Is it safer to have fat transfer in the subcutaneous plane or the pectoral fascial plane? (Photo)

I had my breast implants removed 6 months ago which has left me with small droopy breasts. I can't face having implants again and so have been to see 2 dr's about fat transfer. The first dr said I should have a mastopexy as one operation and then go back to have fat transfer as a 2nd op. He also said the fat should go under the skin only as this is safer. But the 2nd dr said I could have a mestopexy and fat transfer in one operation and the fat would go around the muscle. Which option is best?

Doctor Answers 3

Fat can be placed at any level within the breast.

Fat grafting to the breasts is an excellent option to increase the volume without implants. Looking at your photographs though, unless you add a very large volume of fat you will probably need a breast lift as well. In order to add sufficient fat to avoid that you may need to have more than one procedure.The advantage that you have is that your breasts have been stretched by the presence of implants and there is plenty of room within the skin envelope to add the fat grafting without excessive tension.If you wish to avoid the breast lift I would try fat grafting first as much as your doctors thinks can be done in one setting. At that point you can reassess and if necessary either do a lift or further fat grafting with or without the lift as needed.


Cleveland Plastic Surgeon
4.9 out of 5 stars 21 reviews

Fat

You could have mastopexy with direct fat grafting to the muscle during the first session if there was any concern with blood supply to the skin flaps of the mastopexy... And then a second, or third session of fat grafting  alone. The risk is damaging or decreasing the blood supply to the mastopexy skin with the fat grafting if its done too aggressively. Good Luck.

Breast lift and fat grafting

Breast lift and fat grafting can be done in one stage. To optimize take of grafted fat, it needs to placed in small aliquots in multiple planes, including under the skin, in the breast tissue, and the muscle. Best, Dr. Yegiyants

Sara Yegiyants, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 6 reviews

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