I Have Loose Skin on my Breasts. Would a Fat Transfer Make More Sense then Removing the Skin Itself?

Question

I have C cup sized breast with loose skin, sagging breasts and stretch marks. I was considering a fat transfer to plump them up but read on here its not very reliable. Would it make more sense to just remove the excess skin? Are there any other suggestions? I am 5'2, 120 pounds.

Larry S. Nichter, MD, MS, FACS · Answer

From your description sounds like you mike benefit from both procedures done at the same time. Advantages of using your own body fatFat cells are natural and native to your own body; no foreign or The California Breast Lift is a procedure which transfers unwanted fat from the abdomen or thighs to the breasts. Uses your own natural fat cells. are necessaryHarvesting of fat by liposuction has the added benefit to enhance your shape by removing unwanted fat zonesThe breast can be shaped or sculpted in more detail than is possible with implants aloneMinimal incisions reduce the possibility and degree of scarringNo implant is used, therefore there is never a need for replacement, and there is no risk of rupture, hardening, or ripplingRecovery time is faster: about 1 week and usually less discomfort than with implants

Steven Goldman, MD · Answer

Current issues with fat transfer to the breast include:

	
		high revision rates because of the variability of fat survival;
	
		potential interference with mammography, ultrasound, and MRI for breast cancer screening;
	
		theoretical possibility that injected fat could increase cancer rates (this is not likely but possible);
	
		lower volume increase than typically possible with implants;
	
		generally less upper breast fullness than implants can provide.


	Fat transfer to the face, buttock, or breast has a role in properly selected patients, but if you have a significant amount of loose skin, it will not likely suffice. Given these issues, and the well proven nature of a breast lift when performed by a qualified, experienced surgeon, a breast lift may be a better option for you. Breast implants must also be considered if the breasts have lost volume but are not truly droopy (this is called pseudoptosis). These issues could be clarified based on your goals and physical exam.

	Hope this helps.

Vincent N. Zubowicz, MD · Answer

Although fat injections (transfer) has been employed for years, we really don't know the fate of the injected fat. It is being studied now at various research facilities. Although apparently safe, the results are unpredictable. Treatment for your breasts, in my opinion, should be by more conventional methods (mastopexy).

David Shafer, MD, FACS · Answer

Without "before" pictures or seeing you in person, it is impossible to answer your question.  However, if you have loose skin and stretch marks on your breasts, I doubt that fat transfer will be very useful.  You likely need a mastopexy and possibly an augmentation as well if you need to replace volume.

	 

	Good Luck.

Steven H. Williams, MD · Answer

Thank you for your question. In our San Francisco area practice we routinely perform fat transfer for buttocks enhancement, facial rejuvenation and breast enhancement.  The challenge in your situation has to do with the amount of breast sag you have and the amount of excess skin.

	In most cases, fat transfer can't match the changes that a breast lift (mastopexy) can provide.

	Find a board certified plastic surgeon familiar and experienced with both techniques and see what's right for you.

	I hope this helps.

Scott C. Sattler, MD, FACS · Answer

If you percieve that your breasts are saggy - fat grafting alone is not the solution. A well done breast lift is an amazing procedure that can totally rejuvenate the breast. Fat grafting can add some volume, but not as reliably as an implant. I do fat grafting to the breast in my practice, and recognize its limitations.

Mathew C. Mosher, MD · Answer

There has been a resurgence in interest and usefulness of transferring fat to all parts of the body to achieve shape improvements. Using fat as a means to augment the deflated breast has also been more successful with strict patient selections and careful technique. However, when there is loose skin on the breast the options are to fill the breast skin envelope adequately or tailor and reduce the excess skin with a breast lift. Often a combination of adding volume and tightening the skin works well.

	Not all Plastic Surgeons are supportive of the use of fat transfer to the breast for elective augmentation. Predictable results are not yet possible and there are still some unanswered questions about the long term implications of this procedure. Having a consultation with a Plastic Surgeon should clarify your options.

	Dr. Mosher

Usha Rajagopal, MD · Answer

Thank you for the question. Fat transfer is an option. Fat to the breast would increase your breast volume and size. It will not give an uplift to the breast, your stretch marks will appear the same, if the nipple is a little droopy and the breasts are a little droopy, the position of that will appear the same even though you will have more volume. I do a lot of fat transfer to the breast and depending on the technique, the take or the amount of fat that lives is quite good. You are going to be substituting volume for looseness, so the breasts will still sag a bit, but they will be bigger.

Peter A. Aldea, MD · Answer

In the presence of sagging breasts, especially large, deflated sagging breasts with stretch-damaged skin - adding volume is NOT the answer. Neither an implant nor fat grafting would give you long-lasting, perky breasts. the answer is to lift the breasts by expert tailoring of the breast skin, removing the excess skin and lifting the breast mounds to their youthful positions.

	Good Luck.

	Dr. Peter A Aldea

Steven Wallach, MD · Answer

If your breasts are sagging, it is better to remove the excess skin and lift the breasts than try to attempt to fill them with fat.

I Have Loose Skin on my Breasts. Would a Fat Transfer Make More Sense then Removing the Skin Itself?

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