Could I be a candidate for an increase from a size A to a small C using breast fat grafting? (Photo)

Question

I'm a 5'5 and 135-140lb female, my current measurements are 34' underbust with approximately 13' across, one breast is a 1/2 inch off my chest and the other is approximately an 1'. I breastfed 7mo post partum. I'm researching heavily into correcting volume loss. I know the survival percentage rate of fat graft is largely varying between surgeons and ive heard that it can also vary if they use a Brava. Could anyone advise me if this is reasonable with my current volume shape? Thx

Urmen Desai, MD, MPH, FACS · Answer

Fat grafting will typically only increase your cup size by 1 size, so you would only get to a size B cup.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Randal Haworth, MD, FACS · Answer

A fat transfer to your breasts can increase your cup size some if you have enough donor fat to harvest from other areas of your body. I have had excellent results with  purified fat transfer to the breast but managing expectations with the patient is key. Generally, patients can go up one size maximum. I recommend an in person consult with a board certified plastic surgeon to address a cosmetic treatment plan that best suits your needs.

Rukmini S. Rednam, MD, FACS · Answer

Hello Shelraye,If you have enough donor fat, fat grafting for breast augmentation can be an excellent option. Generally a single fat grafting session can achieve a 1/2 cup to 1 cup increase in size.  Though, I have had patients achieve in a single session, two sessions may be needed for larger volume increases.  Your asymmetry can be corrected with the fat transfer and should not be an issue.  Fat survival in the breast is around 60-70% when fat is placed in both the breast tissues and pectorals muscle.I would recommend an in person consultation with a board certified plastic surgeon with experience in this type of fat transfer to determine if this would be a good procedure for you to meet your goals.Best of Luck!Dr. Rednam

Anthony A. Admire, MD, FACS · Answer

Generally you only increase a cup size with fat grafting to ensure viability of the large majority of fat cells. However, "cup size" is rather arbitrary, and you could certainly get some improvement in shape based on your pics. Also fat grafting would help even out your breasts more as well. You might need 2-3 treatments separated over time to achieve the results you want. Also, without seeing your torso and legs, you have to have enough fat to harvest in those areas as well.

Daniel Barrett, MD · Answer

Dear shelraye,fat transfer to breasts is a great option for individuals which are looking for a smaller increase in size or for correction of small irregularities or asymmetry. Fat transfer will most likely not be enough to increase your breasts from A to C cup. You will most likely need breast implants to achieve that. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. You will get the best recommendations after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Luis A. Cenedese, MD, FACS · Answer

Size increase from a to c is an ideal desire which will require more than one session of fat grafting. Breast fat transfer is definitely technique dependent.  Post breast feeding breast skin is usually loose enough to accept the maximum amount of fat that may be safely transferred. Only 40% of the total liposuction aspirate volume is usable. The Brava is a great concept which may not significantly improve outcome in the post breast feeding elastic breast.Please use this information when consulting in person with an experienced Board Certified Plastic Surgeon to make treatment decisions.

Erika Sato, MD, FACS · Answer

Initially after fat grafting you will appear as thought you are a small C or bigger. Over the 3-6 months following the fat transfer you will lose 30-50% of the fat volume injected. This has little to do with the surgeon's technique and more to do with the normal outcome after fat grafting. Once you undergo the fat volume loss, you will be left with an increase in size of ~1 cup or ~150cc. If you want to go from an A cup to a C cup with fat transfer this would mean two surgeries. Yes, you are correct that the BRAVA can lead to more fat volume survival as it prepared the breast by expanding the tissue prior to the fat transfer. The BRAVA can also stretch your NAC.

Connie Hiers, MD, FACS · Answer

You will first need donor fat for the transfer, and then may achieve only one half to one cup in increase with a transfer. Beyond that, you may need implants. I would suggest meeting with a board certified plastic surgeon and discussing your options.

Jeffrey Ptak, MD, FACS - Account Suspended · Answer

Yes, fat grafting can often make a substantial volume increase in breast size but more importantly be very helpful in improving the overall shape and projection in a small breast.  I have been encouraging patients to consider a combination small implant and fat grafting to achieve both the desired volume and a much better shape that one or the other alone can't achieve.  Since there is a fairly large variation in the success of fat grafting and the maximum amount of fat that should be grafted at one procedure, I agree that you should only expect a one cup increase from each grafting procedure.
J Ptak MD Scottsdale, AZ

Jon A. Perlman, MD (retired) · Answer

Although some surgeons may state that you can achieve a cup size increase in one session alone, I think reality is that many patients require more than one procedure to go from a full A cup even to a small C cup.  I doubt that this can be accomplished in one fat grafting session regardless of what "magic sauce" is used.  In general I think you can assume a 1/2 cup size increase in volume per fat grafting session.  You do appear to be a good candidate and you're correct that preoperative use of a Brava system has been shown to improve results and outcomes but is cumbersome and burdensome.  My experience with Brava was that though it did work it was impractical and very difficult for most patients.Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

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