Breast Augmentation with Fat Transfer. Can I get 275cc on my left and 325cc on my right? (Photo)

Hello,
And thank you for the question and the photos.
Following removal of breast implants without replacement, a patient may choose one of two options: do nothing and see how much the skin retracts or undergo fat transfer to the breasts at the same time.
Fat transfer is usually done through tiny incisions with minimal scarring and often more than one session is necessary to achieve the desired results. It also allows improvement of contour in the areas where the liposuction is performed in order to harvest the fat for transfer.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship TrainedBoard Certified Plastic Surgeon

Your breasts are low on the chest wall and widely separated. I recommend explantation and a breast 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.

Thank you for your question regarding having a breast augmentation and fat transfer simultaneously and for including photos.

In my practice, I have had patients that wish you have a breast augmentation with implant and choose to do fat transfer as well.

I would recommend that you ask for realistic expectations with your surgeon.

To be sure, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.

I hope this helps.

Fat grafting doesn't do anything differently than implants, i.e. it increases volume but doesn't change the indication for a breast lift if it is indeed appropriate. Go on a few consultations for a true evaluation and recommendation. Further, you could downsize and not get a lift; you can wait and see if you are happy with their appearance. If not, a lift could then be performed.

Dear PandaBear888,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

That seems to be the new thing. Implants with fat injection around them. I don’t think very much of the idea and we will certainly find out the problems in the further. But if you want to try it go ahead. Just don’t expect much from the fat part itself. It’s just a gimmick at this point. But all plastic surgeons are jumping in the bandwagon as they usually do

You can certainly replace with smaller implants and compensate with fat grafts .On the lateral view you are sagging a little and may want to consider an internal breast lift with absorbable mesh

No, fat grafting will not avoid the lift and your breast do need lifting, especially if you go down in size.

Thanks for posted photos and yes your requests are possible. But best yo virtual consult with… the Fee from $10,000+. Must have preop mammogram.

Hello! You certainly can replace the implants with whichever volume you feel comfortable with. From your photos, the right breast appears slightly larger and more lateral (towards your arm) than the left so I would recommend intraoperative sizing of the implants to match if this bothers you at all. Downsizing the implants does carry a risk of having the breast tissue droop and often patients that downsize are advised to consider a lift. In your case, your breast tissue is starting to slide off of the implants at the bottom pole of the breast while the nipples remain in good position. This is called pseudoptosis and it would not improve and may even worsen with downsizing the implants. This is generally corrected with a breast lift to remove the extra lower pole breast tissue, redrape the breast tissue around the implant and it is advisable to allow for nipple areola repositioning if the lower breast pole is tightened (otherwise it can pull the nipple down, cause a teardrop shape of the areola and/or flatten the lower breast pole). Just something to be cognizant of although I understand your desire to avoid a lift if possible. If you have saline implants in place, you can pre-rupture them in the clinic 2-4 weeks before your planned implant exchange to allow the breast tissue to naturally tighten up a bit on its own (unfortunately, this cannot be done with silicone implants). In terms of fat grafting, some of the fat will resorb (usually about ~50%) and so it is advisable to overfill some to account for this. I would caution against picking a volume of fat grafting ahead of time and rather aim more for a desired shape/volume appearance to guide your surgeon. Hope that helps provide some guidance. wish you all the best!