Fat Transfer with Breast Implants? Is this something I should consider or should I just get new implants?

My saline implants are over the muscle, and 12 years old. At this point I have had some breast tissue loss, some rippling and generally some overall changes. I was wondering, I have a local doc who said I could avoid getting new implants by doing fat transfer to fill in the problem areas and reshape them. Is this something I should consider or should I just get new implants?

Doctor Answers 4

Implants versus fat transfers

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Fat transfers (in the right hands) is a great way to address some rippling/ wrinkling of breast implants, as well as to add a little more fullness (especially in the upper poles of the breasts) and hide some contour irregularities or asymmetries.  After having your implants in for 12 years and with some tissue loss from atrophy of your native breast tissue, there will be less room to inject the fat and you will more than likely require multiple sessions depending on the severity of your issues and what your goals are.  There are advantages and disadvantages for different options that you have.  Replacing your saline- filled implants with silicone gel implants and placing them under the muscle will also help to address your rippling issue and give them an overall better and more natural looking shape.  If you are considering fat transfers I would recommend you choose a plastic surgeon who has had a lot of experience with it as the success of the technique depends a lot on the operator.  I would also try to get consultations from more than one board certified plastic surgeon as the best procedure will totally depend on your own specific problems and what you have to work with.  Best wishes.

Fat grafting over implants to improve appearance is an option

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Fat grafting can be an excellent option to add fullness to the upper pole of the breasts, without implants or even over the top of implants. Fat can also be used to improve assymetries and help with rippling.

However fat grafting is very technique sensitive, and surgeons who do not pay attention to each aspect of the process may not get consitent results. Every component of the procedure  from fat harvesting, to fat purification, to micrografting, and even preparing the bed of time with techniques like the Brava device, can make a difference. With careful attention to every step, anywhere from 70-90% take of the injected fat can be expected to survive.

We have installed the first Liquid Gold mini fat bank in the US, and with just one liposuction procedure we are able to successfully store fat, which allows us to save as much fat as needed for one or more procedures.

That sounds like a plan from a doctor that doesn't do breast augmentation.

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That treatment plan sounds like something I frequently hear from family practice doctors or others that are trying to develop "fat grafting" clinics and don't perform breast augmentation otherwise.  If this is not the case with that doctor then my apologies.

You have 2 issues going on here; 1)rippling saline implants with minimal soft tissue coverage, and 2) most likely some capsular contracture.

I would suggest switching to silicone implants and separating the scar tissue to prevent implant distortion.  If you still have areas that require filling THEN you may consider fat transfer to the breasts.

Please know that fat transfer to the breasts is a very contested topic right now because of problems with some of the fat not surviving and creating lumps and mammographic (x-ray) abnormalities which may lead to unnecessary breast biopsies.  Please make sure if you have fat grafting to your breasts you see a plastic surgeon that is very well aware of these issues.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 293 reviews

Fat grafting to the breast for implant wrinkling

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I think you'll probably be disappointed with the results of this treatment plan. The fundamental issue you are facing is a wrinkling implant with minimal soft tissue coverage. The most reliable way to correct this problem is to change to silicone implants and move them behind the muscle. I've done fat grafting for a few patients with their implant and coverage situations optimized (as described above), and have still not had complete correction of implant wrinkling. The use of acellular dermal matrices (Strattice from Lifecell) is helpful in this situation, but it is expensive. Seek out a board certified plastic surgeon to discuss your breast revision questions.

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.