Optimal fat cell size

Question

I have read surgeons suggesting that it's better to have smaller fat cells as more can be harvested and transferred. So my question is in skinny fat patients how do you know what size the fat cells are in their stubborn pockets? Can thighs rubbing together and chin fat suggest their fat cells are larger than optimal for a breast fat transfer? Would weight loss of 2 pounds make a difference in a 5/6, 133 pound patient who has been approved as having enough fat for BFT?

John L. Burns Jr., MD · Answer

Rather than size of the fat cells, harvesting from good donor sites it most important.  I typically use the abdomen, flanks, and circumferential thighs.

Ronald J. Edelson, MD · Answer

I answer questions about fat transfer to the breast quite often. Many of these questions are really people complaining that the fat all got absorbed.  I always tell people that if they get fat transfer, keep your expectations low. No matter who tells you how wonderful it is. I’ve also looked at on line photos and they are not impressive at all. Save the money and spare yourself the dissappintjent

Connie Hiers, MD, FACS · Answer

Two-pound weight loss should not be a problem. Fat cells can expand up to 200 times their original size, so the actual size of the fat cell is really not important. The important thing is not to be losing and gaining weight and going up and down in sizes.

Mats Hagstrom, MD (license on probation) · Answer

I suggest not trying to reinvent the wheel or to try to understand technical aspects of cosmetic surgery.
In my opinion, patients are better served by focusing on the variables that have impact on your potential outcome.
In the end, the two most important variables patients should focus on is their own candidacy for the procedure, which includes having a clear understanding of what the procedure can, and cannot accomplish as well as provider selection.
A substantial number of people seeking breast fat transfer are not good candidates for the procedure. Fed transfer has some attractive benefits but it’s important to recognize what the procedure can and cannot accomplish. Breast-fed transfer can increase breast size by approximately 1/2 cup or about 50% breast volume. The procedure can, however, not change the shape of the breast or create any type of breast lift. It does not give a good projection, the way breast implants do. It’s also important to recognize that early fat transfer results can look very impressive but early results do not represent final results. When reviewing before and after pictures, make absolutely sure you understand the timeframe of when after pictures were taken. If results look too good to be true, then they probably are. Breast fat transfer is two procedures done at the same time. The ideal candidate for breast fat transfer should be a good candidate for Liposuction and a good candidate for a fat transfer. 
Delivering consistent quality, Liposuction and fat transfer result is far more difficult than most people realize. The number of plastic surgeon in Sushi remastered these procedures are in a small minority. Being bored, certified in plastic surgery with years of experience, and an overall good reputation does not mean somebody has mastered or is even good at Liposuction, and or fat transfer. 
Somebody who is an excellent candidate for a cosmetic surgical procedure has the potential for having an excellent outcome. They can also end up being disfigured if the choice of provider was not done well. Finding the right plastic surgeon is much more difficult than most people think, and this process is labor-intensive and takes time.
In the end, understanding your candidacy for the procedure, and choosing the right provider are the two variables that will, or will not determine if someone has a quality outcome. All other variables are relatively insignificant.
Gaining or losing a few pounds is irrelevant compared to understanding your candidacy or provider selection.
The following are some general guidelines to help find the best provider, and to begin the process of getting a quality assessment regarding your candidacy for the procedure.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

Optimal fat cell size

Answers (4)

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