Fat grafting to uneven breasts is an excellent option. Fat can be injected into areas of the breast to best correct asymmetries. Once fat has taken in the breast it will enlarge and reduce like the natural occuring fat breast. Loss of fat injected to breasts once it has taken is not typically the case.
Trust in The Surgeon who has operated on a patient should be paramount. Who knows the patient's tissues and history better than the treating physician?
Please use this information when consulting in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions.
Fat grafting to the breasts is considered a permanent fix; however, you have to be at your comfort weight as your breasts will change if you gain or lose weight.
I think it's a great idea to proceed with a fat transfer to your breast. It takes about 6 weeks to 3 months for the transfer to reach a stability point. Once you reach this point then the fat is permanent. Unfortunately, it doesn't stop the aging process and there will be changes in your breasts that may require additional procedures in the future.
After five breast implant procedures I think "fine tuning" with fat grafts is a good idea. No one knows how long the fat will persist however my experience in other areas of the body would indicate that though it decreases in many over time, it does benefit the patients for years. Whether this proves to be five years or twenty-five years remains to be determined over time. Good luck with your decision and remember that the risks of complications after multiple implant surgeries rises so a smaller procedure like fat grafting does have its merits.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
ABC-TV Extreme Makeover Plastic Surgeon
Beverly Hills, California
Dear Ms. Livschmdt,
Thank you for your story and questions.
Nothing substitutes for a personal evaluation, a review of your medical history/medications and a face to face discussion of your options
Unfortunately with out photos and a exam of your tissues I can can only comment based your story, however I hope you find my comments helpful.
Fat grafting is technique sensitive and is dependent on several variables, including but not limited to:
d) areas injected
Fat once incorporated in your breast will be permanent.
I recommend that you collect a number of "model" photos of your desired appearance and I trust your Plastic Surgeon is a experienced and Certified by the American Board of Plastic Surgery. In addition ideally they a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
I wish you my best and success,
R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
Pictures would help to quantify the difference you are talking about. So what I can tell you is that we use fat transfer all the time in breast reconstruction cases but it is usually small volume. Fat cells need really good blood supply to live. So if you just pump a bunch of fat cells into the breast most of them will not live. If it is just a small quantity that can be spread out broadly then it can work very well and usually this fat cells will stay for a good 10 year or more if the cells live. You may needs several smaller volume injection procedures to achieve your final goal.
Without a photo or more of a history, not much can be said about your situation. However, many asymmetries can be improved with surgery. Five failed surgeries is concerning though. Fat that survives will stay forever, but this is only a percentage of the original volume placed.
You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon
There is no procedure that is ideal for everyone. Every procedure has advantages and disadvantages. The best procedure in the wrong hands or selected for the wrong patient will always result in unhappy patients. There are limitations in what fat transfers can do such as the maximum volume that can be achieved per transfer session (usually not more than one cup size). Unless you are willing to maybe have to do more than one session to achieve more than one cup size, then the procedure is not for you. Also it may cause some lumpiness (but so can implants) but in more experienced hands and for patients who are better candidates, there is less chance of this. Not all surgeons have the same type of experience or have the same hands or use the same techniques so choosing the right surgeon who knows not only how to safely perform the procedure but who also knows how to select the proper patient is very important. Being a good candidate is also important. If you have more good quality fat to give, if you have more breast tissue to begin with and if your breast skin is not too tight, then you would be a better candidate. Also having the right expectations is key. If you are wanting to be 2 cup sizes bigger and are not open to having to possibly do more than one fat transfer session, then you should give serious consideration for breast implants. If you choose fat transfers to the breasts in place of implants, you would be able to avoid inherent risks of implants such as rupture, capsular contracture, rippling, wrinkling and migration of implants. Naturally augmented breasts (lipoaugmented) will be less heavy and thus will be out of the way more when you exercise. However, their volume will fluctuate over time especially if you lose weight and decrease your percentage body fat- your breasts will shrink in the process. If you gain weight, they will increase in volume. The transplanted fat in your breasts will also continue to age like fat in other parts of your body so they will eventually atrophy and shrink as you get older.
Getting a consultation from some reputable board certified plastic surgeons who have a lot of experience doing this is a good place to start to see if this is a good option for you.