How successful is fat transfer to the breast after explant?

I'm researching a PS to remove 40 year old small implants that have ruptured within the capsule. MRI has confirmed that silicon has not spread. I do not want another implant but am curious on using fat transfer to help breast look inflated post surgery. I'm worried that my breasts will look deflated after the explant. Suggestions?

Doctor Answers 9

How successful is fat transfer after explant?

Fat transfer can be a good alternative to breast implants but does have a few drawbacks.  First, fat transfer is not as predictable as breast implants, meaning for the fat transfer to be successful, the transferred fat has to develop a new blood supply within the breast tissue vs an implant which requires no blood supply.  For this reason, the predicted amount of fat that successfully survives is about 50% of the transferred amount.  Secondly, there has to be a sufficient donor site for the fat.  And lastly, because only about 50% of the fat survives and the limitations of fat transfer in a single setting, more than one surgery may be necessary to transfer a sufficient amount of fat to achieve your desired breast size.  Another alternative is breast lifting and reshaping at the time of breast implant removal, depending on how much breast tissue you have aside from the implant volume.  Best of luck!


Sacramento Plastic Surgeon
4.9 out of 5 stars 43 reviews

Fat Transfer

A person’s own fat may be used to improve the appearance of his or her body by moving it from an area of excess (or where it is less desired, such as the thighs, hips or abdomen) to an area that has lost tissue volume due to aging, trauma, surgery, certain diseases, birth defects, or other causes.
Ideal candidates are in good health, and have excess fat in some parts of the body and too little in other regions. Fat grafting is most often used for the face, breasts and buttocks. Typically, the transferred fat results in a significant increase in volume of the body site being treated.
Fat for lipoinjection, also called fat transfer, is removed from unwanted areas of the body by a narrow blunt tip surgical instrument with side holes, called a cannula, through a small incision. The fat is then cleaned with sterile saline solution before being restored to the body. The fat is then injected into the desired area using either a smaller cannula or needle, or it may be placed directly through an incision. Since some of the fat that is transferred does not remain over time, your surgeon may inject more than is ultimately needed to achieve the desired end result. Over a few weeks, the amount of transferred fat will decrease.
There is a limit of how much fat can be safely injected into one area. The amount of fat that remains over time is variable from patient to patient. For some patients, more fat or other fillers may need to be transferred in a subsequent surgery to maintain or supplement the desired results.

Fat transfer to the breast involves a relatively short recovery - just a few weeks.

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Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 150 reviews

Fat Grafting to the Breast

Fat grafting to the breast may be a good option for you.  Fat graft survival is somewhat unpredictable and is very technique dependent.  There will be some resorption, so over-correction is important.  If you need a breast lift with the implant removal, you might consider the fat grafting at a later time.

All the Best,

Dr. Brian Reagan

Brian J. Reagan, MD
San Diego Plastic Surgeon
4.8 out of 5 stars 18 reviews

Fat Grafting

Thank you for your question. Fat grafting is a procedure that I perform often, and that my patients are extremely happy with the results. Fat grafting is a novel technique that may be used to naturally augment or accentuate the breasts. It is essentially taking fat from one area on the body and transferring it to another area.

However, the best way to give true advice would be an in person exam and consultation. Please see a board certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!
Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 82 reviews

Fat grafting to breasts after explant

can certainly be done but if not placed in the proper tissue planes, you are wasting your time and fat.  It would be ideal for you to have your capsules removed (including implants), heal, then see where your deficits are.  Then the fat can be grafted with more precision.  This can be done in the office under local if you are tolerant of some discomfort and I'm a fan of the PureGraft system as it makes processing the fat very simple.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

How successful is fat transfer to the breast after explant?

In you case, I would not do fat grafts at the same time of implant removal with total capsulectomy for ruptured implants. This is a wide dissection, have to go through breast tissue. You can have delayed fat transfer (assuming you do have enough fat to transplant) once the implant pocket scars down and there's no open space. If I know that the implants are not broken, I remove them through a very small incision in the lateral chest just outside the breasts. This way, I do not dissect into the breast tissue, I intend to graft. Also, it allows me to place my finger into the pocket and make sure I do not place fat into this open space. The fat is placed into the muscle and breast fat deep and superficial, as the implant pocket is collapsed. See a board certified plastic surgeon with experience in fat grafting for an in person consultation/evaluation. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 35 reviews

How successful is fat transfer to the breast after explant?

We are still in the early stages of fat transfer, but it definitely may be a help for you. Of course you have to have enough fat to transfer and it may take more than one procedure because we never know how much of the transferred fat will survive. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 26 reviews

Fat Grafting Breasts

Hello,

This is a good alternative to implants. It can be done in a staged procedure or simultaneously to explant. Breasts should be overgrafted by 30% to 40% of the desired volume.  The Brava bra system improves graft survival and is worn for two weeks prior to surgery.  You'll need sufficient fat stores to harvest appropriate amount for grafting.  Alternatively, new silicone gel implants will probably last you a lifetime without rupture.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 87 reviews

Can be very successful

Fat transfer post implant removal can be successful but there is only a limited space that the fat can be placed at the time of explantation.  Depending on your goals and expectations, you may require a second session of fat transfer to achieve the size that you are looking for.  

Jules Walters, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 46 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.