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

Question

I am getting a nipple reduction and breast fat transfer. My consult suggested 150 ccs per breast for maximum retention m too much would not be adviseable. I want to trust him and his expertise, but wanted to get other doctors thoughts. Is 150cc/breast worth the trouble? Early 30s, 2 kids, 5'5", 125lbs.

Kenneth Hughes, MD · Answer

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.

Rodger Shortt, FRCSC · Answer

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.

Kristopher Day, MD, FACS · Answer

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.

Alan Gonzalez, MD, FACS · Answer

Hello @Powerful487894 thank you for your question. Between 150 and 250 cc would be an adequate volume for the process and the expectations you have. Best wishes. Alan Gonzalez MD, FACS

Daniel Barrett, MD · Answer

Dear Powerful487894,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Only you can decide if 150 cc's of inserted fat, which will be more like 75-100 cc's of retained fat, about half a cup, is worth it to you. Otherwise, implants can give more volume and are much more stable.

Douglas Taranow, DO, FACOS · Answer

Putting more fat into the breasts does not equate to more fat surviving.  Generally speaking, fat transfer to the breasts enlarges them most commonly 1/2 size (one size larger if lucky).  250cc’s of purified fat is a decent amount in your frame and breast size.

Mats Hagstrom, MD (license on probation) · Answer

Unfortunately simply relying on numbers when it comes to both Liposuction and fat transfer is a bit inaccurate.

Grafted fat often as a significant amount of numbing solution left in it and simply going by numbers of milliliters can therefore be misleading.

If that has been completely separated with the use of a centrifuge then 150 mL may be as sufficient volume.

If it still contains a significant amount of numbing solution then this is a pretty conservative volume to graft.

The proof is in the pudding and I suggest during consultations ask each provider to show their entire collection of breast fat transfer before and after pictures.

Confirm that all after pictures were taken at least three months from the date of surgery.

An experienced provider should have no difficulty showing you at least 30+ sets of before and after pictures.

Highly experienced surgeons will have hundreds.

If the provider can show consistent quality results on patients with similar body characteristics to your self as long-term final outcomes then you’ll know exactly what you’ll be getting.

If your provider hasn’t showed you a plethora of quality before and after pictures with after pictures taken at least three months from the date of the procedure then I suggest having more consultations.

Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe.

Liposuction is permanent and irreversible.

If done poorly you can leave people disfigured.

I recommend all patients have multiple in person consultations before committing to any surgical procedure but this is especially true for liposuction and fat transfer procedures because the learning curve is steep and long.

Even under ideal circumstances the augmentation or volume increase is fairly subtle of about 1/2 to one breast cup size.
Personally I graft fairly aggressively and would probably graft three times the volume.  I have slowly increased the amount that I graft based on what seems to work and not work.

My practice has been specialized exclusively in liposuction and fat transfer for the last decade.

I do a lot of these procedures.  Getting quality results is more difficult than most people believe.

When most patients have problems from fat transfer procedures it’s usually from poorly done Liposuction.

Make absolutely sure your provider has mastered these procedures before committing to having surgery.

Best,

Mats Hagstrom MD

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

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