What's involved with Fat Transfer to the Breasts?
Breast Augmentation with fat transfer (fat grafting) involves borrowing fat cells from other areas of the body to enhance the volume of your breasts. This option avoids the use of implants for those who want to have an all-natural way to enhance their breast volume. In some cases, patients may wish to have fat transfer done in combination with breast implants to help mask the contour of the implants. In other cases, patients may wish to pursue fat transfer to the breasts after having their implants removed.
The borrowed fat is taken out via liposuction – typically from the abdomen, flanks, or inner thighs – where there is generally good quality fat for transfer. Once removed from these areas, the fat cells are permanently gone, and only with significant weight gain would the fat deposit back into these areas. In order to maximize the “graft take” (or survival of the fat cells) in their new location in the breasts, a very careful process of centrifuging the fat is undertaken. The fat is spun down to help separate any blood cells, serum, and inflammatory cells from the actual fat. This allows the purified ‘clean’ fat cells to then be injected with small needles to the breasts without placing any scars on the breasts. There is the added bonus of being able to ‘steal’ fat from other areas of the body where there may be some excess fat which can help improve the contour through lipo-sculpting.
Dr. Sharma will sit down with you to discuss your goals for the surgery and the look you are hoping to achieve. Most patients are interested in a natural appearance to their breasts and we strive to get you the look that you deserve.
Frequently Asked Questions
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Am I a Good Candidate?
- have sufficient areas of fat on their bodies to use as ‘donor sites’
- want an all-natural way to enhance their breast volume
- are self-conscious about the size of their breasts and want to improve their shape and volume
- wish to fill out their bra or swimwear and look more proportionate
- are physically healthy to undergo surgery and have realistic expectations
- may want to correct some breast asymmetry
- may want to mitigate the loss of volume from removing their breast implants
- wish to correct a breast deformity (such as constricted or tuberous breasts)
- do not have a lot of breast ptosis (droopiness) – if this is the case, Dr. Sharma will discuss your options since sometimes the breast augmentation may need to be combined with a mastopexy (breast lift) to correct the low-lying nipple position
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How much fat can be transferred?
There are a variety of factors that go into determining this. Dr. Sharma will discuss this with you, since it is different for each individual. Some factors that play an important role in determining the amount of fat that can be safely transferred to the breasts include:
- how much ‘recipient site’ breast volume you have to start with that can ‘accept’ the transferred fat in order to provide blood supply to the new fat cells
- the thickness of your natural breast tissue
- how much fat you have in ‘donor areas’ and in which locations
- if there has been previous liposuction done in the past
- your personal measurements including the base width of your breast footprint, any asymmetries, breast ptosis, skin excess, your height/weight, and body habitus
- your goals and expectations
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What if I have had implants already?
Breast augmentation revision surgery can sometimes be more complex depending on your individual situation. Dr. Sharma has extensive experience with revision breast surgery and will assess your individual needs to come up with an ideal plan for you.
Sometimes a breast lift may be an option to help manage the excess breast skin from an implant stretching out the skin over many years. Other times, the nipple position can be in an ideal position with little excess skin and no lift is necessary. Fat transfer can sometimes be done at the same time as implant removal depending on your individual situation. Dr. Sharma will discuss all of your options with you.
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What happens on the day of surgery?
Surgery takes place in the operating room with you asleep under a general anesthetic, and can take 2-3 hours. Markings are first made before going into the OR to plan the areas of liposuction, and the areas to inject the fat on the breasts. Once you are asleep tiny 0.5cm incisions are made very carefully to suction out the fat and smoothen out any contour irregularities. The fat is then collected in a canister and centrifuged then transferred into syringes and injected in multiple planes throughout the breasts through very small needle holes, without putting any scars on the breasts. The technique is done to allow for maximum fat survival and to minimize fat necrosis. The small incisions are closed. All of the stitches are dissolving underneath the skin to give you the best possible scars. Drainage tubes are NOT required. Paper tapes and gauze dressings are applied. You are placed into a customized post-operative surgical bra and compression binder/wrap that we give you at the end of your surgery to provide support and minimize bruising/swelling. After surgery, you will be in the recovery room for a couple of hours and monitored closely. All post-operative instructions and prescriptions will be given to you before going home. You will be able to go home the same day of surgery with a responsible adult.
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What happens after surgery?
Recovery is a gradual process. You are encouraged to take it easy but still get up frequently for short walks to reduce the risk of blood clots in the legs from immobility. The first 1-2 days you may need some of the prescribed pain medications, and will be recovering from the anesthetic and medications you were given. Most patients are needing only Tylenol or Advil after that. You will be able to shower directly over the paper tapes after 2 days. Generally it is a good idea to take 1 week off work, depending on what type of work you do. At 2-3 weeks from surgery you will typically feel fully recovered. You will have to avoid heavy lifting and vigorous exercise up until about 6 weeks from surgery. The final breast shape can take up to 3 months before all residual swelling is resolved.
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Is fat transfer safe?
Several studies have proven the safety of fat transfer. It is a common technique to use in breast cancer patients who have had their breasts removed, especially after having radiation. There is no association between fat grafting and breast cancer. It also has negligible impact on breast-feeding ability.
It is important to note that there is an upper limit to how much fat can be safely transferred to each breast, and it can be different for each individual patient. Much like planting individual seeds in the soil to obtain a good crop, if the fat is not carefully ‘planted’ in multiple rows throughout the breasts in small quantities in order to be nourished with new blood supply, then survival of the ‘crop’ will be poor. Over-ambitious fat transfer can lead to fat necrosis, oil cysts, abscesses, and poor survival of the fat. In order to maximize the survival of the fat, Dr. Sharma methodically places the fat cells in order to obtain around 80% fat graft survival. Once the fat has established a blood supply it stays forever. If there is significant weight gain or loss, the fat in the breasts may also fluctuate in a similar manner. Because it is your own body’s natural tissue, there are no issues with any rejection, or concerns with a foreign substance inside you.
Dr. Sharma will be able to discuss fat transfer in more detail with you, and review all of your options to ensure that you are making a fully informed decision.
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