Can I replace silicone implants with fat after tuberous breast augmentation?

You can remove breast implants at a later stage and replace with fat transfer. Fat transfer will create a different look than an implant, as it has less structure, but for the most part you won't have 'relapse' of tuberous breast deformity. At the time of explant, you may need a revision lift in addition to fat transfer to achieve the type of aesthetic you are looking for.

Hello!
An impactful implant procedure cannot easily transfer into a fat transfer procedure - the outcomes are totally different. Fat when transferred goes into the tissues of the breast layer by layer - skin, breast tissue, pec muscle. One cannot create a volume of fat that mimics an implant. Fat nicely enhances results of Tuberous Breast Correction with breast implants, but does not replace implants.
Best of luck to you!

You won't ever get BIA-ALCL with smooth implants. Although no physiologic mechanism has been attributed to BII, there are a few demographics that can increase your risk of BII: advanced age, self reported anxiety disorder or health anxiety disorder, use of the internet for health information, distrust of the medical community, cigarette and/or marijuana smoking, tattoos, and SALINE implants. Forgive me if I have misinterpreted a statement you made in your question, but if you feel that any plastic surgeon is a misogynist because they don't think BII is real, then you clearly have mistrust of the medical community, at least the important ones, like those operating on you for breast augmentation. If that is the case, you shouldn't get breast implants as that would put you at higher risk of BII.

it is very difficult to correct complex tuberous breast deformity without implants. Only on the basis of in person consultation, an experienced board certified plastic surgeon with expertise in tuberous breast reconstruction, could give you more accurate answer. Conditions you are afraid of are very rare and some of them not related to smooth implants (ALCL). It will take several procedures of fat grafting (2-3) to achieve improvement which can be expected with implants in a single surgery. Yous should make 2-3 in person consultation about this issue with board certified plastic surgeons who have significant experience in this area. Good luck.

In the absence of an examination in person, or at the very least, photos, it is not possible to provide you with specific answers or treatment recommendations. That said, however, a breast implant is NOT necessarily required to correct a tuberous breast deformity unless you are especially small breasted and want a significant augmentation. Fat grafting can be used both as a supplemental or adjunctive procedure, as well as a stand alone, with or without the use of an implant. the latter, however, is least likely to be necessary since proper implant selection can eliminate the need for simultaneous fat grafting. If the goal is to avoid implants altogether, an examination by a board certified plastic surgeon would be required to see if you re indeed a candidate for such.

It appears that you have done a commendable amount of research, but a board certified plastic surgeon should be able to answer your remaining questions. Best of luck to you.

Dear Resourceful5100,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. 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

No, there is no way to replace the great results of implants for correction of tuberous breasts by fat. Fat is still use to fill minor volumes, and is very suceptible to infections, reabsortion and fat necrosis.

Sorry to telll you that ALCL and BLL are related to capsular contracture and are simply avoided by removing the contracted capsule and putting on new implants. I think you missunderstood what you read. These two lesions are not related to the implant but to the contracted capsulae. And as soon as you feel is contracted the solution to avoid further problem is really easy.

Very thoughtful question. Fat transfer, assuming you have sufficient fat, will not produce more than a very small change in volume and fat is not forever or consistent. Removal of an implant involves a second surgery with attendant risks and the pocket may be larger than the fat volume so I wouldn’t recommend this. I understand the media hype about ALCL although the risk is minimal and that it has terrified some patients. However, if this is a concern, then you could consider saline implants, which are less costly and do quite well in my practice, or simply correct the tugerosity. Best wishes.

First, the chance of getting ALCL is minuscule (google the newest FDA statement from last month and look at the total number of cases reported). BiI is certainly real for some patients, but once again very rare.
Fat transfer to the breast is mediocre. Generally, patients experience a 1/2 cup size increase. The issue I have had is containing the transferred fat in the breast tissue and not in the capsular space. Go for the tubular breast correction/augmentation and see how you progress over the years to come.
Best wishes
Dr. Taranow