Want to Make Your Breasts Bigger Without Implants? Here’s Why You Should Consider Fat Transfer

Over the last five years, women have been increasingly opting for minimal, more natural-looking breast augmentation results. While there are many low-profile implant options available, fat transfer has emerged as another safe and effective augmentation method for women looking to modestly increase their cup size and/or enhance the shape of their breasts. Read on to learn why you may want to consider a fat transfer breast augmentation.

• What is fat transfer?
• Why fat transfer for breast augmentation?
• How is fat transfer to the breasts performed?
• What are the benefits of fat transfer to the breasts?
• What are the downsides of fat transfer to the breast?
• Is fat transfer to the breasts safe?
• Are you a good candidate for fat transfer to the breasts?

What is fat transfer?

Put in layman’s terms, a fat transfer (also called autologous fat grafting or lipoinjection) is a procedure in which a surgeon harvests fat from one area of your body (hips, thighs, or abdomen) and transfers it to another (breasts, buttocks, or face). Fat transfer uses your own fat as a volumizing agent and requires only a few small, well-concealed incisions.

Why fat transfer for breast augmentation?

Chances are you’ve heard of the most popular fat transfer procedure, Brazilian butt lift surgery; but the breasts are also a common area for surgeons to augment with fat. Fat transfer to the breasts is a procedure with many names but is most commonly referred to as a fat transfer breast augmentation. Surgeons use fat to augment the breasts for a number of reasons, including:

• To provide a more natural breast augmentation result than implants can offer.
• To improve the appearance of implant rippling or other contour deformities.
• To correct mild asymmetry or slight unevenness in the breasts.

• To give surgeons more control over shaping the breasts.

How is fat transfer to the breasts performed?

A fat transfer breast augmentation is a multi-step procedure:

Step 1: Your surgeon will harvest fat from areas of the body that contain a little extra cushion such as the belly, flanks, hips, or thighs using liposuction.

Step 2: Your surgeon will separate the fat using a gravity-filtration system or a centrifuge while preserving the stromal vascular fraction (which contains adipose-derived stem cells) necessary for excellent results.

Step 3: Your surgeon will make tiny incisions in your axilla, and sometimes around the perimeter of your breast, and or areola.

Step 4: Your surgeon will use a small-gauge cannula to inject fat throughout the breast in a precise, layered manner.

Though fat transfer to the breasts may seem like a straightforward procedure, the approach your surgeon takes to injecting fat is key for optimal results.

After your procedure, your surgeon will have you wear a compression garment for six weeks following your procedure to support your body’s cells, including your fat cells and adipose-derived stem cells (fat cells that may play a role in regenerating tissues and organs).

Though fat transfer to the breasts may seem like a straightforward procedure, the approach your surgeon takes to injecting fat is key for optimal results. Since your results depend largely on your transferred fat maturing, or “taking,” there are a few key techniques a qualified surgeon may use:

• Using an internal and/or external tissue expander. Before your fat transfer breast augmentation, your surgeon may recommend you wear a bra-like external tissue expander called a Brava device for several weeks before and after your procedure. The Brava device places suction on the breasts to help expand the tissue to create more compliant skin to accommodate the graft. Rapid negative pressure techniques can be used as well as carbon dioxide insufflation.
• Injecting fat at different depths. An experienced surgeon will inject fat beneath the skin and in the breast tissue & breast fat, as fat maturation depends on good support cells. Thus, they will weave the fat throughout the breast tissue evenly to ensure support for the transferred fat and stroma.
• Injecting fat in smaller amounts. Injecting fat in smaller amounts allows it to be better supported by the breast tissue, enhancing the breast’s overall stability. (An inadequately trained surgeon may inject most or all of the fat in a large mass, which will degrade to a lipid oil or cyst and create a less desirable breast shape and texture.)
• Strategically overfilling the breasts. Modern data suggests most of the grafted fat dies soon after a fat transfer. It is truly the cellular cascade of events, triggered by this cell death, that leads to the development of stem cells into mature fat cells that will carry lipid volume, and thus increase in size. Trusting the experience of a cosmetic surgeon trained in fat transfer will enhance your fat’s survival rate and allow for the maximum amount of volume to be transferred to your breasts.
• Scheduling multiple sessions. Because the success of a fat graft increases when injected incrementally and in smaller volumes, you may have to undergo multiple fat grafting sessions to achieve your desired results. Most patients are pleased with single-stage grafting, though further stages are best evaluated at a year, as this is when the graft will reach full maturity. The worst time to evaluate fat transfer results is at 4 months after your procedure when the graft is the smallest.

What are the benefits of fat transfer to the breasts?

Fat transfer to the breasts can provide a number of benefits:

• Substantially improve the shape of the breast.
• Modestly increase the overall size of the breast while retaining a natural, implant-free feel and look.
• Increase upper pole fullness (volume loss is most common in the upper part of the breast due to breastfeeding, implant removal, or weight loss).
• Round out the edges of the breast.
• Provides natural stem cells to help rejuvenate the skin and tissue of those with radiation damage and help the reconstructed breast heal.
• Creates a visible size increase with less visible scarring than implant-based augmentation.
• Reduce fat in other areas of the body, such as the hips, thighs, or abdomen.

Fat transfer to the breasts can also be used to enhance implant-based augmentation: adding fat to specific areas around the implant allows the surgeon to refine the procedure and create exceptionally natural-looking results.

What are the downsides of fat transfer to the breast?

Fat transfer breast augmentation is a wonderful option for patients who want to increase a cup size (or possibly two), are having breast reconstruction surgery, or want a breast augmentation without having a foreign object placed in their body. However, it’s important to note that this procedure has some potential downsides that should be thoroughly considered:

• A fat transfer can’t provide the same amount of structure, rounding, or projection to the breast as an implant.
• A breast lift is required to address breast sagging and downward-facing nipples.
• A fat transfer requires surgery in two different areas of your body: your harvest site and your breasts. Though these surgeries are minimally invasive and can be performed together, you’ll still have post-procedure soreness in two areas of your body.
• Unlike implants, the volume you’ll gain from fat transfer won’t be exact. Your surgeon can give you an expected range, but ultimately the results will vary depending on your fat’s survival rate.
• Patients who have undergone radiation may have a lower fat survival rate, as circulation in their breasts is likely reduced.
• You may experience slight breast asymmetry and need corrective touch-ups if the fat takes better in one breast than the other.
• Fat cells that don’t survive can cause non-harmful calcifications and oil cysts to form in the breast, which may be mistaken for cancerous cysts and interfere with mammograms. As such, it’s key to share your procedure history with all of your providers.
• While you’ll definitely lose fat in your harvest site, fat transfer doesn’t provide the same body contouring results as a full liposuction procedure. (If you have more significant shaping goals, added liposuction can usually be performed during the same operation.)
• Since the fat cells in your breasts are the same as the fat cells in the rest of your body, your breast size can fluctuate with your weight.

Is fat transfer to the breasts safe?

Fat transfer’s safety and efficacy have improved tremendously since the technique was first developed in the late 19th century. In 1987, the American Society of Plastic Surgeons placed a moratorium on fat transfer to the breasts out of concern that it could increase the risk of breast cancer. At the time, medical professionals were concerned that the calcifications and oil cysts caused by fat cell death (clinically referred to as fat necrosis) were potentially cancerous; however, they later determined that this was rarely the case, and 20 years later, the organization reversed its stance, stating that the procedure can be very effective and poses minimal risks.

Fat transfer breast augmentation is a wonderful option for patients who want to increase a cup size or two.

An Annals of Surgical Oncology study finds no risk of cancer

A 2018 study published in the Annals of Surgical Oncology examined 171 breast cancer patients who underwent breast reconstruction with fat transfer. Out of the group, 10.5% of patients developed fat necrosis and subsequent cysts after their fat transfer, and underwent MRIs to rule out cancer. None of the 171 patients experienced a breast cancer recurrence.

Are you a good candidate for fat transfer to the breasts?

Women who want a minimal breast size increase and natural-feeling results are often good candidates for fat transfer breast augmentation. You must also be a non-smoker (smoking inhibits blood flow, which is essential for fat survival). Other good candidates for the procedure include those who:

• Want added volume without placing breast implants in the body.
• Have had breast implants removed and want to enhance their breast shape via other means.
• Have lost breast volume due to weight loss or breastfeeding.
• Are at a stable weight. (Weight loss can reduce volume in the breasts.)
• Have extra fat available, typically in the hips, thighs, or abdomen.
• Don’t have fibrous breasts. (Dense breast tissue can make it difficult for a surgeon to inject fat properly and may affect fat’s ability to survive.)
• Are open to first having a breast lift to correct sagging. (Fat transfer alone can’t address breast sagging, but it can increase volume and shape following a breast lift procedure.)
• Have visible implant rippling (a complication of breast implants) and need to hide your implant edges.

Will I have enough fat for a fat transfer breast augmentation?

The answer to this question is almost always yes. Even if you’re 100 pounds and a 32 AA cup size, you most likely have enough fat to increase to a full B cup, or possibly even a small C cup.

Choose Dr. Sobel for your Seattle fat transfer breast augmentation

Fat transfer is a very nuanced procedure and should be performed by an experienced, board certified cosmetic surgeon to help ensure optimal results. Dr. Alexander Sobel is certified by the American Board of Cosmetic Surgery and has participated in fat transfer safety discussions in the American Journal of Cosmetic Surgery. Dr. Sobel has been helping Seattle patients naturally increase volume in their breasts, buttocks, and face with fat for decades. Schedule your fat transfer consultation with Dr. Sobel online, or call us at (425) 453-9060.