5’5”, 130lbs, no kids, risks with fat transfer to breast & are they common?

Question

I’ve read the complications of breast fat transfer (necrosis, lumps, calcifications, cyst, asymmetry, infection). I’m really interested in this procedure because I don’t want implants, but concerned. Are these complications common? Are the majority of people satisfied? I have found a board-certified plastic surgeon who does a lot of these, so I know he is skilled, but wondering if the complications make it not worth it, or if im worrying too much.

Irena Karanetz, MD · Answer

Hello, 
Thank you for the question.
Fat transfer to the breasts also known as breast lipofilling can help increase breast volume and projection, and can be performed together with other breast procedures. It is a relatively safe procedure with low risk of complications. This is usually done through tiny incisions with minimal scarring. It also allows improvement of contour in the areas where the liposuction is performed in order to harvest the fat for transfer.
In general, about 50-70% of transferred fat will survive after the surgery and the fat that does survive will act like normal fat. Often, more than one fat transfer session is required to achieve desired results.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast surgeries to further discuss your options, specific techniques, concerns and expectations. 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. 
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship TrainedBoard Certified Plastic Surgeon

Alan Gonzalez, MD, FACS · Answer

Hello @cedar river thank you for your question. It really depends on the surgical technique of the specialist performing surgery. The risk of lumps happens when there is fat necrosis after de procedure. Technique, experience, and technology used by the plastic surgeon determine the success of the surgery. For more information, you should consult one or several board-certified plastic surgeons. Best wishes! Alan Gonzalez MD FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Zoran Potparic, MD · Answer

Despite the fact that fat grafting of the breasts was one of the areas where fat grafts were used first, it is still not very predictable procedure. A survival and retention of fat grafts may vary and for that reason multiple procedures (2-3) may be needed to achieve desired volume and symmetry of breasts even in the most expperienced hands. Breast implants are still the gold standard for breast augmentation. Hope this helps. Good luck.

Daniel Barrett, MD · Answer

Dear cedar river,
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

If properly done and not too much volume is crammed into the breast tissue, the risks are low. Most women, however, want more volume than what a fat transfer can achieve. If you would be satisfied with a half to one cup increase in size and have donor fat, then the fat transfer should work well for you.

Mats Hagstrom, MD (license on probation) · Answer

Breast fat transfer is two procedures done at the same time.
In regards to getting an assessment you need to be assessed for both procedures. Likewise when it comes to vetting the provider you need to make sure they have sufficient skill for both procedures.
The two procedures are liposuction followed by fat transfer.
Delivering consistent quality liposuction and fat transfer results is not as easy as people think.
Simply getting an accurate assessment with the ability to predict and demonstrate accurate before and after pictures of what each individual person should expect is a difficult process.
Results are very provider dependent.
While experience and having done a lot of cases is helpful it does not necessarily mean that somebody has sufficient skill.
Patients need to learn to assess outcomes then personal event different providers and review outcomes.
Breast-fed transfer is a subtle procedure that can generally increase breast volume by 1/2 cup to maximum 1 cup. this means most patients will only get 1/2 cup volume increase.
This is still only if the procedure is done perfectly under ideal circumstances.
If the procedure is done by a provider lacks skill or is not done with correct technique patients will receive even less improvement which may be barely visible.
Fat transfer does not change breast shape in any significant way.
It’s important to recognize the difference between wanting a different breast shape and simply wanting a bigger breast.
For example fat transfer does not significantly increase volume in the upper half of the breast if there isn’t volume in that area to start with.
To start the process I recommend you begin by getting a set of quality pictures of your old body and breast.
Look at how plastic surgeons take before and after pictures and simulate similar pictures of yourself.
Print copies of pictures of yourself and bring those to each consultation to use as a reference.
I recommend patients of multiple in person consultations to help choose the best provider.
I do not think you can choose the right provider by using a computer or having virtual consultations.
During in person consultations ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
During the consultation you will get an examination and should get an accurate assessment. The assessment should explain if you are a good, average or not so good candidate for both Liposuction and fat transfer.
Liposuction only reduces subcutaneous fat.
If access subcutaneous fat or fat distribution is the only variable keeping someone from looking their best then they are generally going to be a candidate for Liposuction.
If other variables are contributing to an undesirable body contour the liposuction may be limited in what it can deliver.
The number one reason patients fail to be good candidates for Liposuction his skin laxity.
In particular older individuals or women who’ve had pregnancy related changes tend to not get the best liposuction results.
I sometimes described ideal Liposuction candidates as “young tight and pudgy” individuals.
While reviewing before and after pictures ask providers to only show you previous patients who had similar body and breast characteristics to your own.
Bring pictures of your own body and breast to use for comparison.
It’s important to only look at pictures of people who had similar characteristics in regards to overall size, skin laxity, BMI, amount of body fat and overall body contour.
The same is true for fat transfer.
Ask providers to show you a variety of outcome including excellent results, average results and results that did not turn out as well as they had hoped. All providers will have a variety of outcomes.
Providers would generally prefer to show you preselected pictures representing the best results of their career.
This is insufficient to get a clear understanding of what the average results look like or how many procedures they’ve actually performed.
To review Liposuction results look very carefully at all after pictures to make sure there are no skin contour irregularities in any treated area.
Ask the providers to point out exactly what areas were treated with Liposuction and what areas were not treated. Transition zones between treated and untreated areas should look natural and appropriate.
The most common area treated with liposuction in conjunction with fat transfer is treating the torso or abdomen.
I personally view the torso as a single anatomic unit and generally prefer treating the entire torso when doing liposuction. Buy treating the entire torso as a single unit patients are left with an even fit in the fat distribution without transition zone between treated and untreated areas. A full torso includes upper abdomen, lower abdomen, love handles, waist, full back and under arms. Liposuction I should be done all the way to the edge of the breast circumferentially. When reviewing fat transfer results always confirm the exact time frame the after pictures were taken in relation to the date of surgery. Early fat transfer results can look very impressive but do not in any way represent final results.
After pictures should never be taken less than three months and preferably six or more months from the date up to the procedure.
Anyone showing early fat transfer results is not showing what the final an accurate true result look like.
Do not assume pictures being shown our final long-term results. you should specifically ask for each picture and provider.
I recommend patients start by having at least five in person consultations with local board-certified plastic surgeons who seem to have a lot of experience with the procedure.
Are there’s no correct number of consultations people need to find the best provider but the more consultations you have the better the chance of finding the right provider.
But Liposuction and fat transfer results should be considered permanent and irreversible.
When done poorly Liposuction can leave people disfigured.
The number of plastic surgeons who do both liposuction and fat transfer well and have mastered the procedure is relatively few.
Being board-certified in plastic surgery with the overall good reputation and years of experience does not mean somebody has mastered either Liposuction or fat transfer.
Fat transfer and Liposuction have more variation in outcomes based on provider selection than any plastic surgery procedure I’ve ever seen.
There are plenty of plastic surgeons with years of training and all the correct certificates who don’t like doing liposuction and are not good at the procedure.
There are in the end only two variables that matter.
Patient candidacy and provider selection.
There is little individuals can do to change their candidacy for the procedure. What patience do have is freedom to choose the right provider.
To do that start by having at least five in person consultations and consider scheduling more if needed.
You should feel very confident you were in the hands of one of the best providers for this procedure before scheduling.
For a reference and experience provider should have no difficulty showing you a minimum of 50 sets of before and after pictures of commonly performed procedures like abdominal liposuction or breast fat transfer.
In reality highly experienced surgeons will have hundreds or even thousands of before and after pictures for these procedures.
Simply being shown a handful of impressive results from the providers past is insufficient to confirm that they have the scale necessary to make an accurate assessment and deliver consistent quality results.
In the end breast-fed transfer is a subtle procedure that often leaves patience underwhelmed with a result that’s more subtle than they had anticipated.
Patient to one significant breast volume enhancement should choose implants which is a superior procedure.
Best,
Mats Hagstrom MD

5’5”, 130lbs, no kids, risks with fat transfer to breast & are they common?

Answers (6)

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