Breast fat transfer. Can I go from a B cup to a D cup and are the results permanent?

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. For those women who prefer a "Natural Breast Augmentation" without implants, fat grafting is a safe, natural, and minimally invasive approach that offers low-maintenance, long-term improvement in size and contour. After harvesting the fat from your body, we purify and enrich the fat before injecting it in the desired areas to improve volume and shape.
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

You actually don't sound like you have a lot of fat, however you can liposuction what you have and transfer the fat into your breasts.  Using similar tools as Brazilian butt lift surgery, the volume transferred can actually be more than previously thought and more stable than previously thought however transferred fat is not form stable.  More form stable substances like a breast implant produce much more reliable results.   Fat traditionally is quoted to retain only 30-40% of the the initial volume.  Using the newer techniques in buttocks, we quote closer to 80% retention.  Get a proper in person consultation with a board certified plastic surgeon to start.  Best Wishes!!

Breast fat transfer is a great tool to balance breasts, improve symmetry, and gain up to one cup size in volume.  In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons.  It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer.  Multiple transfers would be required for additional cc's.  In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used.
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival.  Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. I typically transfer from 250 cc to 400 cc or so per breast.  Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant.  
Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation with a board certified PS to determine your available fat stores.

It sounds like it may be difficult to harvest enough fat at your weight to make fat transfer feasible.   also most fat transfers to the breast provide only a slight degree of enlargement. Going from a b to a d would be quite unlikely to achieve.

Hello,Thank you for your question. Fat Transfer is an affective tool to increase the breast size between1/2 to 1 cup size. But You do need to have enough fat to donate. If you are very thin then you might entertain using implants. Good Luck!

Dear Hepburnn,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello and thank you for your question. It would be useful to see some photographs to give you a better advice. There are certain factors to consider prior to undergoing fat transfer. There is a limitation in the amount fat that can be transferred successfully in one session, which is largely determined by the existing breast volume prior to the procedure. Typically, we can inject 200-250 cc per breast. Patients can expect an increase in the breast volume by 1/2 to 1 cup.  Generally speaking, donor sites are abdomen, flanks and thighs. Other factors to consider are unpredictability of fat retention after transfer and interference with mammography.
My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. Best,

 Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Hepburnn I appreciate your concerns however there are several issues with regard to fat grafting that you must address. First off, you may not have enough fat to increase your breast cup size even one full-size. And please do not consider gaining weight for this operation as it is a bad idea.You do have options, both with pros and cons. Implants have a solid and reliable history with very high patient satisfaction rates but they must be replaced every 12-15 years. Fat grafting has the advantage of using your own body's material to increase breast size, but only small augmentation is possible and it is just gaining popularity and long term results are not yet available. There is always uncertainty about how much fat will "take", increasing the possibility of asymmetry and need for revision. Many plastic surgeons are still concerned about how the fat that did not take looks on mammograms, and if it will increase long term false positive results.  Come see me or another board certified plastic surgeon in our area to help you navigate this decision. Good luck!

The amount of fat that can safely be grafted has a limitation. Usually, 200cc is the maximum amount of fat that can be transferred to ensure survival and prevent fat necrosis. This amount can add some volume but fat graft is mostly done to improve contour and not volume. An in-person examination would be best to determine which procedure would benefit you the most. 

Fat grafting to the breast can be an aesthetic and highly effective stand-alone breast augmentation procedure (provided there is enough donor fat NOT to leave the donor site looking worse off) or as an adjunct to small imperceptible breast implants. Done properly, the fat that survives for six weeks after surgery should last forever (see six week before and after result with mastopexy attached). If you lose weight, your breasts will shrink, if you gain weight your breasts will enlarge. In other words, they grow and shrink like natural breasts. I use 1 cc syringes for the fat grafting process which takes more time and effort in the operating room but has two distinct advantages: (1) I reviewed 30 of my cases and none had micro-calcification or fat cysts that can lead to years of breast biopsies as suspicious-looking masses and (2) the graft take is much higher (better percentage take). My OR assistant has been with me for twenty years; together, he purifies the fat as I inject it. Breast fat grafting is also the best way to obtain symmetry when the breast foundation, the rib cage, is of different heights, as well as to smooth the transition from breast to a more bony or wrinkled decollete.