Fat embolism/thrombosis risks due to lipo to flanks & belly then fat injection to the breasts?

The risks are very low. Liposuction by itself rarely causes thrombosis unless the procedure is very long, longer than 4 hours, and under general anesthesia. Even so, the blood clots are long the long veins in the legs. The fat transfer to the breasts that naturally contain fat is also very low since the injecting canulae are small and medication is injected to constrict blood vessels and reduce bleeding. There is a much higher risk in injecting fat into buttocks, especially if the fat is placed inside muscles which have larger blood vessels and where constricting medication is not placed.

To my knowledge, no one has calculated the risk of fat embolism from breast fat transfer.
I’ve never heard of a single case, but that does not mean a complication isn’t possible. My opinion, the biggest risk patients should be worried about before considering this procedure is not understanding their candidacy for the procedure, what the procedure can, or cannot accomplish, and not focusing enough efforts on finding the best provider.
In regards to serious risk, the risk of being left permanently disfigured by far higher and more real, than theoretical complications that have not yet been described.
All surgery has risk involved, and Liposuction and fat transfer is no exception. Individuals for a highly risk averse should consider not having a necessary elective cosmetic surgery procedures.
All patients have the ability to decrease undesirable outcomes by choosing sufficiently skilled and experienced providers.
Do that I have a multiple of in person, consultations with local, board-certified plastic surgeons, who seem to have experience with the procedure. Ask each provider to open up their entire portfolio of before and after pictures of previous patients who have similar body characteristics to your own.
An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Continue having consultations until you feel confident you found a surgeon with sufficient skill and experience to deliver consistent quality results that meet your needs.When, in doubt, slow down and schedule more consultations.
Breast fat transfer can increase breast size by 1/2 cup or approximately 50% total volume increase. Procedure does, however not change breast shaped in any significant meaningful way. The procedure is good for women who are content with the overall shape and contour of their breast, including nipple position, but just want them to be slightly larger. The result of breast fat transfer is subtle compared to other Aesthetic surgery options, like implant, augmentations, or a mastopexy. Women who want a significant change in shape of their breast, like volume in the upper half of the breast, breast projection, or treatment for breast ptosis should consider more appropriate procedures.
Best,
Mats Hagstrom, MD