Treatment Provider

Scott J. Engel, MD, FACS
Board Certified Plastic Surgeon
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Probably Not Worth It For Me

Breast fat transfer (BFT) is a great procedure for the right candidate. Unfortunately, I think I may not have been a good candidate. After 1.5 years and 3 surgeries, the pros don’t seem to outweigh the cons. I have a love/hate relationship with plastic surgery. Some days I think plastic surgery was worth it, but lately and the more I think about it, it probably wasn’t worth it for me.
I think for major plastic surgery to be worth it, you really have to be unhappy with your body and looking for significant results. My “problem” was that my body wasn’t that bad before plastic surgery, and my results were modest and subtle. I was never really “wowed” or impressed after surgery. A big part of that was that I ended up with side effects like lipo irregularities, anxiety, bothersome scars all over my body, and then guilt and embarrassment from having multiple plastic surgeries.
It’s an emotional rollercoaster leading up to each surgery and then also when waiting for final results. Furthermore, it is devastating to end up with unsatifactory results and side effects. I’ve had letdowns after all 3 surgeries. There have been good improvements from my surgeries, but all the improvements came at a price. And I wasn’t expecting to pay it.
If I had a do-over, I probably shouldn’t have had any major plastic surgery. I was being lazy and took a short-cut with liposuction. I should have gone on a diet, since I was only 10-15 pounds overweight. I had lost that weight before and could have done it again, but I was tempted by a quick-fix. For better or for worse, I had the extra money for what seemed like an amazing short-cut. But there are always consequences for taking the easy way out!
From my first BFT, I have wavy inner thighs and a thigh divot that REALLY bother me from lipo. I’ve had two minor fat transfers attempting to correct my thigh divot… but fail. Didn’t work and makes me sad. I worry about these minor deformities and dealing with them for life. I also have so many lipo scars on my body (just trying to get enough fat… but there was never enough) that it’s ridiculous. Overkill.
Overall, I still like being thinner and going from an A to B cup, but I never cared enough about my boobs in the first place. I probably shouldn’t have sacrificed my body for my boobs. I should have lost weight the good ole fashioned way and maybe have considered implants when I was older or was truly unhappy about my breasts. In the end, I don’t like all the cons of BFT for me:
-breasts healed not symmetrical
-noticeable thigh divot even after trying to fix twice
-noticeable, dented elbow scar and then lots of other lipo scars (some hidden, some dented)
-expensive (over $12,000) possible mistake
-liposuction made my cellulite worse on thighs and also caused some skin laxity
-liposuction makes certain parts of my body have weird, unnatural contours
-3 surgeries and recoveries were painful, stressful, and time-consuming
It is hard to admit that I may have made a mistake signing up for BFT. I thought I did enough research, but I didn’t realize the lipo risks. I should have taken more time before making a decision. I still like my plastic surgeon for reasons I’ve listed previously, and he really tries to make me happy, but I think Dr. Engel should have better explained the lipo risks to me. In addition, I’ve written before that he overestimated my available fat, so then my original goal to go up 1 cup size in 1 surgery wasn’t even possible to begin with. He led me to have unrealistic expectations at times. I truly desired to be “one and done” and did not mean to sign up for multiple surgeries.
While I feel today that major plastic surgery was a bad decision for me, it’s not the end of the world. With or without surgery, I like my body (I fortunately have high self-esteem). I will forgive myself and learn from this. I should be more patient (not easy for me) and not rush through major decisions. I should remember and realize the consequences of shortcuts and a “quick-fix.” I should appreciate the good instead of risking too much trying to be perfect.
Looking at so many BFT reviews on realself, it seems common for women to not be satisfied after one BFT and desire another surgery. Maybe these women weren’t good candidates either, since they lacked enough body fat to make a satisfactory breast increase. On the other hand, I have seen some amazing BFT results online, but the women has to have enough fat. Who I would recommend BFT for: a women who is totally against implants, who is OK with modest breast increase, wants natural results, desperately wants increased breast size without implants, has plenty of extra fat, not prone to cellulite, not bothered by lipo scars, scars heal well, desires and is a good candidate for liposuction.
I’m one month post my third surgery with Dr. Engel. It was a minor fat transfer to dents. He kindly performed the surgery for free. Unfortunately, not enough fat stayed (again) so it looks like I’ll be letdown. The hardest part is learning to let it go. I don’t like to give up and just live with the dents, even if they are minor. But at some point, I have to stop plastic surgery. It may solve some problems, but it causes others. A part of me wants to try again to fix these dents, but I should stop. I need a break from plastic surgery. Please pray for me to move on… peace.

3 Month Follow-Up: Before and After Pictures

I have attached some of my before and after pictures. There's definitive improvement: thinner thighs and bigger boobs! Not as big of boobs as I was expecting, but certainly fuller. I'm still thinking about whether I want a second round surgery or not. The good news is that a second round would be in a reasonable $4000 range, but my doctor doesn't think I would get much improvement from another round. He likes my results and wants me to think about it, which I think is smart. We talked for while, and I'll probably post later about my appointment. I'm still trying to process everything.
My breasts definitely look better in the after pictures! But note that I was standing up straighter today, which pushes out my boobs more than the before pics. I saw my bad posture in my before pics, so I tried to improve that, even though I knew it would mess with comparison. I just didn't want to be slouching again. I like my thinner thighs and fuller breasts, and I hope to retain this fat!

12 Weeks Later

I like my body improvements overall, but I still lack the volume to fill my B cup bras, as I had expected/hoped. Lately, I've been very interested in a second round of fat transfer. However, I have questions for my doctor first and have to find out the cost too.

Also, I'm concerned about some unevenness from liposuction. I would be more worried about my donor areas for a potential second surgery since I did end up with lipo side effects. My inner thighs have a wavy appearance to me, but thankfully it's not too noticeable. My current thinking is to not use arms for donor fat because I'd be too self-conscious of any side effects there. My guess is the recovery would be harder as well with more cumbersome compression garments. In addition, it's not practical to hide arm scars from the sun, maybe wearing bandaids for a year? That's too suspicious. Lipo was worth it for my thighs to be thinner, but it may not be a good idea for my arms. I can improve my arms the old-fashioned way: push-ups, exercise, etc.

I often wonder, "Is it really worth it to have another surgery for only a half cup increase?" I don't know. But that's what I got the first time, and it did really enhance my shape. Even a half cup makes a good difference (when you have small breasts). I think I'd be happy if only a half cup bigger.... That is the size (full B) I was for about 5 years while pregnant and breastfeeding. It's too bad I didn't get there with my first surgery, but my thighs didn't have enough fat, which still shocks me!!

I wish I was totally satisfied with my results and could move on. But from the beginning, I was letdown by the cc amount because I figured it wouldn't be enough. I didn't reached my goal to be a full B cup, and I'm not sure if I can accept that. I feel like my boobs are not finished.

Thinking about a second surgery is a lot less scary. I hope I don't have a false sense of security though! I'm looking forward to my 3 month follow-up this week, so I can get more information about a possible second round. I'm a planner, so I don't like this all being up in the air. I want all the info, so I can make a decision.

I'm curious to see my before and after pictures from my surgeon's office. I plan to post those soon.

Provider Review

Board Certified Plastic Surgeon
2255 S Tamiami Trl., Sarasota, Florida
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I have had three fat transfer surgeries with Dr. Engel. There are several things I like about him; Dr. Engel is kind, smart, personable, generous, and professional. He is patient and takes the time to answer my many questions. I'm often uneasy at doctor appointments and anxious about being naked, but thankfully Dr. Engel is considerate and makes me feel comfortable. Before my first surgery, Dr. Engel could tell I was very nervous, so he held my hands and reassured me he would take care of me. He reiterated that he would treat me as well as if I was his wife, and he truly seemed genuine. After all my three surgeries, I am grateful for some wonderful body improvements, but I also have some unsatisfactory results and side effects. My breasts are better and beautiful, however, I am bothered by liposuction irregularities as well as unmet expectations. If interested, please check out my procedure reviews for pictures and much more information about my breast fat transfer experience. During the ups and downs of this journey, I appreciate that Dr. Engel has remained extremely caring and compassionate.