Is there any benefit that could come from having PRP done before the fat transfer?

Dear 2004sable,
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

I'm so sorry, but PRP has no effect on lifting breasts or improving fat graft survival. The best way to ensure good fat grafting results is through the surgeon's techniques of grafting the fat; harvesting, preparing, and reinjecting the fat are important, but the latter the most important.

Surgeons are still trying to figure out how to control fat retention after transfer. I’m sure surgeons have tried prp but there’s no data to back it up and probably does nothing

PRP has growth factors that stimulate new blood vessel growth .
It is either injected a few days before fat grafting or at the same time as the fat grafting procedure.
I now use PRF that is also obtained from the patients own blood .PRP has been shown to have a higher concentration of growth factors as well as fibrin.
I use the same technique in other areas of fat grafting.

PRP is best done at the same time as the fat transfer, or it is mainly just helping your skin and not fat. For new transfers, avoid compression and tobacco.

I’m not a big fan of PRP treatments and find that while there is theoretical potential gain the actual results hardly justify cost and potential risk.
It’s unlikely previous injection of plasma he’s going to have any positive impact on a future fat transfer procedure. in the end there are only two variables that matter for this and almost all cosmetic surgical procedures. The first is candidacy and the second is skill and experience of the provider.
In regards to candidacy for breast fat transfer we first start by recognizing the fat transfer with significant volume like the BBL or breast fat transfer is in fact two procedures done at the same time. The ideal candidate should be a good candidate for Liposuction and a good candidate for fat transfer.
Fat transfer can increase breast volume by about 50% or 1/2 cup. The total increase in size is subtle. it’s important to recognize that while fat transfer can increase breast size enough to see obvious visual change it is not a good procedure for changing the shape of the breast in any way. it does not give projection and it does not add more volume to the upper part of the breast which is what most women who seek this procedure are hoping for.
The shape of the breast stays the same it’s simply add volume.
Some women’s breast tolerate fat transfer better than others. Brass that have a high percentage of farm fibercystic breast tissue do not do as well as those who have soft fatty breast tissue.
Having a slightly deflated skin envelope is generally favorable for successful graft volumes.
There is a substantial difference in the ability to deliver consistent quality results that are predictable among different providers.
This is true for both Liposuction and fat transfer.
Provider selection is paramount for both Liposuction and fat transfer procedures.
I can’t think of a single operation that is more provider dependent than liposuction and fat transfer.
The importance of choosing as efficiently skills and experience provider cannot be overstated. Patients are well advised to take the vetting of plastic surgeons seriously and put in the required time and effort to do so formally.
I recommend patients do this by having multiple in person consultations with local board-certified plastic surgeons. avoid virtual consultations whenever possible and always avoid traveling long distances for elective surgical procedures if at all possible.
To find the right provider I suggest patients first familiarize themselves with what quality liposuction and fat transfer results look like. You can start the process by taking pictures of your own breast and your own torso and use those as a reference pictures when comparing before and after pictures.
Use pictures of your own body to find appropriate before and after pictures while looking at results online and while looking at results during in person consultations.
It’s important to choose only sample pictures of patients who have similar body characteristics to you around.
There is a substantial variance in candidacy for quality results for both Liposuction and fat transfer.
Looking at results of patients who is candidacy for the procedure doesn’t match mix little sense since Dallas lack candidacy for the procedure I’m never going to have great results regardless of who does the procedure.
Looking at results of patients who is candidacy for the procedure doesn’t match mix little sense since Dallas lack candidacy for the procedure I’m never going to have great results regardless of who does the procedure. on the other hand someone who is an excellent candidate for the procedure may or may not get a quality outcome and this is purely based on the skill and experience of the provider.
It deserves mentioning that early fat transfer results can look very impressive but early results are not in anyway a reflection of final results when it comes to Fed transfer.
Anyone showing early fat transfer results and before and after pictures are doing a great disservice in their ability to communicate what can and cannot be achieved with this procedure. honest and realistic before and after pictures need to be set apart by a minimum of three months but preferably six months or longer.
It’s not difficult to triple breast volume with fat transfer if pictures are taken a week after the procedure or even at the end of surgery.
Those images are however temporary and final results are drastically different.
Keep this in mind when reviewing before and after pictures. Any evidence of providers showing your early results for fat transfer procedures should be discounted as not being honest and representing what results can or cannot accomplish.
Exaggerated results when it comes to fat transfer, from different sources and there’s no shortage if you look at what’s available on the Internet.
This can potentially lead to dissatisfaction and regret.
Getting a clear understanding of what the procedure can and cannot accomplish is paramount in maintaining consistent quality results and high patient satisfaction.
During each in person consultation I recommend patients ask each provider to open their portfolio and show their entire collection before and after pictures for the procedure you’re interested in. for a fat transfer you need to assess both the outcomes of the fat transfer as well as the liposuction aspect.
Ignoring the importance of having sufficient skills and experience and Liposuction can be a potential grave mistakePoorly done liposuction is permanent and irreversible and can lead to disfigurement.
Being shown a handful of preselected pictures which most likely represent the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. this is why patients should push providers to open their portfolio and show as many pictures as the provider is willing to.
For reference an experienced surgeon that should have no difficulty showing you at least 50 sets a before and after pictures of commonly performed procedures.
Ask the provider to specifically show examples of patients who have similar body and breast characteristics to your own. Bring your own printed pictures with you.
Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. ask each surgeon what the revision rate is at what the revision policy is.
Confirm the time frame between before and after pictures.
For Liposuction look carefully at all areas treated to make sure there are no skin contour irregularities anywhere. Look carefully at the transition zones between treated and untreated areas to make sure it looks natural.
Pay attention to arm position and make sure that arms are in the same position in both before and after pictures. arm position can have immense impact on what the mid torso looks like.
Pay attention to how thorough each provider is and explaining all parts of the consultation including making an assessment, describing the procedure, reviewing before and after pictures, discussing the preparation and aftercare, reviewing your medical history, discussing complications and alternative procedures.
Quality plastic surgeons tend to be detail oriented and that includes being detail oriented in and out of the operating room.
Finally I recommend reading all reviews on various physician review websites avoiding providers for any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
Ignore attempts of marketing by claiming that technologies or equipment has a fundamental advantage.
Plastic surgeons have the tools they need to do their job correctly.
Both Liposuction and fat transfer are not equipment intensive procedures and the only variable that matters is the skill and experience of the provider. There’s a little a patient can do to change their own candidacy but with patients do have his full control of decision process.
Continue having consultations until you feel very comfortable you found the most talented and experienced provider in your community.
Consulting with plastic surgeons is a skill that most patients are not all that familiar with.
Recognize that you are the one hiring the surgeon and you have a full right to vent that provider and this includes getting clear confirmation of what average results look like and how much experience each provider has.
Failure of doing this can lead to unfortunate and substantial negative consequences.
When in doubt slow down and schedule more consultations.
Avoid providers who claim that variables like PRP, stem cells or any other marketing tool makes a substantial difference.
The truth is they do not but what does it matter is who does the operation.
Best,
Mats Hagstrom MD