5’6.5”, 114 lbs. and would like a breast fat transfer. Is it reasonable to do the BA with fat transfer?

Question

I am slender and was considering a very modest (200cc) implant but think I prefer fat transfer instead because I don’t want the scars or like the idea of the implant itself. I was also planning some liposuction and renuvion to abdomen, upper arms and outer thighs. Is it reasonable to do the BA with fat transfer? I realize I may not be able to achieve the same “size” as with an implant. I’m 44 and have had one pregnancy and breast fed one child.

Donald R. Revis Jr, MD · Answer

Good afternoon!
Unfortunately the amount that can be transplanted reliably and successfully is very small- much of the transplanted fat doesn't survive and gets reabsorbed over the first year. I doubt you will have enough fat to undergo a successful fat transfer-only breast augmentation.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Although a great option for many, it may prove difficult to obtain enough usable fat to be able to graft.  Hope this helps.

Gary M. Horndeski, MD · Answer

At 5'6 and 114 lbs, your BMI is 18.5. You may not have an effective donor site. If you are size 32 or 34, each 100 cc of fat corresponds to 1 cup size change. If you are size 36 or 38, each 200 cc of fat corresponds to 1 cup size change. Not all the fat survives so you would need 150 cc of fat for 100 cc to survive.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Casey Anderson, MD, FACS · Answer

It is very reasonable to do BA with fat transfer. It is important to talk about the differences and what can be accomplished. Most surgeons will quote you can get about a one cup size increase reliably with fat transfer (though the procedure can be done multiple times). It is very unlikely you would be able to get the upper pole fullness that an implant can offer. If you are looking for a very modest increase, fat transfer may be a good option for you.

As always, be sure to research who performs your surgery to ensure the best likelihood of a positive result

As always, be sure to research who performs your surgery to ensure the best likelihood of a positive result

Gerald Minniti, MD, FACS · Answer

To achieve the same theoretical volume of 200 cc implants you would need about 600 to 800 cc of fat to graft (300 to 400 cc for each breast). I don't think you have enough donor material. Further, fat would not have much projection. An inframammary scar can be very inconspicuous, so don't rule out implants.

Farbod Esmailian, MD · Answer

I perform both procedures, but I prefer fat transfer for contouring rather than augmenting.  Given how thin you are, I don't see you having enough fat to transfer to have a meaningful result.  Also the results are very unpredictable as well.

Breast implants have come a long way and there is no reason to change them every so many years.  The rupture rate for silicone is 0.8% per year.  You only change them out if there are issues.  Implants provide a much higher satisfaction as well as are much more predictable.

I would recommend you see a board certified plastic surgeon and discuss your options.

Hope that helps.

Daniel Barrett, MD · Answer

Dear toomuchsun,
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

Ram Kalus, MD, FACS · Answer

As you may have already guessed, an examination in person is required to be able to provide a definitive opinion, but based on your photo and story it is unlikely that you would be able to receive a result from fat grafting that would satisfy you, nor that would justify the inherent small risk of surgery and anesthesia, not to mention the cost. In my experience, a patient such as yourself would rarely be satisfied with less than 250 cc’s or more, and it is unlikely that a total of 500 cc’s of pure fat can be derived even in more than one stage based on your photo which suggests a very low total body fat content.

That said, many women have some concerns these days regarding silicone gel filled implants. There has been much discussion regarding BIAI (Breast Implant Associated Illness) as well as other concerns, and far be it for me to get into a detailed discussion of these in this forum. The facts remain that millions of women around the globe have found breast augmentation to have provided them with a significant improvement in their quality of life, with minimal health risks. The data shows that 95-98% of women are highly satisfied with their augmentation, and would have their surgeyr all over again knowing what they know. There are options available today that include saline filled implants that many women opt for over silicone gel filled implants, and any board certified plastic surgeon can review all fo these options with you.

The bottom line question you need to answer for your self is whether or not the improvement in lifestyles quality of life, and overall satisfaction outweighs the low risk of breast augmentation surgery, remembering that there is no surgical or non-surgical treatment in the cosmetic sphere that is absolutely risk free.

Do your research, and select a board certified plastic surgeon whose aesthetics seem to align with your own, and whose results appeal to you based on his or her Before and After gallery. It is also helpful to discuss this with friends who may have had this type of surgery. Anecdotes notwithstanding, the chances are high that you will hear favorable opinions about the surgery and the results. Best of luck to you.

Robert M. Tornambe, MD · Answer

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 15 years or so. Fat grafting has the advantage of using your own body's material to increase breast size, but only small augmentation is possible. There is always uncertainty about how much fat will "take", increasing the possibility of asymmetry and need for revision. 
It appears from your photos that you do not have enough fat available for transfer, and small implants would be a far better choice. Be sure to consult with a board certified plastic surgeon to help you navigate this decision. Good luck!

Ronald J. Edelson, MD · Answer

Fat transfer to the breasts doesn’t work as well as many surgeons would head you to believe. One major hurdle is finding enough fat to remove and out in the breasts because you are so thin. Believe it or not many plastic surgeons will actually tell you to gain weight so that is available fat for transfer. That would be a big mistake. If you don’t want implants that’s fine. I have yet to see someone get a worthwhile result from fat transfer, but there are plenty of fixtures who will go it.

5’6.5”, 114 lbs. and would like a breast fat transfer. Is it reasonable to do the BA with fat transfer?

Answers (16)

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