July 13, 2022
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By Dr. Andrew Campbell-Lloyd

Fat transfer (fat grafting) for breast augmentation

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Information

COSTS:
Plastic surgeon’s fee: from $6,200 depending on positioning

Total approximate cost (uninsured patient, day surgery only): $TBC

Associated item number:  not applicable for any cosmetic patient; item numbers are only applicable for cancer reconstruction and patients with developmental breast differences.

May be performed with: BREAST IMPLANT REMOVAL
May be performed with: MASTOPEXY
May be performed with: TUBEROUS BREAST CORRECTION

LENGTH OF PROCEDURE/HOSPITAL STAY:
2-2.5 hours (as a stand-alone procedure)

Will add 1-1.5hrs to the duration of an operation when combined with other procedures (eg. Mastopexy, Breast implant removal)

Day surgery

Key Features

Liposuction for fat harvest – Fat can be removed from different areas of the body (most commonly the thighs, abdomen and flanks/’lovehandles’) using careful liposuction. This involves sucking the fat through a metal tube that is inserted through a tiny cut about 3-4mm long. The fat must behandled very gently to prevent damage to the cells. The fat is then washed and filtered before being re-injected into the breast as a purified form of fat. For some patients, the liposuction offers the benefits of improving contours or removing stubborn fat deposits that don’t change with weight loss or exercise.

No breast incisions – The fat injections into the breast are made through needle holes. These holes don’t require stitches, so there are essentially no scars on the breast, when the breast is enlarged by fat transfer alone.

Soft, totally natural volume – Unlike silicone breast implants, breast augmentation by fat transfer is totally natural. When done carefully, using proper technique, the majority of the injected fat will survive as living tissue. The breast will look, feel and move just like your own natural breast. Perhaps most importantly, after breast augmentation by fat transfer there will not be any requirement for additional surgery, unlike breast implants which only have a limited lifespan and will always require correction or removal at some stage in the future.

Please note:

Fat transfer is an excellent procedure to achieve natural breast enlargement, but it is not a perfect technique, and in some cases the results may not be totally predictable. Whilst many women will retain 80% or more of the injected fat, other women may only retain 50% (or even less) for reasons that are poorly understood. We generally believe that the success of fat transfer is very technique dependent - with proper technique, the rate of survival should be high.

Reasons To Consider This Procedure

Ladies wanting a modest breast enlargement: Breast augmentation by fat transfer is able to enlarge the breast by 1 cup size in a single session. It is unlikely that the average patient can achieve more than this. Some patients choose to have a second round of fat grafting performed, in which case the total gains may be more significant.

Not comfortable with the idea of breast implants: An increasing number of ladies feel uncomfortable with the idea of silicone breast implants. There are a few reasons for this, including the issues of “breast implant illness” and ALCL (anaplastic large cell lymphoma). Perhaps most importantly, breast implants have a limited lifespan and must always be replaced or removed at some point in the future. In other words, breast implants create the ongoing requirement for additional surgery for as long as a patient chooses to have breast implants.

Preference for “natural” appearance and feel: Cosmetic trends come and go. Fortunately, it seems popular once again to aspire to a ‘natural’ breast shape. The natural breast tends toward being fuller in the lower part of the breast without any unnatural ‘side-boob’, or the upper-pole fullness that only comes from breast implants. Fat transfer will always create a more natural appearing breast with a pleasing lower pole curve.

Remember, fullness at the top of the breast and prominent cleavage are both a result of the bra you choose to wear. Even with breast implants, most patients will need a bra to create the aesthetic results they desire. That’s why so many surgeons on Instagram only show photos of their post-operative patients wearing bras and bikinis!

Happy with existing breast shape: Fat transfer will not substantially change the shape of the breast. For patients who are happy with their breast shape, but who want additional volume, fat transfer may be the ideal technique.

Wanting to add volume to the breast at the time of breast implant removal or breast lift procedures: Fat transfer is very commonly performed in conjunction with other procedures to add volume. The most common procedures are:

  • breast implant removal / explant surgery (fat transfer may compensate for the volume lost with implant removal) and
  • mastopexy / breast lift surgery (fat transfer can add volume to the entire breast and enhance the upper pole and cleavage when performed with mastopexy).

 

Reasons this procedure may not be right for you:

Wanting a significant breast enlargement (greater than 2 cup sizes): Significant or disproportionate breast enlargement cannot be achieved in a single operation using fat transfer alone.

Not happy with breast shape: Fat transfer cannot substantially change the breast shape.

  • If the breast is stretched, or drooping (ptotic), then we recommend a mastopexy/breast lift procedure combined with fat transfer for additional volume.
  • If there is substantial asymmetry, we would recommend a mastopexy to allow for the shape of the right and left breasts to be properly matched. Fat transfer can be used to allow for volume matching, once the shape has been corrected.
  • If the breast is tuberous or constricted (click for details), then a mastopexy or breast implants may be needed to force the breast into a new shape. This can be combined with fat transfer to soften the appearance of the breast and give the most natural result.

Wanting significant “upper pole” fullness without a bra (ie. wanting a ‘fake’ look): Whilst we would generally recommend against chasing this appearance, if patients desire a very full upper pole of the breast, we would recommend seeing a surgeon who is happy to insert a silicone breast implant to achieve this appearance.

What To Expect

Bruising and swelling will be present both at the “harvest sites” (where the liposuction was performed) and at the injection site (the breast). This bruising will very often take on a yellowish colour quite quickly in the breast, and will be associated with a feeling of firmness in the first week or two. The breast will soften quickly, but the bruising discoloration may persist for up to 6 weeks in some patients.

Volume will tend to settle lower into the breast rather than creating substantial upper pole fullness.

The breast will maintain natural feel and movement. Silicone breast implants always result in the breast being firm,and immobile. Over time, breast implants will often become harder due to capsular contracture. Fat transfer allows the breast to maintain normal bounce and movement, as the tissue is soft and pliable. The breast will not harden, and there is no scar tissue capsule that develops around the injected fat.

The volume gained is permanent. Once the fat injected has stabilised (around 6-8 weeks), the breast enlargement achieved by fat transfer is a permanent change. If you gain or lose weight, the breast will gain or lose weight accordingly. However, the fat will never just disappear.

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