I am a 5'7, 125 lb very lean, fit women. I run 5 miles a day and have done numerous half marathons. Would this affect results?

Question

I have also given birth to 6 children and they have literally sucked my breasts to nothing but I didn't have much to begin with. I have been considering having a fat transfer breast augmentation done but I am not sure how well this procedure will hold for me. It is my understanding that around 40-60% of fat will eventually be absorbed by my body. I just want to know if I should expect all of it to eventually be absorbed since I am a lean muscular female to begin with?

Gary M. Horndeski, MD · Answer

At 5’7 and 125 lbs, your BMI is 20.  You may not have much fat at the donor site.  However, giving birth to six children may have resulted in a stretched skin envelope.  Unfortunately, you have not provided photographs.  You may be better off with a breast lift using The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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.  Later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear kristielvh,
it is hard to tell for sure without an examination, but if you are healthy, you might be a candidate for a fat transfer. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Robert M. Tornambe, MD · Answer

KristieI completely appreciate your desires and photographs would help, because it sounds like you are not an ideal candidate for fat transfer for the breast because it is doubtful you have enough available fat to make a difference. Someone as slim as yourself who also does a great deal of cardio would benefit from small breast implants rather than fat transfer to achieve and maintain the best possible result. Consult with a board-certified plastic surgeon in your area to explore the best options for you. Good luck.

Kenneth Hughes, MD · Answer

Breast fat transfer is a great tool to balance breasts, improve symmetry, and gain up to one cup size in volume.  In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons.  It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer.  Multiple transfers would be required for additional cc's.  In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used.
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival.  Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. I typically transfer from 250 cc to 400 cc or so per breast.  Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant.  
Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation with a board certified PS to determine your available fat stores.

Connie Hiers, MD, FACS · Answer

If you are lean and running marathons, a fat transfer may not work well. First, you do need donor fat to transfer. Second, with the movement your breasts do while running over 26 miles, the fat may be absorbed more quickly. I would suggest considering implants. Long term you will have a more stable look and the implants will hold up for marathons.

Gilbert Lee, MD · Answer

Thank you for your questions. Its hard to tell without photos but you may not have enough fat to harvest. In general, at least 300cc of fat per breast is grafted to give a result of one cup size larger. I recommend you schedule a consult with a board certified Plastic Surgeon who can assess your specific anatomy. In our office, we offer 3D imaging to give our patients an accurate idea of what their final result will look like. Good luck!

Mats Hagstrom, MD (license on probation) · Answer

Do you need to recognize that you need enough fat to have a successful fat transfer.Patients are often confused in regards to what’s fat and what’s the skin. I see people pinch their skin recruiting it showing how much fat they have. To assess the thickness of your subcutaneous fat but the skin under tension and gently press against your skin until you’re feel of the underlying muscle layer. This is an accurate representation of the thickness of your fat. If you’ve had six children and are a lean long distance runner Then my best guess is you may not have enough fat for this procedure and you may be confusing skin laxity with excess fat.Without pictures we can’t make an assessment if this is an appropriate procedure for you.My average breast fat transfer is 450 mL of pure fat per side. This requires harvesting the equivalent of 2 pounds of fat.Think eight sticks of butter.A typical 5’4” female generally needs to weigh 130 pounds to have enough fat for this procedure though I’ve done them on patients under 120 with good results. It still requires liposuction of the entire torso which includes upper abdomen, lower abdomen, love handles, waist and armpits.other excellent areas to harvest fat from our arms and to a lesser extent inner thighs.Fat transfer is not particularly good at changing breast shape but is good at increasing volume. I typically get 100% of 150% breast volume increase from this procedure consistently. When judging results it’s important to recognize that results change drastically over time. If people are posting early postoperative pictures then the results are not representative of final results whatsoever. Any postoperative picture taken in the operating room, with bruising present or with surgical markings should be completely discounted as in accurate and not representing final results. I would simply not consider providers showing these types of pictures.After pictures should be taken at a minimum of three months after the procedure. At this point results from both liposuction and fat transfer are final and representative of permanent results.A strong argument can be made that breast implants are more predictable, are much better at giving volume in the upper half of the breast, or a much faster Procedure with an easier recovery. Implants are far more consistent and excellent at creating and improved breast contour for those who lack volume in the upper half of the breast.My practice is devoted exclusively to liposuction and fat transfer. I recognize the limitations of this procedure and it’s not for everyone.For  thin women it’s a lit of liposuction to go through to get a modest increase in volume without necessarily getting an improvement in breast shape.The ideal candidate for this procedure is a great candidate for both liposuction and fat transfer. The ideal candidate for liposuction tends to be young, have tight skin and be pudgy with undesirable subcutaneous fat in a less than ideal Fat distribution.The outcomes of liposuction vary greatly among different providers. Anyone considering this procedure needs to take into consideration the possibility of having undesirable outcomes especially for the liposuction aspect.I suppose that’s true for all cosmetic surgical procedures including breast implants though that procedure has much more consistent outcomes with a lower chance of having disfigurement.Best,Mats Hagstrom MD

I am a 5'7, 125 lb very lean, fit women. I run 5 miles a day and have done numerous half marathons. Would this affect results?

Answers (7)

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