Does Fat Transfer to Breasts really work? How long does it last?

Question

I had to have my implants removed due to Capsular contraction. Can I benefit from a Breast Fat transfer instead?

Kenneth Hughes, MD · Answer

Fat transfer to the breasts can be an effective form of breast augmentation for up to one cup size increase.Kenneth Hughes, MDLos Angeles, CA

Randal Haworth, MD, FACS · Answer

A fat transfer to your breasts is an alternative to undergoing a traditional breast augmentation with implants. Generally, the procedure can increase your cup size some if you have enough donor fat to harvest from other areas of your body. I have had excellent results with  purified fat transfer to the breast but managing expectations with the patient is key. I recommend an in person consult with a board certified plastic surgeon to address a cosmetic treatment plan that best suits your needs.

John L. Burns Jr., MD · Answer

Capsular contracture can be a debilitating and chronic problem for breast augmentation.  In these cases, autologous fat grafting of the breast is a very viable and reasonable option.  Great care should be taken in choosing the right surgeon for this procedure.  To ensure maximal graft take we have invested into fat grafting technology with has greatly improved our fat graft survival.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
Without photos, difficult to comment.
I perform a natural breast augmentation with fat. This can be removed from any unwanted areas including the breast itself as part of my lipo-lift procedure. I perform the fat grafting in multiple planes including under the muscle to give the best, most natural enhancement. Fat grafting is a great solution for someone who wants to bring their breast size up a cup or so and use natural tissue vs an implant. However, it can also be combined with an implant or used as a secondary procedure to fill in areas that are flat or thin. It does not affect mammograms or breast feeding. It can be a little lump or hard at first but tends to soften over time.  About 60-70% of the grafted fat survives.  At 6 months you will have a good idea of your results. Some women have a second or third procedure which continues to increase your volume safely. 
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic breast plastic surgery.

Best of luck!

Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Anna I. Wooten, MD, FACS · Answer

Thanks for your question.  Yes, fat transfers really do work.  I do them all the time and patients are thrilled with their results.  You must make sure that you see a board certified plastic surgeon who has experience performing a great number of these surgeries.  He or she will be able to access whether or not you are a good candidate for this procedure.  Your desired results also need to be evaluated as to whether fat transfer is the best way to reach your goal.  About 30-40% of the fat gets reabsorbed by the body, but what you are left with at the 6 month mark should stay.  Staying at a stable weight will enhance your results.  Best of luck in your search.

Curtis Wong, MD · Answer

do work and can bring you up a cup or two in size but it may also require more than one session of fat grafting to accomplish this.  There are many methods surgeons have in preparing their fat and I personally use the PureGraft system.  You can also consider mixing platelet rich plasma (PRP) with your fat to 'help' the take improve but I can't say this is proven but its sure a hot topic people talk about.  In my practice, if you have liposuction somewhere on your body, I graft the fat for free but you must cover the additional OR time needed and the PureGraft costs.  Finally if you have good take, the fat will last you for your lifetime.

Bao L. Phan, MD · Answer

Breast fat transfers (lipoaugmentation is what I like to call it) can give you the most natural looking and most natural feeling results possible in the right hands and for the right patient.  The short answer to your question is that nothing lasts forever especially living tissue, and fat is living tissue which is also the best thing about fat transfers.  If it survives the initial transfer process (which you won't know until about 2- 3 months later), it will act like fat where you took it from.  It will enlarge and plump up when you gain weight and shrink when you lose weight (and plump up again when you gain weight).  As you get older (much older) (and like the rest of the tissues of your body) it will slowly whither away (which is one of the reasons why your face gets more gaunt and hollowed out (and why your natural breasts shrink as you get much older)).  The younger you are when you do your fat transfers, the more robust and hardy your fat is, and the more likely a greater percentage of it will survive.  Here is the other thing to remember though- breast implants don't last forever either, and you are looking at several surgeries at a minimum to deal with certain issues as they age such as rupture, capsular contracture, rippling/ wrinkling, implant migration and just routine preventive maintenance replacement should you decide to have silicone gel implants.  These are things you don't have to worry about with lipoaugmentation.
Having said that though, 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.
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.

Khashayar Mohebali, MD, FACS · Answer

Capsular contracture can be an issue that can recur over time if implants are replaced. Fat grafting can be an alternative depending on your goals.  They can add volume in a conservative fashion while eliminating the potential issues implants give.  You would need to be seen and examined to evaluate if you're a good candidate.  Good luck.

Jon A. Perlman, MD (retired) · Answer

Fat transfer is rarely an equal alternative to breast implants.  If implants are not an option for your due to healing problems, then I would consider fat transfer (if donor fat is available in adequate volume) as your best alternative.  Each session should enable about a 1/2 cup size enlargement and the results should last for several or more years.  Future weight gain will enhance the increase in volume that you obtain.  Regards,
Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Extreme Makeover Surgeon ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

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