The key to fat grafting of the breast is to not inject fat into an area where fat as already been injected. If you do this in a take out of that will not be as good. Therefore putting on the size of your breast initially this will limit how much fat can actually grafted in one session. Some patients require more than one grafting session.
There are a lot of factors that must be considered when deciding to use fat transfer to augment the breasts.What size are the breasts now and how tight is the skin? This will help determine how much fat they can hold. If the skin envelope is too tight, this will limit how much can go in.Can the BRAVA help? Yes it can, but... you have to get the BRAVA, and you have to use it. This means wearing it for several weeks before and after the procedure and being religious about it. It is not FDA approved in the United States for this use but many surgeons who do fat transfer breast augmentations will use it off-label to expand the breast envelope. The American Society of Plastic Surgeons have not commented on it as far as I know.How much bigger do you want to be? Going up one cup size with fat transfer is achievable, two cup sizes is possible but sometimes may take multiple sessions, three cup sizes may be unreasonable and you should probably consider breast implants.How much fat do you have? The more you have, the more you can transfer. Everyone thinks they have enough fat but this goes back to "how much bigger do you want to be?" Do you have enough to get there and even more...you should expect your body to absorb 30-50% of the fat transferred. That means the surgeon will have to overfill if possible to get to the desired end point.What's the best technology for liposuction and fat harvesting? Technology actually isn't as important as the surgeon. Great results have been achieved with power-assisted lipo (PAL), ultrasound-assisted lipo (UAL, Vaser, Lysonix), and hydro-assisted lipo (Water-Jet). Laser-assisted lipo (Smartlipo) is probably not a good idea in this setting. Poor results also have been achieved using all these. Surgeon experience and technique trumps them all. Find someone who does this and is confident doing so.Where does the fat go? It goes in the breast, behind the breast, in the muscle and sometimes behind the muscle. How will this affect future mammograms? After fat grafting to the breast, mammograms may show 'macro calcifications' which are clumps of large calcium deposits and cysts are also commonly seen. An experienced radiologist will be able to discern these as benign post-operative changes. These finding are also common with other breast surgeries such as breast reductions and lumpectomies. So far, there has been no known increased risk of breast cancer.Fat is great for a modest, natural augmentation. Make sure that is what you want. Have a frank discussion with your surgeon. Make sure you are clear on what your goals are. Many woman are keen on having "natural looking" breasts only find out that the happiest day was the day after the procedure when they are at maximum swelling and volume. After the swelling comes down and 30% of the fat resorbs, they want to be bigger again.
