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