I want to increase my breasts at least 2 cup sizes. Could I get both an implant and fat transfer?

I am considering fat transfer to my breasts, but after reading a lot of reviews/looking at photos, it seems that I will not be able to go from a 34B to at least a 34D with that procedure alone. That being said, could I get a silicone implant along with fat transfer for a more natural feel/look than just an implant alone? Also, I live in Ontario, Canada. What would the price be for that and can you recommend any doctors in the Toronto area? (3 hour radius). Thanks for any advice!

Doctor Answers 9

Breast augmentation with a combination of fat and implant

  • The vast majority of the time an implant alone does great. There are times when adding some fat can be beneficial.  The most common use would be to better conceal the upper pole of the implant to give a full result but still looking natural.  The extra fat can add volume for sure, but its bigger role is concealing the larger implant.  Therefore use the implant for the volume you want and the fat to conceal it. Although a consultation would be needed to say for sure, it is quite likely that you would be able to have an implant to get the D cup you desire.
  • The fat grafting can do a great job but must be meticulously placed.  This is true at all times to improve fat survival rate and the cosmetic result.  However, it is even more true in the setting of an implant as you would not want dead fat around a foreign body. Make sure that your surgeon does this as a significant part of their practise.
  • Dr Rodger Shortt is a plastic surgeon in Oakville.  He strives to be the best plastic surgeon and is one of the few plastic surgeons in Canada with a top 5-star rating on Realself, RateMD, and Ontario Doctor Review.  He is an Assistant Clinical Professor and the Director of Cosmetic Surgery Training for McMaster University.  He serves patients from the GTA including Toronto, Oakville, Mississauga, Georgetown, Brampton, Burlington, Milton, and Hamilton. 


Toronto Plastic Surgeon
4.9 out of 5 stars 56 reviews

Implants with fat transfer

Thank you for your question.   From the description of your goals, it sounds like you would benefit from breast implants.  Fat transfer alone is limited in the ability to increase breast size and in your case would likely take multiple treatments to achieve your goals.  Without a physical exam, it is obviously difficult to give the best advice.  If you have adequate breast tissue coverage, you may do very well with a silicone gel implant alone.  In some cases, it is a good idea to combine fat grafting with an implant.  Particularly in patients with widely spaced breasts.  Fat can be used to improve the cleavage line and in some very thin patients can be helpful to camouflage any implant wrinkling or visible edges.  Good luck.  

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon



Can I get implants and fat transfer for breast augmenation?

It seems that you have a few options. One you could have multiple sessions of fat grafting to your breasts. This will allow you to get the look that you want without using implants. The downside is that it is multiple surgeries.

The other option is augmentation with an implant which can give you very natural results. 

Finally, you can combine the two procedures. Fat grafting can help make the augmentation more natural looking depending on your breast anatomy.

As for doctors around you, I would recommend checking out the aesthetic society website- surgery.org to find a surgeon near you.

Good luck!

Ryan Hoffman, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 36 reviews

Breast augmentation

Hello and thank you for your question. Fat grafting can be combined with implants in the right patient.  However, for most patients, optimal results can be obtained with a submuscular silicone implant, which can have a very natural appearance and feel if good technique is used.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 92 reviews

Combining fat transfer and implants

This is now done for breast reconstruction because there may be insufficient coverage for the implant alone. However, in a purely cosmetic augment, the implant alone should be used as it will provide a consistent result.

Implant with a fat transfer?

Implants and fat transfers can be combined, but as you can already see fat transfer can be limited in the volume it can reliably provide. From a B to a D is commonly done with implants alone and may be your best and most predictable outcome.  Lean towards silicone gel implants provided you are comfortable as they tend to feel and look more natural .

Hope this helps.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 98 reviews

Fat grafting and breast implants

Unless you have some sort of deformity or indention of your breast(s) that needs to be filled with a fat graft, it's really not necessary to combine fat grafting with breast implants.  Silicone looks and feels very natural so it doesn't make much sense to do both.  

Implants or fat transfer?

You can achieve a natural result with appropriately sized silicone breast implants placed in a sub-muscular dual plane without the need for fat transfer.  In terms of breast augmentation, implants generally provide a more predictable result than fat transfer.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck! 

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

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.