When it comes to options for breast augmentation, many women are choosing to have fat transferred from other parts of their body to increase volume.
The procedure involves liposuction of other body areas, processing the fat, and injecting it into the tissues of the breasts. The most realistic result, according to experts we’ve interviewed, is a “modest augmentation” that increases the volume of the breasts between one-half to a full cup size.
This article takes a comprehensive look at fat transfer to breasts. We’ve gathered input from four plastic surgeons who offer their expertise about how this procedure works, how much it costs, potential side effects, and other details so you can decide if this option is right for you.
Keep in mind that this article is not intended as medical advice. Before you decide to undergo any procedure, it’s important to talk to your medical provider, first.
Most patients seek fat transfer to the breast to increase breast size and volume for cosmetic enhancement or reconstruction, according to Dr. Yuly Gorodisky, owner of the West Coast Plastic Surgery Center in Oxnard who is board-certified by the American Osteopathic Board of Surgery.
“Breast implants provide more fullness and a more predictable increase in size,” Dr. Gorodisky noted. “Fat transfer usually provides a more subtle enhancement.”
Patients who are interested in fat transfer to the breast may have a preconceived fear of silicone or implant surgery, Dr. Gorodisky further noted, “or some patients who want their implants removed due to scarring or rupture and would like to increase the breast fullness without replacing the implants.”
Both fat transfer and breast implants have their plusses and minuses, said Dr. Brent Moelleken, whose practice, Moelleken Plastic Surgery, is located in Beverly Hills, California.
He noted that breast implants involve placing a prosthetic device either in front of or behind the muscle, increasing breast size.
“Breast implants typically must be redone at some point in the future, but give reliable augmentation in a single procedure,” Dr. Moelleken explained. “Fat injection to the breasts can cause lumps which may require biopsy.”
Dr. Jaime Schwartz, owner of Schwartz Plastic Surgery in Beverly Hills, California, started doing fat transfers years ago, first as part of the normal breast reconstruction process.
“And now we use it for women who don’t want implants, but still want an increase in volume,” Dr. Schwartz said. “The difference is that a fat transfer is an actual living tissue, so the result is an increase in volume in the breasts that looks and feels completely natural.”
Dr. Schwartz added that some women prefer a more subtle enhancement. “Also not everyone is comfortable with having implants in their body,” he said.
Implants guarantee a certain size, less operating room time, only one surgical field, and fewer risks if only one area is operated on, said Dr. Maria M. LoTempio, a board-certified plastic surgeon and owner of LoTempio Plastic Surgery for Women in New York, New York.
She agreed that some people would elect fat transfer over breast implants because they do not want a foreign body inside them.
“They also do not want the maintenance of seeing a plastic surgeon and future surgeries in case of replacement,” Dr. LoTempio noted.
The results of fat transfer to the breasts are less dramatic and don’t give as much fullness as implant augmentation, Dr. LoTempio added.
“There are more possibilities of complications with fat transfer to the breasts,” she said. “The procedure costs more and takes longer than a regular implant augmentation.”
Simply put, fat is harvested from other areas of the body and injected into the breasts to increase volume.
A fat transfer entails harvesting fat from the patient via liposuction, usually, from an unwanted area like their abdomen, thighs or flanks, Dr. Schwartz said.
“The fat cells are prepared and injected into the breasts until the desired shape and size are achieved,” Dr. Schwartz explained. “What sets my practice apart is the technique that I use for liposuction; it’s a closed-loop fat harvesting and transfer system. The fat is always in a sterile contained environment, which I find gives me greater success with this procedure.”
A patient needs to undergo liposuction to harvest enough fat to place in each breast, Dr. LoTempio said.
“They just need to have enough fat to harvest,” she said.
Preparing for this procedure should not involve gaining weight ahead of time, Dr. Moelleken advised.
“The patient should be at their baseline weight,” Dr. Moelleken recommended. “If they gain weight and then lose it, the fat cells that are alive will remember where they came from and lose weight accordingly. It’s essentially programmed into their DNA.”
Dr. Schwartz agreed.
“I tell people not to gain weight prior to the procedure,” Dr. Schwartz said. “The reason being is because it’s unhealthy to gain excess weight and the other reason is that once you lose the extra weight, you will also lose that same amount of weight in the transferred fat. So, it really doesn’t do anything to help the procedure.”
Dr. Moelleken said good candidates for this procedure are those who are not candidates for breast implants – meaning patients with autoimmune diseases or patients who are fearful of implants.
At Dr. Gorodisky’s practice, the best candidates are women with some breast laxity but not too much droopiness.
“They should have enough fat to perform liposuction,” Dr. Gorodisky added. “They should have a baseline mammogram and should not be at an increased risk of breast cancer based on family history.”
According to Dr. Schwartz, a good candidate is anyone that has excess fat in areas they want to get rid of.
“It’s a great option to remove it from the unwanted areas and place the fat in the breasts,” Dr. Schwartz said.
Dr. LoTempio added that an ideal candidate is “anyone who can undergo general anesthesia and has enough fat to harvest.”
Of course, the costs associated with this procedure are a huge aspect of consideration, which we discuss next.
The cost of transferring fat to breasts can range anywhere from $5,500 to $15,000, depending on the plastic surgeon and how complicated the procedure is.
At Moelleken Plastic Surgery, for instance, the price can run between $7,500 and $15,000.
“Costs vary greatly, and may include follow up injection procedures,” Dr. Moelleken said. “It depends on how many procedures are necessary.”
At the West Coast Plastic Surgery Center, the cost of the procedure may vary from $8,000 to $10,000, and the procedure may need to be repeated if the fat is absorbed and more needs to be added.
“Other possible costs may be related to treating complications, such as removing cysts and fat nodules,” Dr. Gorodisky added.
At Schwartz Plastic Surgery, “the cost varies on the amount of liposuction needed, the amount of fat that needs to be transferred, and the length of the procedure,” Dr. Schwartz explained.
In Dr. LoTempio’s experience, the cost of the procedure may vary from $8,000 to $10,000 and the procedure may need to be repeated if the fat is absorbed and more needs to be added.
“Other possible costs may be related to treating complications, such as removing cysts and fat nodules,” Dr. LoTempio said.
Before you decide to spend money on this procedure, it’s important to understand its effectiveness and longevity. Dr. Moelleken noted this procedure is “helpful” for modest breast augmentations.
“Once the fat has stabilized, it is typically permanent,” Dr. Moelleken said. “This stabilization process may take 1 and a half years.”
The procedure is usually effective, Dr. Gorodisky said but may have some degree of unpredictability since some fat may not survive the transfer process.
“The fat that survives the transfer process is permanent but may fluctuate in size as the patient’s weight changes,” Dr. Gorodisky noted.
Dr. Schwartz pointed out that according to literature, 50% to 70% of what is transferred stays.
“I tell people what they see at six months is typically what they keep,” Dr. Schwartz said. “Fat transfers to the breasts are usually long lasting, as long as you maintain a stable weight after the procedure.”
Dr. LoTempio added that “after six months, the fat that has survived will be there for life.”
Dr. Moelleken said the downtime is about two weeks until the patient can start doing light exercise, and about four weeks until they can perform heavy exercise.
In Dr. Gorodisky’s practice, healing can take 4 to 6 weeks, and there may be residual swelling and firmness for 9 to 12 months after the procedure.
“However, most patients may resume normal activities after about two weeks,” Dr. Gorodisky said.
Dr. Schwartz normally recommends about a week off of work for his patients.
Dr. LoTempio said the downtime is a few days, “but the overall period of healing is initially 4 to 6 weeks then 3 to 6 months.”
According to Dr. Gorodisky, the pros are avoidance of implant complications and the added benefit of liposuction as part of the procedure.
“The cons are longer surgery, inability to achieve the same fullness implants provide, a possibility of fat loss and nodules, cysts, and calcifications forming in the breast,” Dr. Gorodisky noted.
In Dr. Schwartz’s experience, the pros are that a fat transfer is a less invasive way to increase the volume of your breasts in a way that looks and feels completely natural.
“The cons are that it’s not a complete substitute for a breast implant,” Dr. Schwartz said. “The amount of fat that will live after the transfer is unpredictable, and sometimes the procedure needs to be done multiple times to achieve the desired results.”
Dr. LoTempio said one of the pros of fat transfer is that the procedure is “natural,” while the cons are that it’s a more expensive, more involved surgery with potentially more risks, and may take multiple sessions to acquire the desired results.
“The pros are avoidance of implant complications and added benefit of liposuction as part of the procedure,” Dr. LoTempio added.
Infection, loss of results, lumps and unsatisfactory results are among the side effects that can occur with fat transfer to breast, Dr. Moelleken noted.
“The risks are loss and re-absorption of fat, development of fat cysts, scar tissue nodules, calcifications in the breasts or asymmetry of the breasts,” Dr. Gorodisky said.
Dr. Schwartz added that “the same risks of surgery apply to fat transfers.”
If you decide to move forward with this procedure, it’s important to find the right doctor to work with, which we cover in the next section.
Be careful and research the plusses and minuses of the procedure before proceeding, Dr. Moelleken advised.
As with any surgery, it is best to find a surgeon who does the procedure often and is straightforward about expectations, possible complications, and aftercare, Dr. Gorodisky recommended.
“Always make sure that they are board-certified and that they have an interest in performing this type of procedure and have a lot of experience with it,” Dr. Schwartz said.
Dr. LoTempio said it’s important to meet with a board-certified plastic surgeon that has experience with fat grafting.
“Ask a lot of questions and expect detailed answers,” she advised. “Don’t except ‘you will look great’ as an answer. Have a rapport with this person and feel comfortable they will take care of you if something were to happen.”
» For Further Reading: How to Find the Best Plastic Surgeon: Expert Tips & Warning Signs
Dr. Moelleken recommends that patients follow the instructions of their doctor who performed the procedure because each doctor treats the postoperative care a bit differently.
Dr. Gorodisky said that avoiding pressure on the breasts for a few weeks after surgery helps preserve the fat grafts.
“After two weeks gentle massage helps to improve swelling and soften the breasts,” Dr. Gorodisky noted. “Maintaining a stable weight should maintain the results.”
Dr. Schwartz said that as long as you maintain a stable weight, eat a healthy diet and get regular exercise, and avoid smoking, you should have good results.
Dr. LoTempio added that avoiding pressure on the breasts for a few weeks after surgery helps preserve the fat grafts.
“It’s important to follow your plastic surgeon’s recommendations,” she said.
Before you decide to undergo this procedure, Dr. Schwartz emphasized the importance of finding an experienced doctor and having realistic expectations about your results.
“I truly enjoy fat grafting breast augmentation,” Dr. Schwartz said. “In my practice, it’s become very common to remove breast implants and replace the volume with fat. Fat is very versatile and I have used it to disguise palpable implants, correct breast asymmetries, and as a standalone procedure for augmentation.”
Dr. Moelleken added that “implants still have the edge in safety and achieving a significant result in a single procedure.”
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