How long does fat grafting to the breast last & is it ever lumpy?

It is possible to augment the breast using a patient's own fat.  A small increase in size can be expected after fat transfer.  We know that not all of the fat will survive the transfer process and estimate approximately 50% of the fat will survive long term.  This means that the initial size and fullness seen right after surgery will become significantly smaller within the first few months.  The fat that does survive is permanent and will behave as other fat in your body in regards to weight fluctuations.  It is possible to get lumps in the breast after fat transfer.  Most of these lumps will go away on their own over time but in rare situations may need to be surgically removed. Implants can give more reliable and predictable results when compared to fat transfer.  However, fat transfer is an option for those patients that do not want to have breast implants. 

When you liposuction and do fat transfer to the breast about half the fat will remain permanently. Keep in mind the size of these fat cells can grow and shrink with fluctuating weight. It is possible to get small bumps from fat necrosis but most of these can not be felt. Another option to consider that does not involve implants and gives a very natural looking augmentation, is a procedure I perform called the dermal bra suspension lift. This procedure uses your own breast tissue and fat to lift and shape the breast. Follow the link to view our photo gallery and check out our instagram page @drsiamakagha for live videos, photos and more.

About 50% of the fat obtains permanence.  You have to consider not only which areas will have perhaps the best fat, but also you have to consider which donor sites will have the fewest problems afterward with the liposuction.  In general, the abdomen and thighs are preferred, but, if those sites are not available, other areas can be used.
I am not sure that the data has been collected on rate of calcification, and then the issue becomes whether that is clinically significant. The calcification lumps are usually not an issue.  It is reasonable to expect  lumps to improve or soften with time. As scars mature, they soften.  This process may take several months.  If the lump is the result of swelling, seroma, or  hematoma,  it should resolve quickly.  If the lump is fat necrosis or viable fat that becomes discrete and remains palpable, it may require further treatment like aspiration or removal.

whatever fat survives the procedure will last forever. yes it can be lumpy.  you could get fat necrosis and calcifications on mammogram.  make sure to get several opinions as 5there are some who are less positive than others about this option.

Dear jelllyb,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If done properly and not with a large volume, fat grafting can last a long time unless you have weight loss. The risks of lumps, oil cysts, and areas of fat necrosis increases with large volume transfers. In women who exercise a lot, fat may not last as long.

Dear jellyb, I like your question because many of my patients face the same dilemma.  I use fat grafting to breasts a lot to correct complications like scarring or contour problems.  It's also very good to correct breasts with implants that have thin tissue.  Fat grafting can be used for augmentation but as you mentioned is less predictable.  Implants allow you to augment the breast in a predictable way because they have a defined shape and size.  Fat grafting, even if successful, will not provide a defined shape to the breast.  Sometimes to achieve the size you want more than one surgery may be necessary.  We need to keep in mind that the sources of fat are limited and that taking fat from somewhere may cause deformity as well. I think fat grafting is very useful but when it comes to augmentation is less practical.

Depending upon how big you want to be, you might need multiple sessions of fat grafting as not all the fat lives. Also the fat has to come from somewhere, if you are thin you may not have enough fat for much of a result. If you gain weight after fat grafting your breasts may grow disproportionately. Get at least two or three in person opinions from experienced breast surgeons so you can better understand your options. Hope this helps, good luck!

It is unusual to get good "take" of the fat that is transferred to the breast like iut does in BBL. If you get one increase in cup size your are doing good. Breast implants are still the "gold standard" to increase one's breast size. 

Fat that survives the transfer is permanent but will increase and decrease in size with your weight. It is still an operation in evolution and there are problems, hard lumps from dead fat is one of those problems.