Fat Transfer Breast Augmentation
Breast augmentation with fat transfer allows women to subtly enhance breast size by using a natural alternative to breast implants—their own fat cells. Also known as autologous fat graft breast enlargement, fat transfer breast augmentation is a unique procedure that can achieve conservative increases in breast size by collecting fat from one part of the body and transferring it directly to the breast tissue, naturally increasing breast volume. It should be noted that only very small breast size increases can be anticipated with fat transfer.
As I approach the one-year anniversary of my breast augmentation, I continue to have nothing but the most positive feelings about my "new" self. I constantly think about how Dr. Kolker and the rest of his staff were so very helpful and caring throughout the entirety of my time with them.K.D. / New York City
Benefits of Fat Transfer Breast Augmentation
While breast augmentation with saline or silicone breast implants is a safe and effective means of breast enhancement, fat transfer breast augmentation is an alternative to be considered for very select individuals. For women who desire a small increase in breast size (approximately ¼ cup size), who may also have areas of fat excess for which liposuction treatment is being contemplated, fat transfer breast augmentation may be ideal. For those that desire a greater breast size increase, breast augmentation with breast implants is preferred. There are certainly several advantages to consider with breast enlargement using your own fat cells, which include no incisions (only needle access sites are used), shorter downtime, and no implant “maintenance” (breast implants will likely need to be replaced at some point in the future).
For patients considering breast augmentation with fat transfer, the following may be advantages:
- No breast incision – fat cells are “harvested” and then transferred to the breast through tiny needle sites
- No breast implant “downsides” – which may include leak or capsular contracture
- No need for implant “maintenance” – breast implants will likely need replacement in the future (10-20 years), whereas the results of fat transfer after graft “take” are long-lasting without the need for implant exchange
- Liposuction – as the fat cells used for autologous fat breast augmentation are “harvested” from areas of relative excess including the abdomen and thighs, liposuction is a necessity; these areas can be sculpted and contoured as part of the breast enlargement with fat procedure.
Limitations of Fat Transfer Breast Augmentation
There are some very clear disadvantages of fat transfer breast augmentation, primary among which is that one cannot anticipate more than a small volume increases with this procedure. If an individual hopes for a ¼ to ½ cup-size increase or greater, breast implant surgery is recommended. Unlike breast enlargement with breast implants, where a more predictable size increase over a wider breast size range can be anticipated, autologous fat transfer can be variable in terms of volume of graft “take”, and the only truly predictable outcome is that small increases only can be anticipated.
For patients considering breast augmentation with fat transfer, the following are limitations and disadvantages:
- For fat grafting to be truly effective, large amounts cannot be transferred as fat graft survival requires an intimate relationship of smaller amounts of fat grafts in contact with well vascularized recipient tissue.
- Small volume increases only are to be anticipated. Breast enlargement of approximately ¼ cup is common.
- Longer term breast volume increases of rarely more than 50 cc to 75 cc can be anticipated. This is less volume than the very smallest breast implants available.
- Several procedures may be required if more substantial beast size increases are desired.
- In slim women or in those who undergo multiple procedures, irregularities and deformities in the fat donor site (where liposuction is performed) may result.
- Lumps, nodules and oil cysts may occurin the breasts, which can confound mammography and routine breast cancer surveillance.
Determining Candidacy for Fat Transfer Breast Augmentation
According to data collected by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, breast augmentation with breast implants remains the most common cosmetic surgery procedure in the US, and is an effective, safe, time-tested approach to achieve beautiful results for most women. Nevertheless, breast enlargement using breast implants is a personal choice and is not for everyone. If your size goals are very conservative and you have areas of “localized adiposity”, or excess fat that remains after diet and exercise, fat transfer breast augmentation may be an alternative. Your candidacy is largely determined by your breast augmentation goals and by your particular breast and body anatomy. Dr. Kolker will help to determine the best breast augmentation options for you, and if you are indeed a candidate for breast enlargement with fat transfer.
The best fat transfer breast augmentation candidates desire an increase their breast volume by approximately one quarter of a cup size. There must also be sufficient fat elsewhere from which to harvest the fat grafts for breast augmentation. Ideally, women should have a body mass index (BMI, a reliable measure of body fat) of below 25 kg/m2, have a normal mammogram, and no personal or family history of breast disease.
The nuances of the fat grafting procedure, and how autologous fat transfer for breast augmentation impacts routine breast surveillance, must be discussed in detail with a plastic surgeon certified by the American Board of Plastic Surgery, and who has considerable experience with all forms of breast augmentation including breast enlargement with fat transfer. Dr. Kolker will ultimately determine the candidacy of each individual, and will make specific recommendations about the breast fat grafting procedure and its alternatives.
The Brava® System
The best fat transfer results are achieved when the grafted fat cells are placed in close proximity with a rich blood supply within the tissues. To promote a well vascularized “scaffold” for the acceptance of fat grafts to the breast, Dr. Kolker often uses the Brava system. Worn on the breasts for a designated time before surgery (ranging from days to weeks), the breasts are “expanded” in preparation for fat grafting. This process alone will temporarily engorge and enlarge the breasts, although without fat grafts the enlargement would be transient only. After appropriate engorgement and recruitment of blood supply with Brava, the results of fat transfer to the breasts may be more reliable and long lasting.
How Fat Transfer Breast Augmentation Works
Breast enlargement with fat transfer incorporates two procedures that are performed simultaneously—liposuction, which enables the harvest of fat cells, and the fat grafting procedure itself, wherein the harvested fat is carefully prepared and then transferred to the breasts.
During the initial consultation, Dr. Kolker will assess anatomic contour, and will discuss your desires in detail. Areas of excess fat that may include outer thighs, inner thighs, tummy, the lumbar region, and elsewhere will be evaluated, and the regions that will best contribute to fat transfer as well as improved body contour will be identified. The benefits of autologous fat grafting to the breast are therefore twofold, in that body contouring of the “donor site” is a necessity.
Fat harvest is performed using liposuction techniques through tiny needle access sites. Dr. Kolker aspirates the fat required for fat transfer to the breasts by hand, rather than with a suction aspirator, to gently remove the fat cells and to maximize fat graft “take”. The fat is prepared meticulously, and is then transferred through small needle sites to the breast. The fat transfer process requires finesse and delicate technique to carefully thread the cells into multiple planes of the breast to promote the best fat transfer breast augmentation results.
Managing Expectations with Fat Transfer Breast Augmentation
It must be reiterated that only very small increases in breast size can be anticipated with autologous fat transfer. If one’s desire is to achieve breast enlargement of approximately one half cup size or more, breast enlargement with breast implants should be considered.
Hear From Dr. Kolker's Patients
I have one word to describe Dr. Adam Kolker and his staff: amazing. I had been researching breast augmentation for years, and had even met with several doctors but never felt confident to go through with it - until I met with Dr. Kolker. I must say that before my breast augmentation consultation I was really impressed by Dr. Kolker's credentials and before and after pictures, but as soon as I got to the office, I was blown away by the warmth of the staff and the calming atmosphere. When I met Dr. Kolker, he was charming and thorough, and incredibly informative and honest. I knew immediately that this was where I was going to have my procedure.D.P. / New York City