Regardless of your level of familiarity with plastic surgery, most of us know about the classic breast augmentation. After all, it’s one of the most commonly performed plastic surgery procedures in the United States. But if you’re someone who’s seriously considering a breast augmentation for yourself, it’s important to know that your options may reach further than the traditional breast implant solution.
Enter: fat transfer. “Fat transfer has been around for several years, and it can be used with or without implants,” explains Naples, FL, plastic surgeon Kiran Gill, MD. “It can be used by itself to shape the breasts, increase the volume, or with implants to improve the contour.”
However, that’s not all that a breast augmentation with fat transfer (also known as hybrid breast augmentation) can be used for. So, if you’re unfamiliar with this surgery option, don’t fret. Ahead, we answer all your pressing questions about enhancing your breasts with fat transfer—with or without implants.
First, how does fat transfer work?
To put it simply, fat transfer, also known as fat grafting, is a procedure where a surgeon takes fat from one part of the body through liposuction—often the thighs, hips, or lower abdomen—and transfers it to another area of the body to add volume. “An added benefit [of liposuction] is that you also get a contour improvement in a different part of the body,” says Dr. Gill.
Once the patient undergoes liposuction, their fat is washed and purified before the prepared fat cells are reinjected into the treatment area. “Washing the fat is important to get the debris and broken cells out to ensure you have high-quality fat to transfer,” explains Dr. Gill. Multiple injections of the harvested fat are strategically inserted into the breasts according to your aesthetic goals.Most commonly, those goals are to add volume, correct any size and shape differences, and improve cleavage.
What are the benefits of adding fat transfer to breast augmentation?
While many patients can achieve a wonderful appearance with implants or fat transfer alone, Dr. Gill asserts that fat transfer used in tandem with implants can significantly boost your results. “[Fat transfer] adds another level of aesthetics,” she explains. “It just adds another layer to get as natural of an appearance as we can.”
Additionally, a hybrid approach is often preferred by patients since fat transfer alone can only give you an enhancement of about one cup size, which may not meet the aesthetic goals of many people wanting a breast augmentation. By using a smaller-sized implant along with fat transfer, you’ll get both the desired projection along with a natural-looking shape.
Who is a good candidate for breast augmentation with fat transfer?
In order to be a candidate for breast augmentation with fat transfer, you must be in overall good health and not have any disease that adversely affects wound healing status. You must also have enough body fat for your surgeon to perform liposuction on. “If someone doesn’t have enough fat for fat transfer alone, we discuss hybrid breast augmentation, which combines implants and fat transfer,” says Dr. Gill.
Can fat transfer also be used for breast augmentation revision?
According to Dr. Gill, fat transfer is also a wonderful option for breast augmentation revision surgery. “Fat grafting improves the soft tissue coverage of an implant,” explains Dr. Gill. “If someone is coming for revision work and the choice is to exchange implants but there may be subtle differences in the soft tissue coverage of the breast, you can use fat to address those differences in shape and size, in addition to adjusting the type of implants we use.”
Another reason fat grafting is often used in revision work is to create a more natural appearance in women who lack breast tissue along the cleavage area of their breasts, leading to implants that look shelf-like on their chest. “You can offer fat grafting to transition the chest wall to the breast so that there’s a smooth transition along the patient’s cleavage,” Dr. Gill explains.
Finally, there are other cosmetic aspects that are often addressed with fat grafting. “Soft tissue improvement [with fat grafting] improves contour and shape,” says Dr. Gill. “In my previous breast reconstruction work, even a centimeter of fat overlying the implant makes a difference in the aesthetics of the final result.”
When is there a need for breast augmentation revision?
When it comes to breast augmentation, a revision may be needed under certain circumstances. “In general, I have patients that come in for revision if there’s a big life event,” says Dr. Gill. “If someone has had a baby and they’ve had implants in, the breasts [and implants] may change to a certain degree.”
“This is also true if a patient has had implants and goes through menopause or experiences drastic weight fluctuations, where the skin and soft tissue may stretch over time,” adds Dr. Gill. “In these cases, fat grafting may be used with a breast augmentation revision and a breast lift to get the desired aesthetic outcome.”
What are the potential risks of a fat transfer procedure?
“With any surgery, there are risks for bleeding and infection, but studies have shown that those risks are low.” Ask your plastic surgeon about possible complications related to your fat transfer procedure. Your surgeon will schedule regular follow-up visits to monitor both the area where the fat was taken from and the area to which it was transferred.
What questions should patients ask their doctor before undergoing this surgery?
Fat transfer results can be unreliable if not performed by an experienced surgeon, so it’s vital to know what to ask your surgeon during your initial consultation. First, ask about your surgeon’s experience with fat grafting and credentials, and ensure that your surgeon is board-certified. Not only will this help support optimal results, but it is also important for your safety during surgery. Results of the fat transfer procedure will vary depending upon your age, surgical site, and experience of your plastic surgeon. Results of the procedure may or may not be permanent.
Then, inquire about their fat purification process and how they prepare the fat for transfer.
Your surgeon should also review their surgical plan with you and what kind of results you can realistically expect post-procedure. Make sure you’re clear on which part of your body the fat is going to be removed from, where along your breasts it’ll be transferred to, what your recovery will be like, and how long you should take off from work before officially booking your appointment.
The bottom line
If you’re considering any breast enhancement procedure, it’s a good idea to inquire about fat transfer. When performed correctly by an experienced surgeon, results from fat grafting can be long-lasting, natural-looking, and can help improve the overall look and feel of your breast augmentation.
However, it’s important to note that fat transfer will affect the price of your surgery. “Since fat transfer increases the time of the overall procedure, it does affect the cost,” says Dr. Gill. Even with the price bump, she says, most of her patients see the benefits of fat transfer as worth it.
So, be sure to explore all your options before booking your breast augmentation procedure—you’ll be happy you did.
Dr. Gill is a paid consultant for Allergan Aesthetics.