Is 150cc per breast fat transfer worth it? If not, how much? (photo)

In general 200cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons. It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer. Fat transfer to the breast could improve the fullness of the breast, particularly at the top of the breast. About 50% of the fat obtains permanence.

When I see patients in my clinic to discuss breast augmentation we typically talk about breast fat transfer and implants.

When they are opposed to an implant and we are focussing on breast fat transfer typically we would try to maximize the amount of volume that they can achieve. This in its simplest form would mean approximately doubling the size of the breast at the time of surgery. Realistically about 40-50% of that volume will be lost. Keep in mind some of that volume is damaged fat cells or fluid, a portion do not survive the transfer process, and the surgery itself causes swelling. All of this goes down over the first few months. Generally, what is seen at 1-2 months is close to the final result, but subtle changes still take place. Some lucky patients maintain more fat than others.

I think it is important to advise patients that excessive fat grafting will decrease the amount of survival and lead to oil cysts. If they appreciate that the goal is to SAFELY maximize their volume, then it can be a great surgery choice. If patients have a very specific goal in mind for size, a breast implant is far more reliable for that.

I do try to give an estimate to patients as to how much fat I can put in. However, at the time of surgery I do try to fill it as much as is safely possible. Again excessive overfilling or careless placement of the fat both decrease survival and increase complication risks. I think a plastic surgeon that does a lot of this surgery, should be considered when having this procedure.

For the right patient, this procedure generally provides a lot of happiness. I think part of being the right patient, one must have realistic goals about size increases.

Dr. Rodger Shortt, plastic surgeon, Oakville, Ontario.

Fat transfer to the breast is a way to avoid breast augmentation with an implant. However, it is also less powerful than implant-based breast augmentation. The best reports of retention of transplanted fat in the body report slightly over one half of the fat is present over a year later. It is probably not as simple of a number of cc's equal a cup size, but most people approximate that it takes 250-300 cc to change a breast by one cup size. So, like anything, I think it comes down to a conversation with a knowledgeable provider and the patient, education, setting expectations, and deciding what approach will or will not meet your goals. If you are doing repeat procedures, of course, you can do less at each stage. But, ultimately 150 cc/breast will likely result in around 70 cc or less long-term, which is about a little more than a quarter of a measuring cup.