Breast Procedures » Fat Transfer for Breast Enlargement

Fat Transfer for Breast Augmentation:  Does it really work?  Yes!

In May of 2011 I decided to add fat transfer to the breast to my practice after attending the annual meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) in Boston.  I attended every presentation of fat transfer to the breast and came away mildly enthusiastic about this procedure.  Now some years later I am very enthusiastic about this procedure.

Quick Facts:

  • Costs :  $8500 – $13,000 depending on how many areas are used for fat harvest and how long the procedure takes.  This includes surgeon’s fee, facility fee, special fat filtering equipment, postoperative bra and Cosmetassure.  These prices are current as of January 2017 and are subject to change.  If you have sticker shock reading this, remember that you are also getting liposuction of your fatty areas.  Oh, and there are almost no scars and you don’t ever have to have an implant revision because there is no implant!  That price is sounding better, huh?
  • How much it hurts:  Not much.  Both the donor areas and the breasts ache for several days. 
  • How big can I go?:  Plan on one cup size.   If you are willing to have two sessions, I can likely get you a 2 cup size increase.
  • Will I need Brava?:  If you have not had children and/or your breasts are tight, you may benefit from Brava for 4 weeks before surgery.  If you have had children or weight loss and have loose breasts, you likely do not need Brava. Effective use of Brava requires that you put most of your life on hold for 4 weeks. The vast majority of my patients have not used Brava and have been very pleased with their results.  
  • Time off work or school:  Usually about a week.
  • Time until driving again:  5 – 7 days or until you are off your narcotic pain meds.
  • Time in post-operative bra and support garments:  Usually 3 weeks. 
  • Time off the gym:  Usually 4 weeks.
  • Time off the slopes:  ditto.
  • Time off the kite board:  Usually 6 weeks.
  • How long it “lasts”:  This remains to be determined.  I have 3 year follow-ups with good retention of the added fat.  I have one patient requesting another session to get an additional cup size increase.
  • Patient satisfaction:  So far, it’s very high.

A few before and afters are worth a thousand words.  Take a look at my gallery for fat transfer to the breast photos. 

Check out these blogs about fat transfer to the breast for tons of info.

And here’s the fine print:

For many years the idea and practice of injecting fat into the breast was frowned upon as being an ineffective and sometimes dangerous procedure. The issue was that the fat did not survive and underwent a process called fat necrosis that would leave painful lumps of calcified scar tissue in the breast that would then interfere with mammograms. The method used was harvesting the fat using the same technique and equipment used for liposuction and then injecting large blobs of fat into the breast.  The large blog of fat would not be able to secure a nourishing blood supply before dying so fat necrosis would ensue.

Well, that was then and this is now and now we know that the technique of both harvest and injection determines whether or not the fat has a chance to survive in its new location.  I have been doing fat transfer to the face and body and areas around the breast for over 10 years with good results.   I use the meticulous technique that I learned from Dr. Sydney Coleman, the fat transfer guru.    Now we know that fat transferred to the breast using this meticulous technique is both safe and effective. The fat, which is deposited in hundreds of tiny parcels has a good chance of surviving and the chance for fat necrosis is also much smaller. Also, mammograms and the radiologist who read them have gotten much better at distinguishing calcification associated with cancer from calcification that are seen with benign conditions. In fact, other breast procedures such as a breast reduction or a breast lift cause more mammogram changes that fat injection does.

There are some disadvantages to fat transfer to the breast. The first is that many women requesting augmentation are slender and don’t have much in the way of donor areas for the fat.  (I’ve had a few patients put on 10 pounds or more so they would have something to harvest!)  The second is that a large augmentation cannot be done. Fat transfer may increase the breast by one cup size, say an A cup to B cup but taking a AA to a C is not possible.

Fat transfer is a nice way of filling out the upper pole of the breast.  This is the area that atrophies with weight loss and/or breast feeding.  Most ladies with this problem have loose skin and breast tissue and are good candidates for some filling in of these areas with fat transfer.   The loose tissue allows injection of a fair amount of fat.  Fat transfer can also shape the breast in ways an implant cannot.

Fat transfer is  time intensive procedure. My average operating time for breast augmentation is about 1-1/2 hours. Operating time for fat transfer is much longer.  Sometimes up to 4  hours or longer!    The reason it takes soooooo long is that the fat is harvested using low suction as opposed to the high suction used for typical liposuction.   And sometimes I have to suction a lot of different areas to get enough fat, especially on a slender patient.  After the fat is harvested, it is filtered to remove fluid and liquid fat and is then loaded into  syringes. Then the syringes and  specialized injection cannulas are used to inject little small parcel of fat into the breast. The smaller the parcel, the better chance of survival.  This is a lot of futzing around and it is necessary futzing if the fat is expected to survive. I am lucky in that patience is one of my few virtues. I can spend all day futzing around to do it just right as long as it’s going to work.  This is not a procedure that should be done by a surgeon who is always watching the clock and has the need for speed.  Check out this blog for why it takes sooooo long.

And last but not least, fat transfer is just not as predictable as augmentation with an implant. I know a 300 cc implant is going to result in a 300 cc larger breast.   But even in the best hands, fat transfer may not always result in as much of a size increase as the patient (or me) had hoped for.

I am pleased to offer this exciting new procedure but limit the procedure to those who can tolerate some unpredictability, desire only a little enhancement, and have enough fat to harvest.

And now for the upside:  fat injection can result in a nicely enhanced breast without the expense and upkeep of a breast implant ………. and it’s all natural!   And fat transfer allows me to place the fat where it is needed and build up the breast mound gradually.   Oh, and one more thing:  those saddle bags and muffin tops?  Gone!

To schedule a consultation with me, please call 206 467-1101.

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As of December, 2106,  I have done fat transfer for breast augmentation on 60+ patients (that’s 120+ breasts!) and thus far have had favorable results, high patient satisfaction and no complications.   Three of those patients have go onto having breast implants.  Careful patient selection is very important.    I am currently very enthusiatic about this procedure but acknowledge that it’s not for everyone.