Need advice! Fat transfer or implants? (Photo)

Question

I'm 5'7 weigh 141 lbs and have 27% STUBBORN body fat that is mainly stored in my lower stomach, love handles, thighs and upper back. i want a small increase - just some cleavage and the top of my boobs filled out. As you can see from the pics my boobs are very side set and i lack volume in the middle. I also would like my areolas decreased but am wondering if the size of them will match when my boobs are more filled out.

Gary M. Horndeski, MD · Answer

Fat transfers are usually only good for 1 cup size increase. However, it can be repeated. From your photographs, it appears you would benefit from 2 cup size increase. You would also benefit from repositioning of the nipple-areola complexes more medial and higher. I recommend using a circumaroela approach.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Chet Mays, MD · Answer

Thank you for your inquiry!  We would be happy to meet with you to discuss your goals.  There are different ways to add volume: fat, implants, alloclae.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Joel Patrick Maier, MD · Answer

Fat transfer is a great option to enhance and shape your breasts. The limitation is how much to transfer given your low BMI of 22, but still could be done with reasonable expectations. Enhancement with implant or fat will not necessarily change the distance between your breast cleavage as this is a set anatomic boundary. Attempts to change that distance can lead to adverse problems such as synmastia or odd shape. A modest, appropriate volume will give you a natural shape and enhancement. Areolas will also expand a bit with augmentation, but I would not attempt to reduce as the scar around the areola can not look so good . . . my opinion. Thank you for sharing.

Gianfranco Frojo, MD · Answer

I highly recommend implants. Implants are far more predictable with respect to final shape, volume, and longevity. There is also an easier recovery because you do not have an additional operative site (no need for a fat harvest location).

Arif Eroglu, MD · Answer

Hello
Fat injection to the breasts typically does not achieve the desired enlargement in a single session. In each session, approximately 200-250 cc of fat is transferred to each breast. At least 2, and sometimes 3, sessions are required, with intervals of 6 months between sessions.

Wayne I. Yamahata, MD · Answer

There is a limit to the amount of volume that can be added through fat transfers alone. Although the aesthetics of an attractive breast are subjective, I suspect most women in your situation would choose to have an enhancement that would require implants.

Jonathan Heistein, MD · Answer

Although you may be able to achieve slightly larger volume with fat transfer, the results with implants are much more reliable.  Implants can give you the desired size increase with the appropriate shape to make you fill in the spaces that need more.  Fat can't give as much and is more variable in terms of healing and outcome.  I would suggest implants.  Talk to your surgeon about both options so you can learn better what the realistic expectations would be for your specific situation.  Best of luck!

Matthew S. Kilgo, MD · Answer

Hello. Thank you for your question. If you are looking for more a more subtle enhancement to specific areas of your breasts, fat grating is a good option. The volume change is significantly less than what you would typically get with a breast implant, but you would also avoid the potential complications and the required radiologic surveillance associated with breast implant surgery. Another advantage would also be contour correction of the donor sites. Sometimes volume increases can be unpredictable with fat grafting, as some of the fat will reabsorb after transfer and more than one procedure may be required. Importantly, you should consult with a plastic surgeon who is board certified by the American Board of Plastic Surgery who has experience with that transfer to the breasts. Good luck!

Daniel Barrett, MD · Answer

Dear Gregarious804060,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mustafa Aydinol, MD · Answer

If you want to look hot and draw attention you should choose implants.If you want to achieve a natural look then the answer is fat grafting.Most of the time implants require another surgery over the time.The disadvantage of fat grafting is the unpredictability of fat survival.You can also choose to have a hybrid breast augmentation (breast implant+fat grafting)In your case the implant will need to be placed under the muscle.Your areolas can be decreased but there might be a small size difference (you also have different sized areolas now)

Gerald Minniti, MD, FACS · Answer

So, if you are already contemplating liposuction for the purpose of sculpting other areas of the body, it would be ideal to place some of the fat (the recipient breasts have a limit to how much fat can be placed - think of planting a seed into soil) into your breasts. For most people, this will not enlarge their breasts enough, so I also recommend an implant too. This can be performed concurrently or in a second procedure.