Can I get these results with a 2nd breast fat transfer or would it require implants? (Photo)

Dear Eclectic531509,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I would take you a different direction . . . seems like you have some ptosis of the breast and a (?) prior peri-areolar "lift". I would recommend a full mastopexy (no implant or fat transfer) as this will help make your breast proportion more appropriate for your frame and reshape your breasts to a proper "C" cup. But this all depends on you expectations and desires. Thank you.

Thank you for your inquiry! That would depend on how much additional volume you want in your breasts and if you have enough fat in other areas of your body to be able to transfer. I recommend scheduling a consult with a board certified plastic surgeon like myself and we can create a surgical plan to best achieve your goals!

Fat is quite soft and will reposition itself. It will not necessarily stay where you placed it but it will flow gravitationally. It is unlikely you will maintain the upper pole fullness you desire. The better technique would be a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Each round of breast fat transfer is going to enhance your breast volume more and more. Regarding breast fat transfer, achieving an appearance that rivals breast implant outcomes is difficult to obtain with only one round of fat transfer. As long as there is adequate volumes of donor fat, two rounds is definitely better than one. Three rounds better than two. And four rounds better than three. And on and on, but eventually donor fat is exhausted. The majority of our patients undergo one round of fat transfer and are satisfied with the relatively subtle enhancement outcome. I have achieved implant-like outcomes with 3 or more rounds of fat transfer. These are staged procedures that are separated by 3 or more months between each transfer.

Additional fat transfer can be performed, you do not appear to have areas to liposuction to obtain adequate fat to use.

Implants would give sustained and predictable upper fullness. Size would be determined.

An exam and consultation with a/your plastic surgeon is recommended to confirm this as well as discuss your best options and expectations.

This is a great question and largely depends on how much volume you want to add. An implant will instantly give you a larger size whereas fat transfer can only augment a mild to moderate volume. Additionally, the fat transfer will have more swelling after surgery and up to half of the fat transfer can be resorbed over time.

If you only want a modest size increase without having an implant, then fat transfer is the way to go. If you want a larger augmentation and want to see a big difference right away, implants may be a better option for you. Hope this helps!

The decision between breast fat grafting vs implants ultimately centers on individual patient goals, available fat stores, tolerance of having breast implants in place. Breast fat grafting is less of an exact procedure, as compared to implants. Most studies would indicate that somewhere around 50% of injected fat is retained, however this can very patient to patient. If patients have significant goals for size increase, or desire a clearly augmented appearance, implants may be a better solution. However if a first round of fat grafting was well-tolerated and you noticed a significant improvement, a second round of fat grafting may be able to give you the results that you are hoping for.
Sean M Fisher MD

Upper breast fullness would be achieved best with implants placed behind the muscle. You may also need a lift to help raise your areolae.

Dear Eclectic,
The photos that you have provided are somewhat suboptimal, and it would be nice to see pre-op photos to compare. If you've had a decent result with good retention of the fat transferred to your breasts and want to avoid the issues associated with breast implants, then a second round of breast fat transfer is very reasonable. Return to your previous surgeon for an examination and photo comparison. He/she will appreciate the follow up. Good luck!