Is fat transfer suitable for me post explant? (Photo)

Question

Will fat transfer achieve a large A or small B bust size for me? See photos. I do not want implants again. Post explant, my new chest appearance has significantly hit my confidence. I've also included a photo of my breasts pre-surgery before any implants for reference. Ideally, if I could reach a slightly larger size than that and similar shape, that would be ideal. Thank you!

Alan Gonzalez, MD, FACS · Answer

Hi @LuckyGal888, thank you for your question. If you had your implants removed due to health issues then implants are totally out of the question. If there is not a lot of breast tissue you could have a breast fat transfer with an experienced surgeon who can create a surgical plan with you to improve the shape of your breast. Fat transfer can be an excellent option if you don't want huge scars and are looking to add some top volume. It is a minimal scar procedure that involves transferring fat from the body to the breasts, which can provide natural fullness and some shape. If you are considering volume enhancement, consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. Best regards.

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation of Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation of Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Joel Patrick Maier, MD · Answer

Yes, fat transfer is a very good option for you. Problem is where to get the fat. Perhaps your inner thighs, but an exam would be necessary. Thank you.

Rodger Shortt, FRCSC · Answer

Breast fat transfer after explantation is a great option for some people. However, fat transfer is not always the solution.
 
The ideal candidate for breast fat transfer generally meets all (or most) of the following:
1. Has some fat to harvest for transfer. Even better if there is an area of fat that is unwanted, so its win-win.
2. Has space to put the fat. Keep in mind that a breast fat transfer can approximately double the breast volume; the larger a breast to start with, the more fat that can typically be placed.
3. Has a nice shape to the breast and really just requires an increase in volume.  A breast lift can be done with breast fat transfer, but the tightening of the skin will limit the volume of fat that can be transferred sometimes.
4. Has modest goals for size enhancement.  Depending on the patient 1-2 cup sizes is typical.  For others, especially if quite thin, after a breast implant removal, tightening of lax skin may be the goal.
5. An aversion to an implant.

Breast fat transfer after explantation can be a great option, but there are limitations to the procedure and patients should have a thorough conversation about those with their surgeon.  Ideally patients would seek the care of a surgeon that does a lot of breast fat transfer.

Dr. Rodger Shortt, Oakville, Ontario.

Daniel Barrett, MD · Answer

Dear LuckyGal888,
you need to have extra fat tissue somewhere that can be harvested and transferred to breasts. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question! Fat transfer is a great and all natural way to help improve shape, volume and contour of different parts of the body including the breasts. It is important to know that as a living cell, the transferred fat must go through a healing process and it is normal and expected not 100% of the fat transferred will "take". Each patient is different but typically 70-75% is a reasonable fat graft take to expect. That said, we also have to consider the quality and quantity of the "donor" fat. For someone very thin it can be a challenge, but still doable. This just means a surgeon must spend time going to more sites (belly, flanks, back, axillae, thighs, arms, etc) searching for more usable fat. For someone with your BMI, this would be the base, but it may still be possible to have enough to transfer for 1/2 cup or so to each breast. The ultimate recommendation would need to come in an in-person consultation/exam with a board certified plastic surgeon. Good luck on your journey!

Gary M. Horndeski, MD · Answer

Yes, fat transfers can be done and are usually good for about 1 cup size increase.  The fat transfers can be repeated, if necessary.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

Fat transfer doesn’t work great. The problem in your case is you are very thin. So there’s minimal fat to harvest.  You don’t state why the implants were remove, but if you had silicone before you could try saline instead

Connie Hiers, MD, FACS · Answer

No Dear, you are not a candidate for fat transfer. First you have no donor fat, and second, you have very little breast tissue to accept fat. Implants are your best option.  If you are concerned about your size being too large for you, consider going smaller.

Mats Hagstrom, MD (license on probation) · Answer

Breast fed transfer can increase breast size by about 1/2 cup or about 50% increase in breast size.
This is when the procedure is done well by an experienced provider.
In your case there may be some inherent limitations. The two potential limitations are first the amount of host tissue to graft into.
The more tissue someone has to graft into the more fat we can graft successfully.
The size of your current breast limits how much fat can be grafted with one procedure.
The second limitation may be the ability to harvest sufficient amounts of fat because you are fairly thin.
Not that much fat is needed since your breast is relatively small.
I’m assuming that implants are out of the question, but if not, then implants would be the way to go.
Delivering consistent liposuction and fat transfer results is more difficult than most people realize.
The number of plastic surgeons who have mastered these procedures are in a small minority. 
Fat transfer can increase breast size but does not do much to change breast shape. 
Provider selection is absolutely paramount and is often far more difficult than people recognize. 
You should vet providers for both liposuction skills and grafting skills. 
Recognize that early fat transfer results can look very impressive but do not present final results. 
I recommend having as many consultations as it takes to find that one surgeon who has truly mastered this procedure. In the hands of the wrong provider you can be left permanently disfigured! 
During each consultation ask providers to show their entire collection of before and after pictures for this procedure. (At least 50 previous patients) 
Confirm the time frame of when after pictures where taken (should be min 3 months) 
Best 
M Hagstrom MD