Breast augmentation with implants is one of the most popular plastic surgery procedures, and in most cases, it yields beautiful results. There are some situations, however, when implants alone may not fully meet your needs.
For example, patients with little overlying tissue or a wide chest wall with breasts that are spaced far apart may experience visibility of the implant or an outcome with less cleavage than originally desired. But thanks to surgical advancements in implant technology and fat transfer (also known as fat grafting), breast augmentations have come a long way from what they used to be. Now, subtle and discreet details of breast augmentations can be enhanced through fat transfer, ushering in a new age of breast aesthetics.
Utilizing fat transfer for refinement or enhancement of breast augmentation with implants has been a major game-changer in the world of plastic surgery. Often used in combination with implants, fat transfer for breast augmentation uses liposuction to remove fat tissue from a specific area of the body where you have excess fat—like the stomach or hips—and then re-inserts it into the patient’s breasts.
Contrary to popular belief, there are quite a few ways one can incorporate fat transfer into their breast augmentation surgery in order to achieve their aesthetic goals (it’s not one-size-fits-all!). Here, we tapped Charlotte, NC plastic surgeon Gaurav Bharti, MD* to answer all of our most pressing questions about the procedure.
How does fat transfer work?
As mentioned, a fat transfer procedure takes fat tissue from one area of the body and re-injects it to another area—in this case, the patient’s breasts. “The idea is to use fat to help enhance the breast by thickening the soft tissue envelope to add volume to the breast, or even to correct certain issues, whether it be reconstructive or aesthetic breast needs,” explains Dr. Bharti.
In what instances can fat transfer for breast augmentation be used?
There are a few different types of augmentations that can utilize fat transfer: Primary augmentation with implants and fat, primary augmentation with fat alone, revision augmentation with fat transfer, and implant removal with fat transfer to restore volume. Fat transfer can also be used to reshape and contour the cleavage area if you are having a breast lift or reduction.
Fat transfer techniques should be tailored to meet specific patient needs. For those looking for a larger boost and improvement in their cleavage, an implant in addition to fat transfer can provide a great result. For those that want a small increase in size but do not want an implant, augmentation with fat alone is recommended.
Some people who already have implants but want to exchange them for a new one (for example, swapping a saline implant for a silicone one or an older implant for a newer one) can use fat transfer to boost their results as well. Fat transfer can also be helpful for patients that are very thin and are experiencing rippling, wrinkling and visibility of the implant.
Who is not a good candidate for this?
Naturally, someone who does not have enough fat on their body to extract for the transfer may not be an ideal candidate for this procedure. However, it’s best to talk to your plastic surgeon so they can assess. “Sometimes people think that just because they’re a thin and skinny patient that they’re not a candidate, but the truth is that you actually might be,” says Dr. Bharti. “For that kind of patient, we just have to go to multiple areas to extract fat—not just one.”
What questions should a patient ask their plastic surgeon before undergoing fat transfer?
Before undergoing any sort of surgical procedure, it’s vital to ask your plastic surgeon everything there is to know about the surgery ahead of time. You’ll also want to discuss with your plastic surgeon how to prepare for the procedure. That way, you’ll be ready for what’s to come and your plastic surgeon will clearly understand your expectations.
“Some of the questions that patients should ask their plastic surgeon are really going to revolve around what results they are trying to achieve,” says Dr. Bharti. “If they want to have a large volume increase and rounded look, they’re not going to get that with fat transfer alone—or at least, it’s going to take multiple sessions. If they want more than a cup size increase, I probably need to look at combining implants with fat transfer.”
In addition to discussing preparation and your aesthetic goals, Dr. Bharti stresses that potential patients need to ask their plastic surgeon to explain their method of fat transfer and the fat purification process. What happens to the fat between the time it’s extracted from the body to the time it’s re-injected helps to ensure the best outcome.
Why does the purification process for fat transfer matter?
For optimal results, ask your plastic surgeon about their fat-purification process for fat transfer. Dr. Bharti explains that re-injecting unpurified fat removed by liposuction, is “like when you pluck blueberries off a bush and some of those blueberries rupture. Sometimes there are thorns and debris, and you need to clean out all the stems and broken blueberries before using them to make yourself a smoothie. If extracted fat isn’t prepared correctly, all the extra debris from ruptured fat cells and so on can cause lumps. You could get something called an oil cyst because you’re literally re-injecting oil from those fat cells that were ruptured.” Talk to your plastic surgeon to make sure they are using a washing and filtration system to help produce high-quality fat for your procedure.
What kind of results can you expect?
As with any procedure, results vary person-to-person. Your plastic surgeon will be able to guide you based on your goals and your body type if an implant alone will meet your needs or if fat transfer is also recommended. For those with little overlying tissue or breasts that are spaced far apart who desire an increase in their cup size, Dr. Bharti recommends fat transfer along with an implant to tailor your look, improve cleavage and add fullness where you want it.
Most people could expect a subtle result from a breast augmentation with fat transfer alone, says Dr. Bharti. “Half a cup size increase is where we would really position this.”
Fat transfer can also be used for those that are having a breast lift or reduction to add volume and improve the contour and shape of your breasts.
What is recovery like?
Breast augmentation with fat takes a little longer that an augmentation with implants alone and patients are allowed to return home the same day as their procedure.
Implants often will tend to start a little high and then come down over a short period of time, explains Dr. Bharti. “With fat transfer, patients can expect more bruising of the breasts and there will be an immediate swell right after. So, the day of surgery the breasts are going to be fuller than expected because of swelling, but this will subside within the first two to three weeks in my experience. It’s important to note that the fat is not disappearing when this happens, it’s just the swelling that’s going down.” Be sure to discuss the recovery process for your specific procedure with your plastic surgeon.
What other important information do patients need to be aware of?
With anything that is done from a surgical standpoint, there are always potential risks. Both the liposuction portion of this surgery and the actual fat insertion into the breasts carry separate possible side effects. Make sure that you speak to your plastic surgeon to better understand the risks and any side effects to expect post-procedure. Also, make sure that you do your research and choose a board-certified plastic surgeon for your procedure.
There are many things to think about if you’re considering a breast augmentation procedure or a redo of your current augmentation. Doing your due diligence is key—be sure to consult with your plastic surgeon to see if adding fat transfer to your procedure can enhance your look and help you better achieve your aesthetic goals.
*Dr. Bharti is a paid consultant for Allergan Aesthetics.