Are Implants Plus Fat Grafting the Best Option for Me? (Photo)

I had a consultation to get breast implants and the doctor informed me that I have constricted breasts and a wide breast bone. I want to get small implants (I believe the size was 235cc) but even so the doctor told me that it is possible I may not have enough fat under my nipple. He said that I will still have a wide gap therefore in addition to the implants it would be an option to have fat grafting to improve my small breast base and my wide breast bone. Would other doctors recommend this?

Doctor Answers 10

Breast Augmentation: It is likely that you could choose implants or fat transfer but not necessarily need both.

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Thank you for your question and the photo.

It's always hard to second guess someone who has already seen you.  It is likely that you could choose implants or fat transfer but not necessarily need both.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

Fat grafting is not the best option for you

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Based on your photograph, you do not have tuberous or overly constricted breasts.  Your nipple/areola to infra-mammary fold distance is slightly shorter than average and your nipple/areola are a bit laterally displaced. But both of these situations are easily dealt with during the course of a standard breast augmentation. 

As for fat grafting, I too would strongly recommend against it in your case. Your case is very straight forward and I'm surprised that any ABPS-certified plastic surgeon would suggest grafting as an option. That yours did is certainly cause for concern so I'd certainly advise seeking a second opinion from a plastic surgeon who does a lot of breast work. 

Whether or not fat grafting to the breast is either safe or beneficial remains to be seen. The risks and complications are significant and would personally only consider it for a very select subset of breast reconstruction or major revision cases - where there are significant irregularities that can not be addressed with an implant or tissue manipulation alone. 

But again, in straight-forward breast augmentation cases like your own, fat grafting not only adds unnecessary costs to the procedure but additional risk of complication as well (which Dr. Horndeski lists in his answer).

Say no to fat grafting in breasts

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Thank you for your question.

I strongly recommend you do not contemplate fat grafting in breasts as it is still a highly controversial technique. Fat grafting anywhere else on the body to improve contour deformities is safe and commonly practiced. However, fat grafts to the breast can bring numerous unwanted  risks and complications, ie; fat necrosis, contour irregularities, false positive results on mammograms, etc. An experienced plastic surgeon can easily resolve the 'wide gap' problem. My advice, get a second opinion.

Kind regards,

Dr. H

Breast implants alone would likely provide a very nice result

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From the one photo alone I am inclined to believe that breast implant alone would result in a very nice result.  You would likely need slightly different size implants as your breasts seem to have some volume asymmetry.  Fat grafting could also achieve a satisfactory result but this would require more than one session to accomplish the ideal result.  My guess is that breast augmentation alone will be the most straightforward, least expensive, way to achieve improved volume and symmetry of your breasts.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

Is Fat Grafting Right for Me?

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I agree with your doctor. If you want implants, fat grafting would be an excellent option to improve overall appearance. In the end, whether or not your doctor proceeds with fat grafting will be based on your desires. To ensure good results, make sure that your surgeon is experienced and board certified.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Breast augmentation and fat grafting

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Your posted photo is not a true frontal and your shoulders are not level as you are not standing up straight. This makes it difficult to assess your current state. I suspect your breasts are fairly symmetric. I assume that by wide breast bone you mean large spacing between the bases of the 2 breasts. If you look at the upper inner edge of both breast creases you will see that they are not that far apart so I do not know where the idea of a wide breast bone comes from. I fail to see what fat grafting would add to the picture if you have breast implants (especially if you get appropriate implants for your body size) other than to cover the edges of the implants if they become highly visible after placement. The nipple to breast crease distance looks a little short but I am not sure it is severe enough to be constricted breasts.

Be careful of focusing on the number size of the implants in cc's the implant dimensions of diameter and projection are equally as important and in some cases more important.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

You dont need fat injections

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I cannot say for sure without examining you, but I do not see any visual suggestions of constricted breast.  I do not think there is any indication for you to need any fat injections to the breast at all.  I think you will do fine with a straight forward sub pectoral (under the muscle) breast augmentation.  I hope this helps!

Implants alone

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Fat grafting to the breast is a fad thing these days and can lead to problems with lumps and bumps that may mimic breast cancer.  It is best to use implants alone if possible in my opinion.  You just need an implant which is wide enough to get close to the midline so you don't have a big gap in the middle.  Those with tougher starting points really need to go to the most experienced plastic surgeons and see many photos of not just any patients but specifically ones who have a resemblance to you.

Are Implants Plus Fat Grafting the Best Option for Me?

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Yes the photo demonstrates inferior pole restriction. I also recommend implants with fat grafts. But you need a doc very experienced in doing both., 

Fat Grafting And Breast Implants

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Dear wondergirl98,

Based upon your photo, it does not appear that you have constricted or tuberous breasts. It also appears that position of your breasts on your chest is more due to your chest wall shape rather than your breast bone size.  Women who have a more rounded(convex) chest wall shape will tend to have their breasts lay more lateral than women who have a more concave chest wall.  Implants will increase your breast size and the larger size will give you more in a bra or a top to achieve the cleavage look you desire.  Implants however will not move your breasts more towards the middle of your chest.  That being said, it appears that implants alone should be able to give you an aesthetic breast shape and size without fat grafting.  I would recommend  you obtain a number of consultations with board certified plastic surgeons before deciding to proceed.  Hope this helps.

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.