I am considering a breast implant removal with fat transfer - will I be able to go up one cup size with this alone? (photos)

Question

Hi. Im planning an removal of 360 cc implants of 10 years. Prior to surgery I was an a cup. Im having my consultation in the end of summer and Im not sure whether or not I have enough body fat for this procedure. I have flanks and my inner thighs could use some lipo. Could I fill my breasts by one cup size with this? I dont wanna be left flat. Thank you very, very much for all your answers

Alan Gonzalez, MD, FACS · Answer

Hello @Peaceful2294, thank you for your question.  Everything depends on the surgical technique of the specialist performing surgery.  Remember that any kind of explant must be complete, that is, the surgeon must remove the whole capsule out. Complete capsulectomy.  Also it would be necessary to carry out a preventive biopsy on each capsule. In any case, I do not perform breast fat transfer during a breast implant removal procedure because for me, the breast explant must be performed with a breast reconstruction in which the mammary tissue is placed adequately in place again. If the fat seeding is done at the same time, it might get infected or die; there is no guarantee that the seeding will stick. with breast fat transfer is posible to go up one size. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),   International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Joel Patrick Maier, MD · Answer

I think you have enough donor fat to make a proportionate, sizable breast. With proper techinque, we should get the volume needed in one stage. Thank you,

John L. Burns Jr., MD · Answer

When breast implants are removed there is a lot of excess skin that will remain after the implants are removed.  Replacing implant volume with a fat transfer is a great way to prevent a deformity and give you back some breast size and shape.

Daniel Barrett, MD · Answer

Dear Peaceful2294,
generally speaking, implants removal and fat transfer is a viable option. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You appear to have enough fat with just what you showed. However, you may gain a half up to one cup increase in size. With removing the implants, you will be smaller than you were originally due to stretching and thinning your own tissue with the implant.  Your surgeon can help you understand how much actual beast tissue is left.

Mats Hagstrom, MD (license on probation) · Answer

Breast fat transfer can deliver 1/2 cup size 1 done by a sufficiently qualified provider. Occasionally patient will report having one full cup, but this is not the norm. The procedure is subtle, especially compared to implants. I’d like implants breast fat transfer while it does increase the breast size does not do much to change breast shape. Breast implants are the other hand change breast shape dramatically, especially giving forward, projection which fat transfer would not do. 
I’m an aesthetic perspective implants are far superior and if you’re expecting results anything similar to what you get from implants, you’ll probably be left disappointed. I personally would not do fat transfer in conjunction with explantation.
There’s a lot of information needed to make a good assessment, including what’s happening with your breast implants and what do you indication as to remove them. You didn’t include breast pictures. Based on the pictures you did include you have plenty of fat for breast fat transfer. You may or may not be a good candidate for Liposuction but you have enough of that for a breast fat transfer procedure.
Unless there’s a good reason for explantation, consider having your implants, exchanged or address the concern with your current implants.
Patients who choose to have fat transfer done at the same time, as explantation will never have the opportunity to see what their breast look like after removal of the implants. They will most likely deflated compared to your preoperative pictures when you had your augmentation 10 years ago. Without a comparison of what your i breast look like now without implants, you’ll have no way to assess the outcome of the fat transfer procedure. This is one more reason why I recommend patient stage explantation and fat transfer.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who can deliver consistent quality results that are predictable based on numerous before, and after pictures are in a small minority.
Patient should be highly selective when choosing providers for both Liposuction and fat transfer procedures.
I suggest having multiple in person, consultations for local, board-certified plastic surgeons, who have extensive experience with breast fat transfer and a proven track record of delivering consistent quality results with both Liposuction and fat transfer. Recognize that breast-fed transfer is two procedures done at the same time. The first being Liposuction and the second being breast-fed transfer. Liposuction is always required to harvest the fat required for the fat transfer. A significant number of patients end up having disfigurement from poorly done Liposuction, when the primary purpose was fat transfer. 
I recommend patients avoid making self assessments regarding the candidacy for anything plastic surgery procedure. This includes indications for explantation and candidacy for both Liposuction and fat transfer. 
I suggest having multiple in person, consultations with providers in your community to get a better understanding, and help choose the right provider.
Best,
Mats Hagstrom, MD

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Of course you should have a consultation with an expert in fact transfer to the breast, which I am not.

However obtaining the survival of the fat transfer larger than 250 cc almost always requires a second fat transfer treatment.  Based on your history you will certainly want at least 400 cc enlargement to compensate for the loss of your implants.

I am considering a breast implant removal with fat transfer - will I be able to go up one cup size with this alone? (photos)

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