Is it possible for fat grafting to give me an under boob and more round, full appearance? (Photo)

Question

I am now wondering if it's possible to release the tight skin on my under pole and fat grafting to give me an under boob and more round full appearance? Considering implants but going more natural would be nice. I don’t know of the risks of fat grafting because it is a newer procedure than implants. I also wonder if the tight skin will stretch and fill out naturally after pregnancies in my far future.. it makes me hesitant on doing any procedures but would really like to improve my appearance

Rodger Shortt, FRCSC · Answer

Lower breast volume can be created with fat transfer to give a fuller and rounder breast.  In patients that have essentially normal breast development it can work great to give a modest increase to the size of the breast.  It is possible in severe lower breast lack of development such as tubular breast that an implant would provide a more stable lower breast volume.  In severe cases there is a need for more stretch to that tissue that an implant provides better than fat.  However, there is still a role for fat in my opinion.  I have found it very successful to do a combination of an implant to provide a fuller breast and to expand the lower breast combined with fat grafting.  The fat transfer helps to thicken the soft tissue coverage over the implant providing better concealment and a softer feel. This is not something most plastic surgeons are experienced in doing, however, so make sure to find a surgeon that does a lot of breast transfer if looking for this to get the best results.Dr Rodger Shortt, Oakville Plastic Surgeon.

Dhaval M. Patel, MD · Answer

Thank you for your question and photos. Your expectations will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals.  Best of luck!
Dr Dhaval Patel
Double Board Certified
Plastic Surgeon
Chicago
Hoffman Estates 
Oakbrook 
Orland Park

Kenneth Hughes, MD · Answer

The breast shape can be improved with a periareolar incision. The periareolar lift involves making an incision around the areola and lifting the nipple areola complex (NAC). This is also referred to as a circumareolar, concentric, donut, or Benelli lift.  This lift is only useful for a small amount of breast droop. It can also be used to improve symmetry of the areolae or to reduce the size of the areolar.  This lift tends to flatten the breast to some degree.Breast fat transfer is a great tool to balance breasts, improve symmetry, and gain up to one cup size in volume.  In general, 200 cc 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.  Multiple transfers would be required for additional cc's.  In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used.
Some of the retention rate will depend upon the amount of fat transferred, as smaller volumes will likely have a higher survival.  Occasionally, a patient can resorb a great deal of the fat despite optimal transfer procedures. I typically transfer from 250 cc to 400 cc or so per breast.  Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant.  
Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. You would need a consultation with a board certified PS to determine your available fat store.

Gary M. Horndeski, MD · Answer

Your breasts are widely separated and subconstricted inferior medially.  You would benefit from a modified Benelli lift.  Using a circumareola incision, the breast tissue is reshaped, elevated higher on the chest wall, more medial to increase your cleavage and eliminate the medial flatness.  At that time, you can undergo fat transfer or small implants. Implants are not lifetime devices.  6% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

George Marosan, MD · Answer

Thank you for your question and photos. You have bilateral constricted, tuberous breasts. This responds well to fat grafting, but seeing your abdomen and back, you do have limited fat supply for transfer. The skin tightness in the lower pole of the breast can be expanded by doing "rigottomies". This is a process described by Dr. Gino Rigotti of Italy, by making multiple needle punctures on the skin. This is similar to a skin graft that has been meshed to allow for coverage of a larger defect. In your case, these needle poke holes heal without a scar. This could give you up to one cup size increase and will change the shape of your breasts.See a board certified plastic surgeon experienced in these types of surgeries for an in person consultation/evaluation. Good luck.

Gregory A. Buford, MD, FACS · Answer

From the photos you provided, it does appear that you have some lower pole constriction but I think a modest amount of added fat would give you a very nice result.  If you are looking for a more conservative look, then AFG would be a very nice option.  But if you are looking for a more dramatic increase (2 or more cup sizes) then you would really need to look into use of a breast implant.I hope that helps and wish you the very best!Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and  Published Author

Ronald J. Edelson, MD · Answer

I suggest you look at photos on line of fat grafting to the breasts. You might as well start with the websites of local plastic surgeons. This is the best way to determine if fat grafting will even work for a situation like yours. It’s easy fir a plastic surgeon to tell you that it works great. The   photos  on line will give you a better idea of whether it give you result you would be happy with.

Daniel Barrett, MD · Answer

Dear Optimistic5630,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.
Tuberous breasts can rarely be corrected without implants or at least a small one. The breast needs to be scored radially from the inside to expand it. If you don't place an implant behind the radial scoring it will fall back to its original state. You could theoretically remove the implant at a later day and graft with fat but that would be a separate surgery.
Daniel Barrett, MD

Norman Bakshandeh Day, MD, FACS · Answer

You have a very mild form of the tuberous breast. Your best outcome and results will be with breast implants and some mild reshaping of the breast envelope. Your scars will be minimal, concealed and restricted to around the areola or lower part of the areola only.You appear to be a very fit young lady without much fat deposits. I do not think you have enough fat here to get a good result with fat grafting. In a patient who is much heavier this is a reasonable choice although breast implants work best for these patients as well

Connie Hiers, MD, FACS · Answer

With the shape of your breasts, you will do better with implants to achieve the size and more rounded shape you want. Fat transfers are limited, especially in changing shape. I would suggest meeting with a board certified plastic surgeon and discussing your options.

Is it possible for fat grafting to give me an under boob and more round, full appearance? (Photo)

Answers (12)

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