Fat transfer to the breast can be a great option for many patients. The most significant limitation is the amount of fat that can be transferred at any one time. In general, I try to not transfer more fat than would double the size of the breast. Of the fat transferred, some will be permanent and some will be absorbed. We refer to this procedure as Up A Cup because that's a realistic expectation. It is possible to have fat grafting done more than once. As a general concept, doubling a very small breast is still not a very large breast. Doubling a full C or D cup can make a substantial difference because it can mean adding several hundred cc's. The highest success rate is in healthy patients where healthy tissue is transferred. The fat transferred needs to be in small individual particles that are as evenly placed throughout the breast tissue, fat and muscle as possible. Using good technique and minimizing tissue trauma is critical. Avoiding the use of tobacco products before and after the procedure is imperative.We routinely do these procedures while patients are awake, using no needles, no scalpels and no sutures. The recovery is easy. You see immediate improvement not only of the breasts but also in the area where the fat was taken originally. I don't think the BRAVA/fat transfer combination has been proven to be more successful, but it is an exciting concept that I believe may help high-volume fat survival. In terms of finding the right surgeon, I would focus on finding someone who has a lot of experience with fat transfer to the breast. That is in my opinion. It's more important than using the BRAVA combination. I hope that helps. Best of luck,Mats Hagstrom, M.D.