Should I get breast implants? Or another fat transfer? (Photo)

Question

Underwent Fat transfer, October 2022, due to breast asymmetry. Fat taken from flanks and stomach. I'm 5ft 5 inches and 120lbs. Looked great at 6 week review, now I'm back to where I started. Surgeon has suggested another FT. I want implants, he takes a lot out due to Breast implant illness and be warned me about this. He said he would want to do another fat transfer first. I feel like it's a waste of time! Picture attached And advice much appreciated!

Joe Gryskiewicz, MD, FACS · Answer

Hello,
Fat transfers are very unlikely to be a one and done type of surgery. The fat may metabolize over time. If you want a permanent result, I'd suggest breast implants. Otherwise if you do another fat transfer you may run into this issue again. Patients with BII may have underlying health issues.  
All the best,
Dr. Joe

Daniel Barrett, MD · Answer

Dear AR1808,
fat transfer can achieve some increase in size. however, if you want a significant increase (more than one bra cup size), then implants are a better option. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

Hampton A. Howell, MD · Answer

Hi.  Based on your photograph I would expect you do not have a whole lot of fat to use to harvest for the fat transfers, and thus it is doubtful that you would see much improvement with another round of fat transfers.  It is obviously variable in terms of how much of the fat stays and how much of it goes.  But if you want breast implants then find a board certified plastic surgeon with good experience with breast implants and move forward in that direction.  
Good luck and take care, 
Dr. Howell

Ronald J. Edelson, MD · Answer

You have just discovered the truth about fat transfer. It’s a hit or miss procedure at best. If you get it again the same thing will probably happen. Breast implant illness is rare if it even exists. Get another opinion.

Ram Kalus, MD, FACS · Answer

The answer to your question rests with your goals. An examination in person would be required to properly evaluate you and make specific recommendations, but if you are pleased with the enhancement you achieved with prior fat transfer, and you have enough "donor fat" to allow for a repeat transfer, then this might be an acceptable option for you. Remember that fat graft "take" is variable and unpredictable, and based on your one photo it appears that you have pretty and well proportioned breasts, although one breast appears to be larger than the other. Asymmetry is quite common and by no means "abnormal", however the most predictable and precise way to achieve optimal symmetry is with a carefully planned and performed breast augmentation with appropriately selected implants.

Please discuss this with your plastic surgeon or any experienced board certified plastic surgeon with whom you are considering having assume your care. Best of luck to you.

Please discuss this with your plastic surgeon or any experienced board certified plastic surgeon with whom you are considering having assume your care. Best of luck to you.

Connie Hiers, MD, FACS · Answer

Fat is limited on size and in some women does not appear to last long. Implants do not change in size with time. You could consider smooth saline implants for a nice increase with the lowest risks.

Camille Cash, MD · Answer

Breast implants are a reliable way to enhance the breasts with a predictable outcome.  Fat transfer can be sometimes problematic when the fat doesn't take or takes unevenly.  There can also be issues with transferred fat when mammograms are read.  I encourage you to do your research and visit with a few board certified plastic surgeons to hear varying opinions.

Douglas Taranow, DO, FACOS · Answer

If you desire breast implants, then seek out a board certified plastic surgeon who performs them.  You appear to be a very good candidate for the procedure.
Best wishes,
Dr. Taranow

Sealtiel Machuca, MD - Account Suspended · Answer

hello, I recommend Breast implant, your result is not as expected with the transfer of fat to the breasts, the incidence of implant disease is very low and we must be careful, always investigating risk factors and following steps during surgery to reduce the risk of this disease.

Richard P. Rand, MD, FACS (retired) · Answer

You should seek other in person consultations. The condition called Breast Implant Illness is not fully confirmed as a real illness. There are very specific symptoms associated with real medical conditions. In BII, literally every symptom under the sun has been "associated" with it from aches and pains, to brain fog, headaches, skin rashes etc etc. Whatever ails you, it must be the implants. REAL medical conditions don't work that way.

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