Thank you for your question. You are an excellent candidate for fat transfer. I think upper pole fullness is the ideal indication for fat transfer. I do it with a lot of my mastopexy patients that do not want implants. In my experience, usually only 1 procedure is required for upper pole fullness (I have never done more than 2). Usually 3 or 4 procedures are required only when you want to transfer a lot of fat and for these patients I usually recommend an implant.
The use of fat for upper pole fullness is a great option if you have fat to donate from other areas. I do fat grafting and mastopexy at the same time. Please see the link for examples
I like fat transplantation for filling of the upper pole of breasts in situations of a mastopexy. I think that this is an art and just like artists can paint on different campuses, with different mediums and different colors, plastic surgeons have developed their own methods of adding fat grafts. We have used PRP in our office for many years now for small volume fat grafting to the face. There is some data to support there is a ratio of adding PRP to fat grafts that would make the fat grafts more likely to survive. When adding 200 to 400 mL of fat to the upper pole of a breast, it would take a lot of blood to make enough PRP that the science would support its use. I do agree that fat grafting may need to be repeated in order to get the best possible result. Good luck.
You do have options, both with pros and cons. Implants have a solid and reliable history with very high patient satisfaction rates but they must be replaced every 12-15 years. Fat grafting has the advantage of using your own body's material to increase breast size, but only small augmentation is possible and it is just gaining popularity and long term results are not yet available. There is always uncertainty about how much fat will "take", increasing the possibility of asymmetry and need for revision. Many plastic surgeons are still concerned about how the fat that did not take looks on mammograms, and if it will increase long term false positive results. Be sure to consult with a board certified plastic surgeon to help you navigate this decision. Good Luck!
Thank you for your question. Fat transfer is an excellent choice in patients in your situation. This involves the transfer of fat from one part of your body to your breasts. This is an excellent choice for women who want to remain completely natural because fat is natural, yours, and has the potential to last a lifetime. The reproducibility of fat can vary from surgeon to surgeon and is, therefore, technique dependent, however, in my 15 years experience with fat grafting, it has been very reproducible. I do not agree that you would need multiple procedures to achieve your desired results since you are not going for a larger breast. I would certainly consult with a board certified plastic surgeon who is experienced in these matters. I hope this helps and have a wonderful day. Dr Kayser - St Clair Shores