Going from Saline Implant to Fat Transfer Breast Augmentation?

I have had saline implants for 8 years. I know that I will need to make a decision soon about what to do next. I'm considering fat transfer augmentation. I know I will first need to remove the saline implants. Can the saline implant removal and fat transfer procedures be done at the same time? I am 5'6" and about 120lbs. I am also concerned about not having enough fat to harvest and re-inject. However, I have read about the addition of stem cells to the harvested to help with this issue. If Fat Transfer is not an option for me then what other options do I have? Thanks!

Doctor Answers 4

Fat Grafting to Breast after Saline Breast Augmentation

First - If you are happy with your current appearance I would suggest doing absolutely nothing. Your current implants may last for many more years. On the other hand if you are having issues with the implants and simply want to eliminate them fat grafting is definitely an option. The amount of graft material  present can be a limiting factor in some patients. However it all depends upon what your base size is an how large you wish to be. Breast ptosis/ sagging can also affect the final decision. With  the fat  transfer approach I would try to place fat between the skin and gland. I would harvest an appropriate amount based on how much I feel I can place. I would then remove the implant and perform a total capsulectomy. After you have healed, if you are desiring more volume another liposuction could be performed and additional fat added  below the breast as well as between the breast and gland. There are many options but much of the decision will be based on your base anatomy and how much fat for grafting you have.  Best of luck   Dr Harrell

Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

The fat would be placed between your skin and your current breast capsule


There are a few things to keep with regards to fat grafting breast augmentation after implants are removed:

1) the fat will need to be placed where there is blood supply which will be between your skin and your old implant breast capsule, not in the breast implant pocket

2) on average, one cups size of increase can be expected with fat grafting.  For an average size woman this is around 250 ml of fat.  most women require 2 fat grafting session

3) you will need implant removal first.  +/- followed by residual fat tissue expansion such as Brava system all before fat grafting can be done.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Switching saline implants

First of all, you are mistaken in thinking that just because you are approaching ten years that you are going to have to do something.  I have seen multiple patients with 40+ year old salines that never changed them and were perfectly fine.  So, unless you are unhappy with the result in some way, do nothing. 

You can't take the implants out and fill up the pocket with fat, it doesn't work that way.  Basically, you would need to stay an implant patient and either replace the salines or change to gel.  Hopefully you will realize that maybe you need nothing.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast Fat Transfer and Saline Implants possible but technically difficult

If you are happy with your Saline Breast implants keep them until or if you have a problem.

If you have a problem with your Saline Implants such as folds or contour irregularity or capsular contraction then Fat Transfer may be helpful.

Your current Breast Implants have a capsule around them and injecting into this area which is poorly vascularized (fewer blood vessels) will limit the amount of fat which can survive. As mentioned earlier by Dr Repta the fat would have to be injected into the skin overlying the capsule, which if your skin is thin could be very difficult.

Fat Transfer of the breast has been successfully done to treat capsular contraction and contour deficiencies by injecting the fat around the implant which has been left in.

However with Saline Implants the risk of puncture of the implant during fat injection must be considered.

You will need an honest estimation of how much size can be achieved if the implants are removed by a Plastic Surgeon experienced in this technique.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.