Can you have breast fat transfer at the same time as implant removal and anchor lift? Or, is it best done separately?

Question

I got 210cc filled to 240cc saline implants with a lift 6 years ago. I am in need of another lift. I would drain the implants ahead of time.

Gary M. Horndeski, MD · Answer

I do not recommend the anchor lift because of the unacceptable vertical scars.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness, elevated 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, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Kenneth Hughes, MD · Answer

I usually perform the explant and lift first.  The fat grafting I typically perform in about 3 months. Some of the success will depend upon existing tissue available for receiving the fat.  Fat grafts should always be optimized with the best blood supply available. Fat is injected through multiple planes in small amounts to the tissue through one tiny incision under each breast.  In general, the abdomen and thighs are preferred donor sites.  The fat grafting will likely take several sessions to produce a similar result unless the breast implants were extremely small.

Ronald J. Edelson, MD · Answer

If you just need to be lifted a bit further it could be done while leaving the original implants in place if you volume. You don’t make it clear if or why implants would be removed or changed. Don’t get your hopes up too much about fat transfer to the breast. Most of it will get resorbef.

Siamak Agha, MD, PhD, FACS · Answer

Breast fat transfer is best done for about 1 cup of breast augmentation. In my practice, I do not do this at the same time as a breast lift since the breast lift opens up the breast tissue, creating dead spaces, and that may result in the fat cells to migrate and end up in the open spaces.  I prefer to have the breast healed after a breast lift and then wait for the breast to settle for a few months before I sculpt the breast with fat transfer- which I typically like to place in the other breast.  Below is a patient who's breasts were built in  this manner. She also had other procedures.....Best of luck.

Robert M. Tornambe, MD · Answer

JenniferI appreciate your concern and it may be possible to utilize breast fat transfer to replace your implants if you have enough fat to satisfy your needs with regard to size.You do have options, both with pros and cons. Implants have a solid and reliable history with very high patient satisfaction rates but they must be replaced every 12-15 years. Fat grafting has the advantage of using your own body's material to increase breast size, but only small augmentation is possible and it is just gaining popularity and long term results are not yet available. There is always uncertainty about how much fat will "take", increasing the possibility of asymmetry and need for revision. Many plastic surgeons are still concerned about how the fat that did not take looks on mammograms, and if it will increase long term false positive results. Be sure to consult with a board certified plastic surgeon to help you navigate this decision. Good luck!

Daniel Barrett, MD · Answer

Dear Jennifer411,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others. Generally speaking, those surgeries can be done at the same time. 
Daniel Barrett, MD

Connie Hiers, MD, FACS · Answer

Whether the fat transfer can be done at the same time as the removal and lift depends upon  several things. One of the main things is how much actual breast tissue is present and how much lifting is required. For a full lift, I choose to do the fat transfer later to increase the survival rate of the fat cells.

Gilbert Lee, MD · Answer

Thank you for your questions. It is common and safe to fat graft the breast at the same time as a lift. The fat grafting gives volume to the upper pole of the breast while the mastopexy lifts the sagging tissues. I recommend scheduling a consultation with a board certified Plastic Surgeon who is experienced in fat grafting. In our office, we offer 3D imaging to give our patients an accurate idea of what their final result will look like. Good luck!

Robert L. Kraft, MD, FACS · Answer

I think we need to know much more.   Why do you need a repeat lift after only six years?   what surgical approach was used?   Do you have enough fat to make a noticeable difference?   All these issues need to be discussed in consultation with your plastic surgeon. Best wishes.

Bennett Yang, MD · Answer

Hello and thank you for the question. Yes, both can be done together, given you are healthy and have no risk factors that would preclude you from having additional surgery. Question: why are you removing vs replacing the implants? Fat transfer to the breasts is a possible option and works well in certain cases. 1. you only want a small volume of added fat to the breasts. Larger volumes tend not to work and doesn't give the same fullness and size that a breast implant would. It is best reserved for modest volume corrections 2. you must account for some fat loss. Generally, for brazilian butt lifts, about 80% of the fat remains long term. In the case of breasts it is much less, around 50%. So you need to somewhat over correct the breast knowing in advance that about half will be gone. It is unusual to need another breast lift in 6 years, unless it wasn't a full anchor type lift the first time? Sometimes, weight fluctuations, repeat pregnancy can cause the breasts to sag again. Doing a full anchor, although it does leave scars, is the best option to lift the breast in the most permanent manner. For some examples of my before and after patients, please follow me on instagram: @bennettyangmdThis surgery typically takes 2-3 hours to complete, and requires about a week off of work and a month out of the gym. Before having any surgery, you should be healthy, non smoking, and make sure any health conditions are being managed by your primary care md. Best to you.

Can you have breast fat transfer at the same time as implant removal and anchor lift? Or, is it best done separately?

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