I’m not sure if anybody has made a point of calculating mortality rates for liposuction with breast fat transfer. Mortality rates from Liposuction is about one and 10,000. Adding fat transfer may increase that just slightly but I would say it’s probably no more than one in 8000. This mortality rate is comparable to an average driver, driving a car for about one year. Do you drive cars? If so, do you worry about dying from car accidents the same way you worry about your surgical procedure? If so, why not? In my opinion, there are two single variables. Patients should stay focused on when it comes to Liposuction and breast fat transfer. Serious medical complications can happen, and for those who are risk averse, perhaps having surgery that is for cosmetic purposes only isn’t the right way to go. For serious outcomes, you simply need to except the risk and recognize that this is not something you can control and instead focus all your resources under the variables you do have control over. Things go wrong with Liposuction and fat transfer all the time. The number of patients get results consistent with what they had hoped for is probably fairly small in reality. When things go wrong, it’s not patient’s blood to death or had massive medical complications. White patients should be concerned about is understanding their own candidacy for the procedure and provider selection. These are the only variables that matter, when it comes to delivery quality outcomes, and this in the end is the basis for having the procedure. Ignoring the fundamental basics of why you’re having the procedure at the cost of worrying about things that are unlikely to happen, makes little sense, but is usually the end result of anxiety some individuals have. There’s a very nice prayer called the serenity prayer. It goes like this “ God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”.Whether you are a spiritual person or not, the prayer has some very valid points. Focus on the variables you have control over. Now, for the variables, I think people grossly overlook at what in my opinion are the most important. Patient candidacy is the fundamental most important aspect of the procedure, because it determines if you even have the potential for getting quality outcomes. Breast fat transfer is always two procedures done together. The first is liposuction, and the second is fat transfer. It’s possible to be a good candidate for Liposuction, but not a good candidate for breast fat transfer. Any combination of candidacies can exist, and the candidacy, for Liposuction is usually unrelated to the candidacy for breast fat transfer. Breast fat transfer can increase overall breast size by about 1/2 cup. This is when the procedure is done correctly by a sufficiently experienced provider. What fat transfer is not good at doing is changing the shape of the breast. If you don’t like the shape of your breast, then the fat transfer is just going to give you a slightly larger version of the same shape. It is critical to understand the difference between making the breast larger and changing the shape of the breast. The impact of fat transfer is a radically different than the impact of the implant augmentation. Breast implants radically change the shape of the breast, creating projection and volume in the upper half of the breast. Fat transfer does not do any of those in any significant way. Fat transfer is complex for many different reasons. One of them is understanding what the procedure can deliver and not being disappointed by the outcomes. Recognize that early fat transfer results can look very impressive. A week after the procedure many breast can look as good as breast implant augmentations. Early results, however, do not represent final results in any way. For this reason, it is imperative, that patients understand that would be reviewing before, and after pictures the timeframe of when after pictures were taken, must be taken into context. Providers looking to put their best foot forward. May be tempted to show you early fat transfer results. I would say this is very common. Unless the pictures are taken a minimum of three months, but preferably six months or longer after the procedure after pictures are not representative of actual final results. To confirm the timeframe of when after pictures were taken, I suggest you directly ask providers the exact timeframe of when each said a before, and after pictures were taken to confirm. The most common reason for patients to be disappointed from this procedure, is because they saw impressive results online representing early fat, transfer results that are not possible in the hands of any provider as long-term final results. For Liposuction candidacy, there are many variables that need to be taken into consideration. In the most simplistic way to describe an ideal Liposuction candidate would be to say someone who is “young and tight and pudgy.” The opposite is also true. Older individuals with thin layers of subcutaneous fat and significant skin laxity tend to not get quality liposuction results. Now, for a little bit of discussion, recall selection. Liposuction in particular, but fat transfer is probably equally similar seem to have the greatest discrepancy in skill and experience among plastic surgeons than any other nation I’ve seen. The different outcomes from Liposuction results based on who does the procedure can vary from stunning body transformation to grotesque, irreversible body disfigurement. This can include work done by experienced board-certified plastic surgeons with overall good reputations. Delivering consistent quality, liposuction results is far more difficult than most people realize. Being board-certified in plastic surgery with years of experience, and an overall good reputation does not mean somebody has mastered any one single procedure, especially not Liposuction and Fat transfer. The number of providers who truly mastered these procedures, are in a small minority. Never assume somebody has the skill and experience to deliver a quality outcome based on anything other than an impressive collection of honest quality before, and after pictures finding the right provider, for these procedures is not easy or straightforward. It generally requires having multiple in person consultations. in my opinion, you cannot select the right provider by using your computer or smart phone. my practice has been focused exclusively on Liposuction and fat transfer for the last 15 years. I spent the first half of my career doing general plastic surgery with a strong emphasis of all forms of breast surgery, including cancer reconstruction. for the last 10 years I’ve done all liposuction with patients awake using local anesthesia with mild sedation. this includes all breast fat, transfer procedures as well. Avoiding general anesthesia has a man’s benefit when doing body contouring. In particular, it allows the surgeon to have the patient move and hold different positions during the procedure. This is ideal for contouring the body, which is very three-dimensional. That transfer does not require repositioning, but Liposuction does. Unless you’re planning on having just a front of your abdomen treated you will need to be repositioned during surgery to get quality results. Anybody contemplating having body contouring done under general anesthesia should have a clear understanding of if the surgeon is planning on turning you during the procedure. this may sound like an important topic but it is fundamental. I see no need to do the procedure in the hospital, which usually adds unnecessary expense. Using an anesthesiologist is up to each surgeons choice. Most plastic surgeons do not have skill and experience in doing awake liposuction and fat transfer. Learning how to do this without causing undue discomfort to the patient requires going through a learning curve that is fairly steep and long. Having years of experience in doing awake Liposuction I believe it as being a far superior method. I’ve spent decades doing liposuction with general anesthesia and decades, doing it with patients awake, and at this point in my career, I would never put someone to sleep for Liposuction or fat transfer. I currently work for an Elite Body Sculpture , which exclusively offers the airsculpt and procedur. you can check out their website to learn about the advantages of how we do liposuction and fat transfer. There are plenty of plastic surgeons who do quality work using general anesthesia. In fact, most plastic surgeons use general anesthesia for Liposuction and fat transfer.When it comes to decision making, I suggest you focus and understanding your candidacy for the procedure at selecting the best surgeon and then follow with their recommendations in regards to anesthesia choice. The following are some general guidelines for provider selection. For Liposuction and a fat transfer I don’t think it’s unreasonable to start the process by having at least five separate consultations. To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial 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. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider. There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery. Best, Mats Hagstrom, MD