Explant, Lift and Fat Transfer - is it possible to increase upper pole fullness without an implant? (Photo)

Dear Bright714223,

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 implants
You 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

The answer is a hard no. The only thing that can give you upper pole fullness is an implant, which is safe and effective, and does not cause systemic illness. Surgeons' talk about 'auto tissue transfer' as part of their breast lift or fat grafting are not being honest about true upper pole fullness with any sort of durability past 3-6 months.

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. I have been in practice for over 30 years, and breast revision surgery is a large portion of my practice. I have seen 100's of cases similar to years who have had excellent outcomes. In your case, there is virtually no way to have long-term upper pole fullness without an implant. I have developed a technique That was exactly designed for your issues. It is termed "Reductive Augmentation" and this was published in 2017. It combines a breast augmentation, mastopexy/lift, and removal of inferior pole breast tissue. You should be able have an excellent result. Best wishes to you.

The short answer is yes it is possible but it also depends on the amount of breast tissue you naturally have. Fat grafting can certainly help but it is also important to have a reasonable amount of breast tissue to allow us to shape the breast primarily and then we use fat to improve cleavage and upper pole fullness.

Based on your post photo, you would need an explant with a full anchor breast lift and nipple complex reduction, followed by liposuction and back grafting to upper polls for a slight fullness. This is the one surgical session best of virtual concert with expect fees to range from $10,000-$20,000.

The simple answer to your question is no.
Breast fat transfer can increase the breast size by about 1/2 cup, but does not change the breast shape in a meaningful way.
The reason volume cannot be created in the upper half of the breast with fat transfer is because that area has so little tissue to graft into.
In order for the grafted fat to survive, there has to be sufficient host tissue to support the grafted tissue.
Implants give fullness in the upper half of the breast.
Mats Hagstrom MD