Oil cysts found after first breast fat transfer - would it be risky to do a second fat transfer?

I'm not a fan of fat transfer and this is one of the reasons. Why are you considering having a second procedure? Did the first one not do what you wanted? A second transfer will be no better. And 650 cc each breast? Far too much. I would advise against another round of fat transfer.

Dear abcd_xyz,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I would suggest avoiding such a large amount transferred again to have better success. The larger the volume transferred, the more pressure is applied to the new fat and the greater is the chance of oil cysts or even necrosis.

Those are sizable cysts.

Developing papa bola hard nodules of fat necrosis or developing it clinically significant oil cysts are related to grafting technique. In particular the placement of too much fat in a single area. In order for fat to survive and minimize these clinical side effects the grafted fat should be stratified through live tissue in a diffuse manner as possible. The best analogy to this I’ve heard described is a chessboard where the white squares represent small individual particles of grafted fat and the black squares represent live vascula host tissue to support the graft. In order for the graft to survive every white square needs to be surrounded by black squares. when grafted fat is in contact with grafted fat viability goes down leaving patients with fat necrosis. fat and the crosses can convert to oil cysts or firm lumps of scar tissue.

I don’t think you have the substantial increase in infection rate though I would be apprehensive of a second grafting procedure as well. The oil cysts represent spaces that could fill up with even more fat and the oil does not represent viable live tissue. any fed injected into the oil cysts during the procedure will become more necrotic tissue making the cysts larger.

This is something you need to discuss with your provider and expect each plastic surgeon to have a different view.

I think taking a cautious approach is appropriate.

And MRI could be helpful for the surgeon to ascertain exactly where the cysts are and possibly avoid grafting in this tissue plane though not absolutely necessary.

Follow up with your provider and discuss with him or her.

For a formal second opinion schedule those as in person consultations bring it with you before and after pictures as well as a copy of your operative report. All of these are part of your medical records which do you have a right to.

Best,

Mats Hagstrom MD

Many thanks for the interesting question. I would think a 650 cc in each breast was a good volume in the first sitting and more augmentation may be disfiguring if the person is not a large body and weight.Since 1.5 years have passed you can safely undergo more fat transfer without bothering with oil cysts.Just remember larger the breast faster it will hang and then one may need a lift ending in scars over the breast that no one wants.