Fat transfer definitely gives long-lasting results.
The main limitation to this procedure is the total amount of volume able to be added in a single procedure.
One of the great advantages of fat transfer to the breast is the ability to custom shape the breast to create symmetry or add volume in certain areas.
Breast implants do not actually add volume to the breasts themselves.
Implants are typically placed on the chest wall underneath the pectoralis muscle and simply push the breast forward, making the breast appear larger.
Fat transfer, on the other hand, enhances the breast itself giving more opportunity to customize the desired shape.
Best of luck,
Mats Hagstrom, M.D.
Fat transfer is a very good option in aesthetic breast surgery.The limitation is the volume. While the buttocks allow for very large volumes of fatgrafting in the breasts the achievable volumes are much more limited.
This explained by the fact that on the breasts we can only graft into the layer right underneath the skin and into the breast muscle, not into the breast gland itself. As a consequence, the transfer volumes are somewhat limited. For a substantial augmentation, you will normally need 2 sessions, or more.
However, fatgrafting is a wonderful addition to breast implants, especially with regards to shaping the cleavage area and the gap between the breast. Fatgrafting supplementary to breast implants can significantly boost your results here.
Yes I believe that fat grafting works well within the right parameters.
A) You need enough fat to be liposuctioned
B) You can only increase the size of the breast by about 1 cup at each session of fat transfer
C) About half of the transferred fat resorbs in the breasts
D) You can repeat the procedure multiple times to go from say A cup to a D cup.
Below I put a link to a young patient of mine who was born with significant breast asymmetry. After 3 session of fat transfer, she had D cup breasts on both side. Best of luck
While it is possible to do fat injections to the breast as a
cosmetic augmentation, currently, it is felt that only up to 50 of transplanted
fat successfully survives in its new location. The remainder doesn’t go
elsewhere. It is just resorbed by the body. Fat injections to the breasts may
be useful in making small modifications and correcting asymmetries, but many
plastic surgeons feel this procedure is not as reliable or predictable as an
augmentation with breast implants.
The concerns: Long term results do not yet exist, like any
procedure there are potential risks including infection, oily cyst formation, mammographic
changes which can be confused with breast tumors, asymmetry, the results are
not totally predictable and are inconsistent as compared to breast implants
which are the most extensively tested and FDA approved medical devices with a
lengthy record of safety and efficacy, it is a lengthier procedure, more
costly, may require additional sessions of fat injection, and to optimize the
results usually requires a prolonged use of an external device called BRAVA
which is uncomfortable and has a poor record of patient acceptance and compliance.
There are an increasing number of satisfactory reports of
this procedure being performed, but there are still a wealth of additional unresolved
issues: The extent of resorption of the fat, the large volume of fat that is
required to produce an improvement, the limitation of the amount of the very
modest augmentation that is possible (usually only up to ½ or one cup size), and
specifically a concern about long term safety with regard to tumor stimulation (currently does not seem to have been a problem),
which all need to be further investigated with valid scientific studies before
fat injection should be viewed as a standard procedure for cosmetic breast augmentation.
Robert Singer, MD FACS
La Jolla, California
Thank you for your question. Fat grafting to the breast has become quite widely used. Fat is transferred via liposuction from areas like the abdomen or thighs and then injected by a syringe into the breast to add volume. What fat does survive the transfer will generally be there forever. The shape of the breast can be fuller, but it will not give results similar to an augmentation with an implant. It will provide a very natural look and shape.
Fat grafting to the breasts has become a widely used way to increase the volume of the breasts as well as effect changes in the shape of the breasts in some instances. When we do this, we are essentially removing fat cells from one part of the body, preparing them as a graft, and then transferring them into another part of the body, in this case the breasts. With fat transfer, while some of the fat cells - sometimes up to around 50 percent of those injected - won't survive, the rest will, and when they do, they become living fat cells as a part of your body. Thus, once the cells "take" and live, they will be there permanently, and this is how we get long-lasting results from fat transfer. As far as changing the shape of the breasts, this is one of the things I like most about fat transfer. When we use an implant, we are committed to the shape of the implant, whether it be round or anatomical (teardrop shaped) to produce a certain shape of the breast. Furthermore, that implant is one solid mass, thus it behaves that way with regard to its volume, and if you want volume in only one part of the breast, you may have to accept it also in another where you don't want it because the implant will cover the full area that it will cover, even if you don't want it to. In contrast, we can inject fat into one specific part of the breast and augment that one part only, and in this way we can potentially change the shape of the breast. One good example of how I might use this concept is in the case of a patient who has deformity of her breast after losing some tissue with a breast lift, or from removal of a tumor. We can fill in the areas of volume deficit or flattening, and thus restore a more pleasing rounded contour to that specific area of the breast. This is only one example of the many ways that this can work. Each case is individualized, thus if you are considering fat transfer to the breasts it is very important that you start by scheduling consultations with surgeons that are experienced in fat transfer. This is a very "technique dependent" procedure, and it is necessary to find someone with good techniques in order to maximize the amount of fat that will "take" and thus optimize the result. You should locate board certified plastic surgeons for this. Not only should your surgeon be certified by the American Board of Plastic Surgery, but he or she should also voluntarily participate in the Maintenance of Certification program administered by that board. This is the best way to know that your surgeon not only has the best training and experience for the procedure, but that he or she has maintained currency in the certification requirements as opposed to practicing on a "lifetime" certificate which has only been reviewed once at the beginning of his or her career. For more information on this you can visit ABplsurg.org or ABMS.org. Good luck.
Fat transfer is an alternative option to implants providing a more subtle and natural appearance. After the initial resorption, you can expect to keep much of the fat long term similar to the rest of the fat in your body. As we age, we do lose some of the fat in our face, breasts and hands.
An in-person exam with a
board-certified plastic surgeon is the best way to assess your needs and
provide true medical advice. Best of
luck. Dr. Michael Omidi
The patient undergoing fat grafting to breasts needs to be an ideal candidate for fat grafting to breasts. The biggest disappointment is not obtaining the size they desire once the swelling and fat reabsorption takes place. Breast implants typically give you a more desired result.
Fat grafting definitely can be used to altar and/or increase the size of a breast. There are a number of limitations associated with the procedure. There is currently a lot of research being undertaken trying to figure out the exact mechanism behind fat grafting. In general, fat grafting will only increase the size of the breast by about a half a cup to one cup and can require a number of different sessions to increase the breast size to a satisfactory level. There are also a number of associated risks with the procedure. Breast implants still are the gold standard when it comes to enlarging the breasts. In many situations fat grafting can be done in conjunction with breast augmentation to further contour the breast. I would meet with a board certified plastic surgeon and have a discussion regarding fat grafting. There are many issues that need to be reviewed prior to undertaking this procedure. Good Luck!
Fat grafting to the breasts is still a relatively new procedure, but the beneficial role and results in many patients can't be denied. Years ago, there was a concern that the transferred fat would be potentially mistaken as breast tumors / cancer, but the Radiology literature has shown that this is not the case - radiologists have been able to tell the difference between tumors and fat transferred. Thus, fat transfer to the breasts has increased in popularity for both cosmetic as well as reconstructive cases. This has been more commonly used in Europe and other countries, and is now becoming more popular in the states. It is critical however, to realize that the results are not the same as for breast implants. Implants can predict a volume increase, but most surgeons that do fat transfer agree that for every 400cc of fat transferred, that only 200cc usually remain.
It is also critical that you take in consideration the "graft capacity ratio" - that means if you are A cup and have a "tight breast" it is less likely to get a good result, that if you have a deflated C cup or looser tissue. The shape of the breast can be manipulated depending on the looseness of the tissue. However, though results are promising, it is hard to define "long lasting" as this depends also on time as well as weight stability.
I have used this technique on candidates who has looser breast tissue (space to put the fat in) and who refuse implants, and my patients who wish to have their implants removed have been particularly happy when we replaced the volume with fat. So there are several factors to consider. It is definitely best to seek a consultation with a surgeon who is board certified by the American Board of Plastic Surgery, and who has experience with fat transfer as these cases need a surgeon who is experienced in both liposuction, fat transfer, and breast reconstruction. Thus, you can best review what option is truly best for you:)