Would taking out silicone implants to start breast fat transfer be a good idea?

Question

I'm 5'6", weigh 129 pounds and barely filled an A cup before getting 300cc moderate silicone implants placed under the muscle 1 year ago. They look good, but they don't feel as natural in body as I hoped they would. Do you think that after having my implants removed I could gain 300cc of fat in each breast? Should I gain weight for the breast fat procedure? Can liposuction in the same donor site be done again for subsequent procedures to increase size?

Kenneth Hughes, MD · Answer

Breast fat transfer is a great tool to balance breasts, improve symmetry, and gain up to one cup size in volume.  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.
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. I typically transfer from 250 cc to 400 cc or so per breast.  Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant.  I place one incision under each breast and the fat can be injected to the locations specified by the patient.
Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation with a board certified PS to determine your available fat stores.

Gary M. Horndeski, MD · Answer

At 5’6 and 129 lbs, your BMI is 21 and you are quite thin.  It may be hard to find donor sites however, I usually harvest from the anterior thigh.  You told us your cup size but not your bra size.  At size 32 or 34, each 100 cc of fat corresponds to 1 cup size.  At size 36 or 38, each 200 cc of fat corresponds to 1 cup size.  Fat transfer does not all take, but approximately 60% does.  You would need to have 150 cc of fat for a 100 cc gain for 1 cup size if you are 32 or 34.  However, removing your implants will most likely result in your breasts hanging.  You may benefit from a breast lift at the time of explantation using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Best Wishes,Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

I think it needs to be determined if you have implant encapsulation that would make them feel hard. If they are soft I doubt the fat transfer will be a superior result that that which you already have.

Farbod Esmailian, MD · Answer

Breast fat transfer is not a substitute for breast implants.  Do not let someone tell you otherwise, you will be definitely disappointed.  Fat transfer to the breast is a good procedure for patients who have had implants and desire removal but are fine with being smaller but want to keep some of the upper pole that breast implants provide.  Fat transfer will not give the volume that implants give and will not give the upper pole fullness that implants give either but it is a compromise.  Commonly I will perform removal of breast implants and most patients would require a lift and then perform fat grafting of the upper pole of the breast to restore some of the upper pole fullness.Hope that helps.

Frank Agullo, MD · Answer

It is certainly a procedure that is done often. My preference is to remove the implants and let the breast heal. 3-4 months later you can have liposuction and fat transfer. In my experience, enough fat can be found in the flanks and/or medial thighs to transfer to the breast, even in petite patients.#Staybeautiful #RealDrWorldWide

Daniel Barrett, MD · Answer

Dear Valpslbx,
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

Connie Hiers, MD, FACS · Answer

Fat that is transferred is not place in the space where the implant is, but actually in breast tissue. If you are an A cup, you will not have enough tissue for 300 cc's of fat to be transferred. With a transfer, you can expect to gain one half to one cup in size. With minimal breast tissue, you will do better with implants. You can have fat added to your breasts and keep you implants for volume.

Johnson C. Lee, MD · Answer

Fat transfer can actually be done on top of existing implants. This can help increase your volume and create a more natural feeling at the same time. If you would like your implants to be completely removed, then you may need several fat grafting sessions to achieve the volume you are looking for. Your breasts will likely also appear less perky with less cleavage if you were to remove the implants as fat alone does not have the power to create strong cleavage unlike implants. Liposuction can be done multiple times in the same area if necessary. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Robert L. Kraft, MD, FACS · Answer

Considering that you are slim, you will not have enough fat to augment t your breasts. I would never advise weight gain for this purpose. You can’t use the same donor site repeatedly. Where would the fat come from? Unsure why after a year you still feel the implants but recommend that you return to your plastic surgeon to discuss.

Would taking out silicone implants to start breast fat transfer be a good idea?

Answers (9)

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