smaller breast and try to correct it.
1. How big is the risk that one breast will absorb the fat and the other not, leading to asymmetry? -no risk at all. Most of my patient come with a slight asymmetry wich can be corretedI already have a small asymmetry and I am afraid that the smaller breast might not receive the fat.-the fat usually gets absorbed the same in each breast2. Are there situations when you wouldn't recommend this procedure to a patient? YES if one of the following applies to you: 1. breast cancer (or high riks of breast cancer) 2. BMI under 17 3. Sagging breast of unpleasent breast shape! (the augmentation will only slightly correct deformities) 4. Patients expectation are more then one cup size per sergery!
3. This procedure will also change the shape of the breasts? only slightly. 

For most women, if the asymmetry is not too large, the amount of fat transferred can be adjusted to make the breasts more even. The exception is if the smaller breast is tiny and cannot hold much fat. However, fat can always be added later.

The answer to your question is pretty straightforward.

If you’re not a post to implants then you should have implants. It’s a better procedure that’s more predictable and gives better results.

If you’re completely opposed to implants then fat transfer may be an option.

Fat transfer does not change the shape of the breast much at all. It simply makes them larger by about 50 to 75% sometimes 100%. This equates to 1/2 or maximum 1 cup breast size.

Experienced surgeons can typically adjust asymmetry and in my hands typically I can get asymmetry corrected as long as the shape is the same and it is only a volume issue and the discrepancy is moderate or mild.

Implants contribute significantly to breast shape especially projection and volume in the upper half of the breast. without pictures we can’t make an assessment but if you feel like the shape of your breast is perfect and you just want a small amount of increased volume then fat transfer may be an option.

You should also know that the result from fat transfer varies immensely among providers.

There’s a pretty long learning curve to mastering Breast Fatula Transfer and in the hands of inexperienced providers you will have minimal results.

Inexperienced providers may also perform the procedure in appropriately leaving patients with oil cysts and palpable fat necrosis lumps.

I suggest finding local board-certified plastic surgeons who have sufficient experience with Breast Fatula Transfer that they can show you a collection of before and after pictures that has at least 30 to 50 examples.

With the fat transfer results typically look very impressive early after the procedure but as the fat reserves the results settle down and change.

There is always a temptation to take early postoperative pictures and to show these as final before and after results. early postoperative pictures after fed transfer procedures are not at all representative a final results and this is a big big no no.

Always make sure after pictures were taken a minimum of 3 to 6 months after surgery or the provider is not being forthright or honest about their work.
Unfortunately I see early pictures being demonstrated all the time including on this website.

If you’re OK with implants then that’s the way to go.

I’ve been a board-certified plastic surgeon for 20 years. The first 10 years of work included all aspects of plastic surgery especially all forms of breast surgery. The last 10 years I’ve been focused exclusively and only liposuction and fat transfer procedures. I am a specialist exclusively in just liposuction and fat transfer and because of that I have an unusual amount of experience.

My results took several years of doing these procedures consistently before they started getting consistent and as good as they are today. Even the best results are still insufficient for many women to feel it’s a justified procedure.

It depends what you’re trying to achieve and what you’re willing to go through.

Please schedule multiple in person consultations with local board-certified plastic surgeons who seem to been doing this procedure for many years.

During the consultation ask the provider to show their entire collection of before and after pictures which should I dearly look like a telephone book.

Avoid providers who narrow it down and show you three or four examples only.

The surgeon who has hundreds of before and after pictures to choose from and can find patients who look just like you in the before pictures and has consistent good results without any significant number of justified negative reviews on various physician review sites as the provider you want.

An abundance of reviews typically just means a strong marketing campaign because they are not necessarily organic.

Because all negative justified reviews are organic they are far more telling than an abundance of positive reviews.

Experienced surgeons will have hundreds and hundreds of before and after pictures and this is how you know they have the experience needed to deliver consistent high-quality work.

Typically you’ll know it when you see it.

In the meantime continue scheduling more consultations than you think you need.

Do it once do it right.

Find the right plastic surgeon and everything falls into place.

Best,

Mats Hagstrom MD