Procedures/ Breast fat grafting

Breast fat grafting

Procedures 5 min read


Breast Fat Grafting

Fat grafting, also known as autologous fat transfer, is a new and emerging method of breast reconstruction and breast augmentation. Keep reading to learn everything there is to know about breast fat grafting, an innovative breast augmentation plastic surgery.

What is breast fat grafting?

Breast fat grafting is a breast surgery in which fat cells are removed from a donor site, usually the belly, thighs, or buttocks, through the process of liposuction. The fat cells are purified, processed into a liquid, and injected into the breasts for the purpose of breast augmentation or increase in breast size. The procedure is also called structural fat grafting or fat transfer breast augmentation.

Augmentation with fat transfer is an alternative to the more traditional breast surgeries for breast enlargement, such as the placement of synthetic implants containing either saline or silicone gel. Breast augmentation with liposuction and fat transfer is increasingly being offered to people because it can create a natural, lasting result with minimal scarring.

Besides its use in cosmetic surgery, liposuction and breast fat grafting is also performed in breast cancer patients who have undergone mastectomy surgery. The fat transfer helps to create a reconstructed breast that matches the natural breast in these patients.

Another type of fat transfer called lipofilling is used to fix minor problems in the breast size, shape, position, and symmetry.

Benefits of fat grafting for breast augmentation

One of the key benefits of augmentation with fat transfer is that uses autologous fat (your own tissue) obtained through liposuction, rather than a synthetic prosthesis. As a result, there is a lower chance of the body rejecting the injected fat cells. An added advantage of breast augmentation with fat is that fat cells are removed by liposuction from areas where they are undesirable. Last but not least, many women report that the outcomes from fat transfer breast augmentation are soft and very similar to the natural breast. In comparison, breast implants can look and feel artificial.

The key benefits of breast fat grafting are summarized below:

  • Natural procedure that uses the body's own tissue instead of synthetic medical prosthetics like implants
  • Permanent results, unlike implants that may need to be replaced after a few years
  • More natural and customizable breast size and shape
  • Slimming down in problem areas like the thighs and abdomen through removal of fat by liposuction
  • Minimal scarring

Risks and Warnings: Why not to augment the breasts with fat?

One disadvantage of breast augmentation with fat is that no large studies or prolonged followup has been done on this procedure. Smaller studies have shown good results, but it is not clear at present how long the results will last. It is also unclear whether this breast augmentation procedure is suitable for all women.

Another disadvantage of augmentation with fat transfer is that breast cancer patients who have undergone mastectomy (surgical removal of the breast) might need to wear a tissue expander device for 4 weeks or more before the fat transfer for breast reconstruction.

It can take 4-6 sessions of augmentation with fat transfer to get the desired breast size. Also, the body can reabsorb some of the injected fat cells over time, leading to a reduction in breast volume several months after the procedure.

Other complications include the formation of oil cysts or the occurrence of fat necrosis, whereby some of the fat that is injected into the breast dies. This can cause symptoms like black or blue skin, fever, bleeding, numbness, and pus discharge.

Plastic surgeons who use liposuction and fat transfer in breast cancer patients have to consider the possibility that the procedure could exhaust a key source of tissue for breast reconstruction with tissue flap in the future, should the fat grafting be unsuccessful.

There is also concern that liposuction and fat grafting to the breast could stimulate cell growth and cause dormant breast cancers to grow. However, more research is needed to find out if this is indeed true.

Breast implants plus fat grafting

In women undergoing breast augmentation with breast implants, the use of fat grafting can help achieve more natural cosmetic outcomes. In particular, liposuction and fat transfer can achieve a cleavage that is similar to the natural breast rather than the artificial "separated" appearance that often occurs when breast implants are placed.

A technique in which fat transfer is performed in the parasternal region (near the breast bone and pectoralis major muscle) along with breast implant surgery has been shown to achieve a more natural shape and to soften the transition zone between the breast bone and the edge of the implant. On a survey of breast attractiveness, the narrower distance between the breasts achieved with this technique was preferred.

Breast lift plus fat grafting

Many women are unhappy with sagging breasts and low nipple position that occur with advancing age or after pregnancy and childbirth. Also, some women are unhappy with their breast shape because the upper part appears flat and the breasts do not look perky. Many patients are not keen on breast augmentations with implants but would like to fill the bra cup size so that there is no gap at the top.

In such patients, a combined breast lift and fat transfer can correct the problem of volume loss in the upper breast that results in a more elliptical breast shape than the natural breast. The breast lift procedure raises the nipple higher and lifts sagging breast tissue. The fat transfer provides a subtle increase in breast volume in the upper part of the breast that often becomes deflated after pregnancy and childbirth.

Fat grafting for implant problems

A common problem in patients who have breast implants is the appearance of ripples or wrinkles. When this occurs, the outlines of the breast implants are visible or palpable under the skin. These side effects are more common when the size of the breast implants is too big for the patient's chest. Rippling should not occur when the augmentation is performed by an expert plastic surgeon. However, if it is present, rippling can be fixed with fat grafting to make the surface smoother. The fat transfer provides cushioning around the implants where a lack of natural breast tissue is causing the rippling.

Is breast fat grafting safe?

The most common complications encountered with breast fat grafting include infection, bleeding, scarring, contour irregularities, and over or under correction.

According to the American Society of Plastic Surgeons, grafting fat for touch ups or corrections to the breasts is safe and works well. There is also good data about the proven effectiveness of fat transfer for breast reconstruction. However, there is still a question mark over the safety and efficacy of cosmetic breast augmentation with fat. Nonetheless, more and more experts are convinced that breast enlargement with excess fat from donor sites can be considered a safe option in many patients.

Is breast fat transfer painful?

Breast enlargement with fat transfer is not a painful procedure. The surgery is done under general anesthesia or local anesthesia and sedation, so you will not feel anything. After the surgery, your doctor will give you pain medication to manage any mild discomfort that you may experience.

How long does fat grafting to breast last? Is breast fat transfer permanent?

Plastic surgeons are not sure how successful fat grafting to the breast is over the long-term. This is because it is a new type of plastic surgery and no large clinical studies have been performed to evaluate long-term outcomes. The research that has been performed on these breast surgeries has less than four years of followup.

In many patients, autologous fat injected into the breast tissue can be reabsorbed by the body over time, causing a loss in breast volume. For this reason, plastic surgeons often over-fill or add more fat than initially needed at the time of the fat graft.

Ideal candidate for a fat transfer to breast

You are a good candidate for breast augmentation with fat if you desire a minimal to moderate increase in cup size without resorting to implants. A fat transfer procedure is also ideal for women who want a natural breast look and feel using their own tissue.

Fat transfer breast augmentation procedure

Before undergoing fat transfer breast augmentation, your plastic surgeon will consult with you to discuss your cosmetic goals. You will be shown photos from past patients to demonstrate the likely results. The medical team will obtain a detailed health history and examine you. Photos will be taken for comparison after the fat transfer breast augmentation.

Your surgeon will discuss the surgical plan for the breast augmentation with fat, including the donor sites, your desired breast size and shape, and the incisions that will be necessary for the procedure.

How long does a fat transfer to breast procedure take?

A breast augmentation with fat transfer typically takes three hours to complete. This is longer than a breast augmentation with implants because it involves several steps:

  • Harvesting of the fat from the belly, flank, thighs, calves, or arms with liposuction.
  • Processing of the fat in a centrifuge machine to remove impurities and concentrate the fat cells.
  • Injection of small amounts of fat at a time into the breast.

Recovery from fat grafting

How quickly you recover from breast fat grafting will depend on how many donor sites were required for liposuction to obtain the fat for transfer. In some patients one site is sufficient while others require multiple donor sites.

You can expect to have some minor pain, bruising, and swelling after the augmentation with fat transfer. This typically subsides in about 2-3 weeks, but some subtle swelling can linger for up to 6 months. Most patients can return to work about a week after fat transfer breast augmentation. Your surgeon will likely permit light exercise 10-14 days after the procedure. You will be advised to avoid putting pressure on the breasts, sleeping on your back, and avoid lifting heavy objects during the recovery period.

Fat grafting results

In general, breast fat grafting can achieve a maximum increase in breast size of one cup size. Breast enlargement in excess of this usually requires procedures like breast implants.

As noted, some of the fat that is injected into the breasts can be absorbed by the body over time. Surgical techniques that provide the grafted fat with a good blood supply reduce the risk of this happening. Nonetheless, there can be some volume loss in the breasts in the first few months after breast fat grafting. Whatever breast size remains after about 4 months is usually permanent.

Is fat grafting for breast augmentation right for me?

Breast fat grafting may not be right for everyone. For instance, some patients may not have enough reserves at donor sites from where the fat can be harvested. The best person to determine whether you are a good candidate for fat transfer breast augmentation is a board certified plastic surgeon, cosmetic surgeon, or other expert who has experience with this type of breast augmentation procedure.

How to find a board certified plastic surgeon for a breast procedure?

The MeTime app makes it easy to find cosmetic surgeons and plastic surgeons with expertise in breast fat grafting. You can click and upload pictures and have suggestions sent directly to you. Looking for breast fat grafting providers in your area? Try the MeTime app now!

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