Is fat transfer to the breasts permanent? How severe is the scarring?

Question

Hello I am 24 years old and am considering increasing my breast size one cup size. Can fat transfer do that? It seemed like a good option because they would feel a lot more natural I believe. I mainly wanted to know if it's permanent and how is the scaring after surgery.

Ronald J. Edelson, MD · Answer

You are correct in saying it sounds like a good idea.  Unfortunately, in practice, the results are not very good.  Most of the fat ends up being absorbed.  I have seen very few cases where there is much if any size increase.

Constantino G. Mendieta, MD · Answer

Hello, and thank you for reaching out to us.A fat transfer to the breasts could certainly help you achieve the size increase you are looking for. Your surgeon will take fat from your body, in most cases your abdomen, and transfer it to your breasts.We cannot be certain without a consultation, but I believe that you could certainly achieve the results you have laid out through a fat transfer. Remember, only consult with a board-certified plastic surgeon and don't be afraid to request before-and-after pictures. Every surgeon has a different style, so you want to be sure your vision is reflected in the work they have done.It is all about designing the perfect plan for You. Survival rates of the fat transferred is about 60 to 70% of real, natural fat, that was yours to begin with. Good luck, please let us know how it goes.- Dr. Constantino Mendieta

Michael M. Omidi, MD, FACS · Answer

The fat that remains after the initial resorption should remain there permanently.  Like other fat cells in your body or breast, there may be changes with age.  However, it is not a "temporary" event. As we age some of the native fat from the breasts will atrophy.Scars are small incisions for liposuctioning and for the needle used to transfer the fat. An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice. Best of luck. Dr. Michael Omidi

Allan M. Kalus, MD · Answer

Hi and thanks for your question! Yes fat transfer to the breasts can be permanent (and the scarring minimal) but it is obvious from some of the answers given that it depends on the Surgeon and the technique. When I started doing this procedure about 3 years ago I was getting about a 50% survival of the fat. This has now increased to 80%! In some women their breasts have increased in size (rather than their hips!) as they have gained weight! So, yes it is permanent! To be suitable, you have to have some spare fat (usually on the abdomen, hips or thighs). This fat is then harvested in a procedure similar to (but not identical to) liposuction. The fat is then processed before being grafted as multiple small injections into the breasts. Only about half the volume of fat harvested is suitable for grafting.So, if 600cc of fat is harvested then 300cc would be available for transfer. This equates to 150cc per side. If, as expected, 80% survives your volume increase would be 120cc which is 1 cup size if you wear a 32 bra. For larger bras, the cup sizes are larger so you would need a little more!If it helps, I was recently discussing breast augmentation with a young female plastic surgeon with whom I work. We were talking about all the usual things:-silicone or saline, in front of or behind the muscle, textured or smooth. I then asked her if she, with all her knowledge as a Plastic Surgeon, were ever to have breast augmentation, what would she choose? Without hesitation she replied that she would only ever have her own fat put in her breasts!So there you are! Find a surgeon who gets good results and have your breasts enlarged while getting rid of some unwanted fat and (best of all) avoiding implants! Best wishes

Robert Singer, MD · Answer

While it is possible to do fat injections to the breast as a
cosmetic augmentation, currently, it is felt that only up to 50 of transplanted
fat successfully survives in its new location. The remainder doesn’t go
elsewhere. It is just resorbed by the body. Fat injections to the breasts may
be useful in making small modifications and correcting asymmetries, but many
plastic surgeons feel this procedure is not as reliable or predictable as an
augmentation with breast implants.

The concerns: Long term results do not yet exist, like any
procedure there are potential risks including infection, oily cyst formation, mammographic
changes which can be confused with breast tumors, asymmetry, the results are
not totally predictable and are inconsistent as compared to breast implants
which are the most extensively tested and FDA approved medical devices with a
lengthy record of safety and efficacy, it is a lengthier procedure, more
costly, may require additional sessions of fat injection, and to optimize the
results usually requires a prolonged use of an external device called BRAVA
which is uncomfortable and has a poor record of patient acceptance and compliance.
Scarring is usually minimal.

There are an increasing number of satisfactory reports of
this procedure being performed, but there are still a wealth of additional unresolved
issues: The extent of resorption of the fat, the large volume of fat that is
required to produce an improvement, the limitation of the amount of the very
modest augmentation that is possible (usually only up to ½ or one cup size), and
specifically a concern about long term safety with regard to tumor stimulation (does not appear to be a problem so far),
which all need to be further investigated with valid scientific studies before
fat injection should be viewed as a standard procedure for cosmetic breast augmentation.Robert Singer, MD  FACSLa Jolla, California

David S. Rosenberg, MD · Answer

fat transfer is permanent.  If you lose weight, some of that fat loss may come from your breast.  There is very little scarring.  It gives fantastic, natural results!!

Khashayar Mohebali, MD, FACS · Answer

Thanks for your question.  Fat grafting to the breast is a good alternative because it gives a natural results with no scars on the breasts.  The fat is injected through a needle so no cut is made on your breasts.I advise patients that fat grafting is best if you're looking for about a half of cup to one cup increase.A percentage of the fat placed into your breast will get reabsorbed initially but the rest that remains is permanent.

Joseph L. Grzeskiewicz, MD, FACS · Answer

As long as the size increase we are looking for is relatively modest, say in the one cup size range, fat transfer can be a great option to enlarge the size of the breasts without using implants.  Typically we harvest (remove) the fat from another area of the body like the tummy, flanks, or thighs with a liposuction-type procedure, and we prepare it specially as a graft to be reinfected into the breasts.  From the standpoint of scarring, the only scars you would have would be the same small puncture scars next to the harvest sites that you would have from any liposuction procedure (usually about 3 mm in length and hidden in creases) and then we make small needle punctures on the breast, usually around the border of the areola or in the fold below the breast to inject the fat.  Those usually leave no scar as it is the same size as when you get an IV in your arm.  Fat transfer is one of the most highly technically sensitive operations we perform, and this among many other factors can influence the success, and thus the permanence of the result.  The way that the fat is harvested is critical, as is the way that it is prepared, and finally the way that it is injected.  Each part of the process is technically important, and some ways of doing it are more successful than others.  This is why it is important that you find a board certified plastic surgeon with a lot of experience in fat transfer to perform the procedure for you.  In addition, not only should your surgeon be certified by the American Board of Plastic Surgery, but he or she should also voluntarily participate in the Maintenance of Certification program administered by that board. This is the best way to know that your surgeon not only has the best training and experience for the procedure, but that he or she has maintained currency in the certification requirements as opposed to practicing on a "lifetime" certificate which has only been reviewed once at the beginning of his or her career. For more information on this you can visit ABplsurg.org or ABMS.org. Good luck.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Fat grafting is permanent; you will lose some volume over the first two months but that is due to loss of swelling (fluid reabsorbed). The fat volume that you gain will be permanent and be altered only by weight gain and loss that is in your control. Please make a consultation to discuss details of how much volume you could expect to gain.

Is fat transfer to the breasts permanent? How severe is the scarring?

Answers (9)

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