Gummy Bears vs Fat Transfer?

Fat transfer, while an option, is a less reliable means to deliver volume for augmentation. It is much more effective as a compliment rather than a substitute/replacement for an implant.

The unpredictable nature of fat grafting is the limiting factor. The degree of fat graft take and subsequent long term viability has the greatest impact on final result. Graft take can vary greatly from 50-75%.

With regards to your specific question, I would recommend implants over fat grafting for the purpose of delivering volume.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Dear Enthusiastic923585,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Dear Enthusiastic923585, thanks for sharing your questions, first will be good to see some good pictures to determine what will be the best approach for your case.Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

First, implants are not a forever device, but there is no mandatory reason to remove them just because a period of time has elapsed, most commonly misunderstood to be 'every ten years'. The only reason to reoperate on breast implants is if there is some cosmetic reason (they have become too big or too small for your taste, implant displacement, capsular contracture, or changes to your breast tissue over the years), or implant rupture. Implant rupture can only be detected via ultrasound or MRI. the good news is that most surgeons have high resolution ultrasound in their office and offer free surveillance of your implants for a lifetime (it takes about ten minutes in your surgeon's office). Next, evidence based best surgical practices inform us that an inframammary incision leads to the lowest rates of complications and reoperations. The nipple incision offers the highest risk. Finally, fat grafting leads to a VERY different result than breast implants. Further, fat grafting requires an additional procedure on another body part(s) in the form of liposuction. So, if you don't have suitable donor sites for liposuction, fat grafting should not be performed. If you do have areas of disproportionate fat distribution, liposuction can actually be beneficial. In some situations a hybrid approach, implants and fat grafts, can yield the best result possible. No recommendations here, that would require a consultation, either in person or via Zoom.

You first need to decide if you want to proceed with either surgery as it seems you have reservations. I prefer to place implants through the inframammary fold. This allows me to visualize the pocket for inspection and optimal placement. It also carries a lower risk of capsular contracture. I would caution you in your consideration of fat transfer as this can lead to microcalcifications that can interfere with future mammography.

It's great to see a patient who is so well educated. Yes, implants are not "lifelong devices" but they can last many years. They are FDA approved for 10 years. Without a doubt, the best access point is the crease under the breast. It has the lowest complication rate (compared to the areola) and makes access for future removal/exchange very easy. I even do implant exchanges, through the crease, as a 30 minute awake procedure.

Personally, I do not like gummy bear implants since they are firm, but prefer the softer ones. Second, you did not say how large you are now and what size you would like to be. With fat, you may gain a half to one cup increase in size. Not all the fat transferred will survive. Implants will be more consistent in size and you can go larger than just a cup.

Hi - these are great questions that you have and sounds like you are being thoughtful in considering a breast augmentation. There is a lot that goes into the decision of implants versus fat transfer including your anatomy, your goals and aesthetic desires, longevity, etc. I think that these questions are best answered by an in-person consultation with a board-certified plastic surgeon so that they can go over the details of all the options including technique and the risk and benefits of each.