Breast fat transfer vs. augmentation? (Photo)

Question

I love everything about my breasts, I'd just like them to be larger. I think I have ptosis 1 in one breast and grade 2 in the other. I don't want a lift. I've seen photos of people with ptosis grade 1 who have had implants with no lift and I love how they hang naturally. I just want to get an opinion on whether my larger breast is too low for an implant without a lift (don't want a snoopy boob!). If I would need a lift then I'm going for fat transfer!

Randal Haworth, MD, FACS · Answer

In your case, I strongly believe that a lift would be necessary in addition to a breast augmentation. Opting for breast implants without addressing this kind of ptosis can potentially increase the risk of complications . For example, there may be an increased risk of implant malposition, bottoming out (where the implant descends below the desired position), asymmetry due to the underlying breast tissue sagging, snoopy deformity and the implants may probably sit even lower on the chest.

Fat transfer to the breasts could be a good option !

I hope this helps,
best of luck !

Fat transfer to the breasts could be a good option !

I hope this helps,
best of luck !

Joel Patrick Maier, MD · Answer

The likelihood of a Snoopy boob appearance is high with implants, the tissue will hang off of the implant. This would not happen with a fat transfer as the fat can be spread evenly throughout the breasts enhancing the breast more globally. You also have the advantage of no implant which can have significant problems long term that would not be seen with fat transfer. Thank you.

John L. Burns Jr., MD · Answer

You can enhance your breasts with either an implant or fat transfer.  Fat transfer is more limited in that it is variable and can only increase your breast volume about one cup size.

Daniel Barrett, MD · Answer

Dear djdjdjdjdk,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

If you like the appearance of your breast but just want a volume increase, then fat is the way to go. Using an implant will lead to shape issues that will make your lovely breast look odd without a breast lift. Using fat will evenly distribute volume (in the form of your own natural tissue) throughout the breast and look the most natural. You would only need to harvest fat from your hip region and get a marvelous result there too.

Alan Gonzalez, MD, FACS · Answer

Hello @djdjdjdjdk, thank you for your question. Breast fat transfer is a really good option because the fat seeded will stay there for life and you don't have to change implants. If you decide to go the implant route bear in mind that the placement of the implant is what can cause the snoopy boob, not the implant itself .  That said, Even if you choose to get implants or fat transfer you will need a lift to rearrange the position of the breast, enhance the shape and projection. I link a video to shed more light. Best wishes! Alan Gonzalez MD, FACS.  American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Hilton Becker, MD · Answer

Breast augmentation alone  does not work very well in a ptotic breast.
If you are OK with the ptosis and just want extra volume  fat grafting  may be effective

Connie Hiers, MD, FACS · Answer

You are not grade 1 ptosis and do need a lift. Without the lift, you will just have larger and still sagging breasts.

Mats Hagstrom, MD (license on probation) · Answer

Grade 1. Ptosis means the nipple is at the inframammary fold. Great to ptosis means dinner phone is substantially below damn for a memory fold, but the nipple is not the lowest part of the breast. Grade 3 ptosis means the nipple points straight down. Where it is the lowest part of the breast.
We can’t see your inframammary fold on the picture, but based on the picture, it looks like you have a grade 2 ptosis in both breasts. In order to have a natural appearance, recognize that the breast implant will sit underneath your pectoralis muscle, which ends at your inframammary fold. In other words, the bottom of the implant will be above your inframammary fold and your breast will hang off the implant.
For that reason, you will most likely need a lift with implant augmentation. Fat transfer can increase breast size by 1/2 cup, but does not change the shape of the breast in any significant way. Breast fat transfer gives a very different appearance, and then implants.
Fat transfer is subtle compared to implants, and just makes the same breast slightly larger.
I suggest having multiple in person, consultations with local board-certified plastic surgeons in your community.
Best,
Mats Hagstrom, MD

Breast fat transfer vs. augmentation? (Photo)

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