For three decades, fat-grafting procedures, which are also referred to as lipoaugmentation, have been evolving into what they are today, essential tools for aesthetic and reconstructive surgeons. For years, breast fat transfers have been a good solution for patients who want to conservatively increase the size and enhance the contours of their breasts. Now, this innovative procedure is being used to provide patients with breasts that are up to a cup size larger than their current size, to improve the results attained through breast reconstruction and for patients who need revision reconstruction. These advancements in the use of the breast fat transfer for reconstruction and revision reconstruction are quickly becoming more commonplace.

What is a Breast Fat Transfer?

During a breast fat transfer, the surgeon uses liposuction to harvest fat from other areas of the body. The areas where the surgeon chooses to harvest the fat from are usually those that are resistant to diet and exercise (e.g., the love handles, abdomen, thighs, etc.). The surgeon harvests fat from the selected sites via liposuction and then strategically injects the fat cells into the breasts.

While injecting the fat, the surgeon uses a specific technique that involves placing the fat cells throughout the breasts in fine strips that are less than a millimeter in width. By using this technique, there are very small hidden scars.

What Are the Benefits of a Breast Fat Transfer?

Besides fat reduction and contouring in the areas where the fat is harvested, there are a number of other benefits associated with a breast fat transfer.

Benefits of a breast fat transfer include:

• A shorter recovery time — when compared to a traditional breast augmentation procedure.
• The surgeon can provide higher levels of customization while reshaping the patient’s breasts with a breast fat transfer than he or she can with implants.
• The patient’s own tissue is used, which eliminates the risks associated with placing foreign objects into the body (i.e., breast implant).
• There are no incisions created on the visible portions of the breast; therefore, residual scarring is minimal.
• Many patients state their breast fat transfer reconstructed breasts feel soft. In addition, their breasts have some sensation — sensations that are similar to what their other unreconstructed breast feels.
• Fat is harvested from areas of the body where the patient wants to lose weight.

Who is a Good Candidate for Breast Fat Transfer?

It is not uncommon for the breasts to lose their volume after pregnancy, following weight loss or due to aging. Breast fat grafting is the natural alternative for those who want to address their volume loss with plastic surgery, but do not want to have breast implants placed. When a breast fat transfer is used to increase the size of the breasts, patients enjoy a natural-looking result.

A good candidate is:

• Physically healthy with realistic expectations.
• Not currently breastfeeding or pregnant.
• Fully developed.
• Unhappy about the smaller size of her breasts.
• Someone who has a breast or breasts that did not develop properly.
• A woman whose upper portions of breast look empty or deflated.
• Unhappy with her breasts because they are elongated, shapeless and/or empty looking.
• A woman who has breasts that look lopsided.

A woman who wants to increase her breasts several cup sizes may need to consider breast implants instead.

Preparing for a Breast Fat Transfer

Autologous fat transfer (AFT) may involve preparing the breasts using External Expanders in select cases. Once the breasts have expanded, the augmentation procedure can be scheduled.

Prepare an at-home recovery area. Remember to place things that will be needed within easy reach. These items include facial tissues, water, remote controls, telephones, a trash can, medications and anything else that may be necessary.

The patient needs to have someone to drive her home after her procedure because she will not be able to drive because she was sedated. In addition, someone must stay with her for at least 24 hours, but preferably 48 hours to help her.

When showering, the patient should use antibacterial soap.

The Procedure

1. Anesthesia is Administered

The patient is put to sleep using either general anesthesia or local anesthesia with intravenous sedation. The surgeon discusses which type of anesthesia he or she believes will suit the patient best prior to the procedure.

2. Creating the Incision(s) for Liposuction

Very short, inconspicuous incisions are created.

3. Infusing the Tumescent Fluid

Tumescent fluid consisting of lidocaine and epinephrine is infused into the sites where the surgeon will be harvesting the fat. This liquid is an anesthetic, it also reduces the incidence of bleeding and trauma.

4. The Fat is Harvested

Using a hollow, thin tube, that is referred to as a cannula, the plastic surgeon loosens the fat to be harvested. With the tube, the surgeon carefully moves back and forth beneath the skin. Once the fat is dislodged, the plastic surgeon removes it from the body using either a surgical vacuum, or syringe that is attached to the cannula.

5. Preparing the Harvested Fat

Once the fat has been harvested, it sits until the fluid separates from the fat. The fluid is the extra tumescent fluid that the patient’s body did not absorb.

6. Injecting the Fat

After removing the fat from the fluid, the surgeon will use his or her skills to strategically inject the fat into the breast to create the shapely, voluminous breasts that the patient desires.

Recovering from a Breast Fat Transfer

After the breast fat transfer, patients may have inflammation, bruising and/or tenderness; however, these symptoms are typically well managed using medication. The breasts may appear somewhat larger than the size intended, as time passes, this issue will resolve. This larger size is temporary and is caused by the inflammation that occurs following breast fat transfers.

Most patients return to work within 10 days of their breast fat transfer; however, to ensure the patient heals properly, sports, heavy lifting or any other strenuous activities should be avoided for several weeks.

Results: What to Expect After a Breast Fat Transfer

The results achieved with a breast fat transfer are long-lasting and often permanent. Since the procedure requires the use of one’s own body tissue, the breasts will absorb some of the fat cells that were transferred within the first six weeks after surgery. The remaining fat survives; however, if the patient’s weight changes following the procedure, the breast size may be affected as well. Sometimes a patient must have multiple breast fat transfer procedures to attain the look she desires.