Fat Transfer to Breasts

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Fat Transfer to the Breast is a Natural Way to RAISE YOUR CUP®

You may have heard of the natural breast augmentation, the no-implant boob job, the fat implant, the no-implant implant, the vegan breast augmentation, or simply breast fat transfer. All of these procedures Raise Your Cup® by lipofilling the breast. Silicone or saline breast implants are not placed during this procedure. Your own fat is removed from unwanted stubborn areas, such as the stomach, and injected throughout the breasts. The grafted fat provides support, fullness, and a more youthful appearance to the chest.

The Difference Between Breast Fat Transfer and Breast Implants

Fat is living tissue. Transferring your own fat to a different part of your body is also called autologous fat grafting. It can be performed on a large variety of breasts, from normal to droopy, with very satisfying results. It is placed throughout the breasts, targeting desired areas like the upper pole and cleavage. Breast fat transfer is performed safely and comfortably under minimal sedation local anesthesia. Fat transfer to the breasts requires liposuction to obtain the fat and surgical time is typically 2 – 4 hours depending on the extent of fat removed from the body. The typical recovery is described as sore and most patients return to work in a few days. Exercise resumes at two weeks. The breasts are usually increased 1/2 to 1 cup size with one session of fat transfer. Breast size may be increased beyond 1 cup but this usually requires more than one session of fat transfer.

Breast implants are inanimate objects. They provide significant size enhancement. When the breasts are droopy, a concomitant lift is recommended. Implants are typically placed under the chest muscle and in a single pocket. Successful breast implant placement requires general anesthesia. The procedure is completed in approximately two hours. There is moderate to significant discomfort for the first few days and most patients return to work in one week. Depending on the patient’s goals, the breasts are increased by one, two, or more cup sizes. Of note, fat grafting may be used during a breast implant augmentation to further optimize aesthetic outcomes in the upper pole and cleavage. The combination of fat transfer and breast implants is called composite breast augmentation.

Deciding Between Fat Implants or Silicone / Saline Implants

One should consider fat implants if fat is available, mild breast enhancement is the goal, local anesthesia is preferred, foreign body implantation is unacceptable, or breast scars are unendurable. Silicone/saline implants are the treatment of choice if significant size enhancement is the goal and the amount of donor fat is very limited.

Fat is Obtained Using PRECISION SCULPT®

PRECISION SCULPT® is our exclusive liposculpting procedure. The fat is carefully withdrawn using gentle powered blunt tip cannulas under low harvest pressure. The procedure is performed in our private office under local anesthesia. Optimal sites for fat harvesting are the abdomen, flanks, love handles, waist, arms, thighs, and knees. Chin, neck, and buffalo hump fat do not provide sufficient quality or volume for fat transfer procedures. Although laser and radiofrequency devices are commonly utilized, the energy is delivered after the fat has been removed.

Fat is Gently Prepared for Transfer

Once the fat is withdrawn using PRECISION SCULPT® it is prepared for transfer to the breasts. Tumescent fluid and debris are eliminated using a specialized filter. The remaining concentrated adipocytes are cleaned with a sterile balanced solution. This process results in viable fat and adipose-derived stem cells which enhance graft take. The purified fat is handled with care as it is assembled into small syringes.

Fat is Transferred to the Breast

The breasts are sterilized with cleaning solution and completely numbed. Two small hidden skin openings are created; one at the edge of the areola and the other within the fold under the breast. Small parcels of fat are slowly injected under low pressure. To enhance projection, fat is transferred throughout the footprint (base) of the breasts using the breast fold incision. The cleavage, upper breast, lower breast, and side boob are enriched using the openings in the edge of the areola and breast fold. The placement of fat is handcrafted with careful attention to the enhancement of volume and shape as well as correcting contour deformities. Because the incisions are tiny, there are no sutures required.

Recovery From Fat Transfer to the Breasts

At the completion of the procedure the patient is dressed in a specialized outfit. Soft foam pads are placed over the liposuction areas and a compression garment is applied. The newly augmented breasts are dressed in a gentle surgical support bra. The patient recovers in the comforts of their own home. The initial post surgical garments are worn for two full days. After approximately 48 hours, all the garments are removed at home and the patient showers. The garments are replaced immediately after the shower and worn all the time for a minimum of two weeks. Wearing the compression and support garments for four or more weeks may maximize the results. Patients are encouraged to avoid pressure on the breasts and therefore are encouraged to sleep on the back for two to four weeks. The pain is typically described as “sore.” Although a short regime of prescription pain medication is prescribed, the discomfort is easily managed with anti-inflammatory medications such as ibuprofen or motrin. Basic activity is encouraged for the first two weeks. Low impact exercise is allowed after two weeks. Full unrestricted gym activity is permitted at four weeks.

Outcome From Fat Transfer to the Breasts

During the first couple weeks, the breasts are very full. The volume is a combination of the new fat and swelling. Patients frequently undergo hyperbaric oxygen therapy during this time to improve fat survival. Over the next four to six weeks the breasts will settle down to a stable enhancement. Although results vary and retention may be above average, the usual fat retention is about 50%. The results are permanent and the outcome is soft and natural.

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Frequently Asked Questions and Answers About Fat Transfer to the Breasts

In the case that a patient has no significant donor fat, then augmentation with an implant should be considered.

Yes, once the patient has completely healed, the retained fat is permanent.

There is no evidence that fat transfer increases the risk for breast cancer. The American Society of Plastic Surgeons fully endorses fat transfer to the breast as an alternative to breast implants.

Preoperative imaging is requested if the patient is due for a normal screening due to age or medical history. Most patients under the age of 40 do not require a preoperative mammogram.

Because we perform breast fat transfer under local anesthesia with minimal sedation, there is no need for preoperative blood work.

Any unusual or concerning breast findings should be addressed with your surgeon immediately. If there are no significant new findings, we recommend waiting at least six months before breast imaging after the fat transfer.

Fat is transferred in small aliquots and layered so that the end result is a smooth enhancement. In the early healing phase, isolated firm areas may be felt but eventually soften and blend with the surrounding tissue. If a lump is still felt after complete healing, it is usually scar tissue or an isolated cyst. An ultrasound will help define the fullness.

All surgeries come with risks but if performed safely and gently, risks are significantly minimized. Fat necrosis may happen and this usually presents with an area of faint redness on the skin. The body usually absorbs the devitalized fat and no action needs to be taken. On a rare occasion, the fat may form a cyst and either completely drain from the skin or require a small incision to evacuate the fluid. This infrequent complication is easily minimized and managed by closely following post-surgical instructions, attending post-operative appointments, and quickly communicating any unusual findings with your surgeon.

The average fat retention is about 50% and this is permanent. Younger healthy patients may exhibit a higher fat survival compared to older patients. Fat that is obtained from areas that have undergone previous liposuction may exhibit a lower retention rate.

With our Raise Your Cup® procedure, only two minuscule skin openings are required to fully augment the breasts with fat. One incision is hidden in the fold under the breast and the other at the junction of the areola and normal skin of the breast.

Breast feeding should not be limited secondary to fat transfer to the breasts. Fat is not transferred into the breast gland and therefore the function of the breast should not be altered. The incisions are tiny and very superficial and should not interfere with the ducts (milk channels). The answer also depends on the ability to breast feed even without any breast procedures. If the patient has never breast fed an infant, this ability is usually not known at the time of the procedure.

We never recommend weight gain before any procedure, especially a procedure that involves body contouring. Gaining weight does not lead to more fat cells. Gaining weight only increases the size of the fat cell and stretches out the cells. Gaining weight does not lead to more fat cells being transferred. The extra body weight deteriorates the soft tissue and can be disappointing for the patient longterm. The recommendation is not to gain weight. Gaining weight does not increase the number of fat cells. Gaining weight increases the size of the native fat cells. Not only does weight gain stretch out your skin, it stretches out the fat cells. The more you’re in shape, the better the outcome.

Depending on the responsiveness of your fat, the transferred fat may decrease in size with weight loss but that does not mean that fat cells are lost. There will always be more fatty tissue in the breast then there was before the procedure.

The transferred fat cells can take on more fat with weight gain. Gaining weight after the procedure typically leads to larger breasts.

The preferred resting and sleeping position is only on the back. This position removes intense sheer forces and intense compression to the initially fragile transferred fat cells. Any significant pressure on the breasts is detrimental to the fat cell survivor during the early healing phase. There are no restrictions in positioning after four weeks of healing.

Minimizing breast trauma is always recommended during the first four weeks of healing, therefore, soft support bras without wires are recommending during this time.

Although we have had patients successfully spray tan without problems one to two weeks after their procedure, this is not recommended. Due to the wide variety of skin sensitivity in the general population, the safest answer is three months.

Breast fat transfer is performed using PRECISION SCULPT® and Raise Your Cup®, both performed without the need for general anesthesia. This allows the patient to travel within two days of the procedure. It’s not unusual for patients to vacation within four weeks of their procedure.

Although we encourage early massage of the lipo areas, we do not recommend massage of the breasts for the first four weeks. Massage may disrupt and injury the newly transferred fat tissue.

Although fat retention may be higher in younger patients, fat transfer to the breasts is good for all age groups. There is no age limit for fat transfer to the breasts. We have successfully treated patients aged 18 to 78 years old.

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