Is it possible or safe to inject 1000-1200cc into each breast for a fat transfer to the breast?

People, including doctors, think that "40% - 60% of my fat lives" when fat injection is done in large volumes to the breasts.
I believe that this does not, and cannot happen.
First, most of the cells in my research using the trypan blue exclusion method are dead after harvesting of fat with the Coleman method and apparatus. Maybe 25% survive. There are better studies done with radioisotope uptake which shows even lower survival rates.
The body incorporates grafts by producing vascular ingrowth (blood vessels) into the grafted area. Only living cells can continue to live. Dead cells cannot live because, well, they are dead. I(t is likely that some cells might survive as living cells, and some as nonliving pools of fat or fatty cysts which are not alive. The body is only capable of revascularizing something the size of 1/3 (1 cm) of an inch before the inner cells die of cellular starvation.
The most common complaints of patients having breast augmentation with large amounts of fat is that the fat didn't last, and now they need additional procedures; and that now there are lumps in the breasts and they have to get MRI's, mammograms, ultrasounds, etc. on a frequent basis to make sure the lumps are not cancerous.
To be sure, many patients are happy with fat injection to their breasts, but many are not for the reasons above.
For these reasons, I prefer autologous fat fascial grafts for breast augmentation in patients who don't want or can't have a breast implant. Otherwise, implants may be a better choice.
So just go into the procedure with your eyes open!

No. Unfortunately that is not how breast fat grafting works. All the fat must be surrounded by living tissue to get blood flow and ultimately survive. Breast fat grafting is generally 100-300 cc per breast. Now, that being said, the procedure can be repeating but it is VERY unlikely you would ever get to the point you have suggested. Additionally, the fat does not give the same appearance as an implant so you likely wouldn't be happy in the long run if it were possible. Best of luck.

If you are a size B, it would be impossible to inject 1000-1200 cc of fat into each breast. Unfortunately, you have not told us your bra size. If you are size 32 or 34, each 100 cc of fat corresponds to 1 cup size change. If you are size 36 or 38, each 200 cc of fat corresponds to 1 cup size change. You are correct in how much fat survives. If you want 100 cc of fat increase then you would need 150 cc of fat injected. Attempts to inject large amounts of fat can result in an inadequate bed for the graft to take and the fat will undergo absorption or may calcify and leave hard nodules.

Best Wishes,

Gary Horndeski, M.D.

In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons. It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer. Multiple transfers would be required for additional cc's. In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used. The fat must be injected through multiple planes in small amounts to the tissue through one tiny incision under each breast. About 50% of the fat obtains permanence
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival. Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant. Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations.

BII has not been validated as a real entity. It is defined as such, and it's treatment determined by women with no clear scientific evidence of cause and effect relationship to implants. It almost entirely afflicts middle and upper middle class women who frequent social media. The BII groups monitor their follower's activity and comments, and anyone who does not follow the groups' vision of breast implants leading to illness leading to 'en bloc capsulectomy' leading to perfect recovery are blocked. Further, there appears to be a fiduciary relationship between the BII groups and their 'selected surgeons'. I suggest you let our leaders in plastic surgery science tease out the details to determine any legitimacy of claims. In the meantime, it appears to be a very unlikely entity, if it is anything at all. Go get your implants, because fat grafting, no matter how large a volume, will not produce implant like results. And no, you can't graft a liter of fat into each breast, most of it would die, and you'd have hard oil cysts in your breasts.

Dear Considerate2136,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If you get that amount of fat transferred to each breast the survival rate will be quite low because there won’t be enough blood supply to the fat. As a result most of the fat will die. You will also have increased risk if lumps or even abscess formation. Fat transfer isn’t that great a procedure anyway, but if you try to push its limits there will be problems.

No, it is not safe to inject that much fat in one breast in one session, nor is it realistic. For most women, that size is much too large for their frame and tissue and does not look good over time. You need to be more realistic about what size you want.

Fat grafting into the breasts is not the same as the buttocks or other areas of the body. The breast is comprised of connective fibers and bands laced throughout the fat. Therefore, the breast cannot take as much fat as the buttock with each surgery. 1000-1200cc is extremely high volumes and very unlikely to fit in the breast in one surgery. Most patients can expect to only go up 1/2 to 1 cup size per session so you would need at least 3 separate sessions to achieve your goals. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

The most I would consider grafting into a typical B cup breast is around 550 mL.

Sometimes more, sometimes less because becomes very in size.

The volumes you are referring to will not fit into your breast.

Trying to graft excessive volumes of fat leads to a higher percentage of fat graft failure and increased chances of complications.

Instead you should consider having implants.

The science supports this as being safe and universally more or less 100% of plastic surgeons are still comfortable in planting them including friends and family members.

If you want to maximize what you can obtain from fat transfer you should plan on having multiple rounds of fat transfer.

You can get 1/2 to maximum one cup from one round of fat transfer. The most you could possibly hope for is a small C cup. A second round a fat transfer could potentially build you up for a modest or a full C cup. A third round a fat transfer and then build up your breast to possibly a small D.

That is how it’s done with fat transfer.

Women who have become breast I want to be a DD should go straight to implants.

Best,

Mats Hagstrom MD