34, 60kg, 165cm, how many ccs do you think I'll need to add volume to upper pole? (Photos)

Question

I have bad explant of 330cc implants and lift with 120cc fat transfer previously. I am looking at getting more fat transfer and I want more volume in the upper pole and lesson look of stretch marks. How many ccs do you think I will need? And costs? I don't mind having small breasts but the shape/cleavage/stretch marks is what I want to fix. I am 34, 60ks and 165cm tall.

Alan Gonzalez, MD, FACS · Answer

Hello @Intuitive7986, thank you for your question. In order to extract a larger amount of fat, it is important to revise the surgical process and perform Liposculpture. I can see from the size of the breasts that we are talking about 350 grams of fat that will be used to make a fat injection to add volume to the breasts. 120 grams of fat is very little and that is why you see the flaccidity and that is lack of fat in certain places. For more information and recommendations is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Joel Patrick Maier, MD · Answer

Your plastic surgeon did a very high quality lift, excellent job. And yes, fat transfer can help fill the upper poles to help with shape and volume. Thank you.

Gary M. Horndeski, MD · Answer

Unfortunately, the lift technique you had was inadequate. The technique I recommend is 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 if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

There is no standardization to how much fat should be transferred. Especially since the surgeon can’t predict how much will survive.  Also it is not uncommon for surgeons to do it in stages to gradually build up the amount of fat that is retained.

Daniel Barrett, MD · Answer

Dear Intuitive7986,
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

Hilton Becker, MD · Answer

Breast volume can be increased with fat grafting. Further volume can be added with PRF Obtained from the patients own blood .Additionally absorbable mesh can be placed to increase the volume
stretch marks  and thinning skin can be treated with ultra micro fat grafts that are injected directly into the skin.

Connie Hiers, MD, FACS · Answer

Fat is placed in actual breast tissue so the whole beast will be enlarged, not just the upper pole. The amount of fat transferred is limited by the amount of breast tissue.  More volume is obtained with implants than fat, and implants can be placed behind the muscle for more upper breast fullness which is not done with fat. Hopefully, your tissue will support 150 to 200 cc's of fat this transfer, and hopefully you have donor fat available.

Mats Hagstrom, MD (license on probation) · Answer

Well done fat transfer can increase breast size by about 50% or 1/2 cup.
Fat transfer however does not change the shape of the breast in any significant way.
It’s not a good procedure to develop breast projection.
In order for fat transfer to be affective fat needs to be grafted through all tissues and cannot be grafted in one small area.Fat grafting is not successful or a good procedure for giving upper pole volume. The correct procedure for that is a breast implant.
Fat transfer is simply limited and is not a good procedure for creating shape.
120 mL of fat is a very conservative volume for breast fat grafting.
My typical volume on someone like you would be around 500 cc per side.
Do not expect fat transfer to give upper pole volume or breasts projection. The procedure simply doesn’t accomplish that.
Theoretically fat could be grafted in one part of the breast but the amount of fat they can be successfully grafted in the small area severely limits the total volume that the breast can be increased in size.
Focusing on grafting only the thinnest part of the breast severely limits how much fat can successfully be grafted to.
The success of grafted tissue is based on the availability of host tissue and the upper pole of your breast has virtually no host tissue to support any significant volume of grafted fat.
This is the primary reason fat grafting fails in creating desired shape and is good for increasing volume only.
Potentially specific shape or volume in part of the breast could be achieved by having multiple rounds of fat transfer.
As a single procedure it will not accomplish what you are to obtain
To get a significant change in shape would probably require four rounds of fat transfer to the upper part of the breast.
Fat transfer is inherently a subtle procedure.
For what you describe implants is by far the best way to do that. 
Best,
Mats Hagstrom MD

34, 60kg, 165cm, how many ccs do you think I'll need to add volume to upper pole? (Photos)

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