42, 5'8, 140lbs, post explant revision/fat transfer - is this realistically correctable? (Photos)

in cases like your's where you have excess skin that has scarred down or adhered to the chest causing a deformity it is difficult to correct this with a fat transfer. Fat requires robust vascular tissue to survive. Where there is both scars tissue/adhesions and a lack of vascular tissue the fat won't survive. Furthermore, fat will go to the areas of least resistance meaning that it won't overcome the effects of scar tissue. For these reasons a fat transfer in your case wouldn't help much. You might consider removing excess skin with a breast lift which would leave you with a flat chest but less excess skin and adhesions.

Dear whenindoubt81,
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

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Although you have considerable deformity , With pre expansion and serial fat grafting you can be considerably improved.

Fat will not give enough volume to the center part of your very thin breast tissue. Your implants stretched and thinned your own tissue in that area. Fat is injected into actual breast tissue and not into the space where the implant was. You might be a candidate for a lift first and then try fat.

Thank you for sharing your photos!! It is difficult to say without an in-person examination. A mastopexy (breast lift) can give you a perkier, more lifted breast. During this surgery, excess skin is removed, the nipple is repositioned, and the skin is re-draped and tightened to support the breast. It will also be possible to improve the asymmetry you noted. Depending on your goals, this can be combined with transferring your own fat from another part of your body (like your thighs or hips) to your breasts to add fullness. These techniques can be performed with minimal scarring as an outpatient procedure without the need for general anesthesia. I suggest making an appointment with a board-certified plastic surgeon to discuss your options in more detail!

To improve your breast appearance, you need volume and reduction of the skin redundancy.
To get a decent outcome, most likely require staged procedures.
Fat transfer can increase breast volume by about 50%. Most patients view this as being a 1/2 cup to possibly 1 cup in unusual circumstances.
This is the best you can hope for when the procedure is done well by someone with sufficient skills and experience.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who mastered these procedures are in a small minority. If the procedure is not done well, you could end up being disfigured from poorly done liposuction and see virtually no improvement from fat transfer.
Fat transfer tends to be synergistic in that each round of fat transfer creates more host tissue, allowing more successful grafting during repeat procedures.
To get an ideal outcome, would probably require a few rounds of fat transfer, finally followed by reducing the skin envelope with a mastopexy procedure.
I cannot emphasize enough the importance of provider selection when it comes to Liposuction and fat transfer.
To find the right provider, I suggest patients have multiple in person consultations. 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 had similar body and breast 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. Make sure you judge both Liposuction and fat transfer results. Recognize that early fat transfer results can look very impressive, but do not in any way represent final results. When reviewing fat grafting outcomes, always confirm the timeframe of when after pictures were taken in relationship to the date of surgery. After pictures should be taken, no less than 3 to 6 months from the date of the procedure in order to be representative of the long-term outcomes. Do not assume that after pictures represent long term final outcomes.
Always confirm with each provider.
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures.
You may want to do this for both fat, transfer and mastopexy, though I think most plastic surgeons will do a fairly competent job at the skin excess while Liposuction and fat transfer seems to have far more variability in outcome, depending on provider selection.
Some providers may recommend doing both procedures at the same time. I personally would not, but different providers will have different opinions.
Best,
Mats Hagstrom, MD